Emergency Medical Technician (EMT) Intermediate Practice Exam

A 19-year-old female presents with severe pain to the left lower quadrant of her abdomen. She is restless, tachypneic, and tachycardic. When you inquire about her last menstrual period, she tells you that it was approximately 2 months ago. You should suspect:

1. appendicitis

2. ovarian torsion

3. a ruptured ectopic pregnancy

4. pelvic inflammatory disease

The correct answer is: a ruptured ectopic pregnancy

In this scenario, the symptoms and history presented align with a ruptured ectopic pregnancy. The key elements to consider are the patient's age, the specific location of her abdominal pain, and her last menstrual period, which indicates potential irregularities in her menstrual cycle. Severe pain in the left lower quadrant, especially in a young female with a delayed menstrual period, raises concern for a possible pregnancy-related issue. The tachypnea and tachycardia suggest she might be experiencing some form of shock, likely due to internal bleeding, which can occur if an ectopic pregnancy ruptures. This type of injury can lead to significant blood vessel damage, resulting in symptoms of instability. While other conditions such as appendicitis, ovarian torsion, and pelvic inflammatory disease might also present with lower abdominal pain and could be possibilities in a differential diagnosis, the combination of the patient's age, the specific description of the pain, the significant risk factors associated with ectopic pregnancies in young females, and the absence of signs typically associated with those other conditions make a ruptured ectopic pregnancy the most likely diagnosis in this case.