1 Day Of Light in Obstetrics & Gynecology — 40yo Woman | General Gynecology | SMLE Q#1530

SMLE Question #1530

Obstetrics & Gynecology General Gynecology

Objective: OBJ-ETH-STERIL

Last updated: February 2026
A 40-year-old woman (G4P4) had tubal ligation 4 years ago. She presents with 1 day of light vaginal spotting and 6 weeks of amenorrhoea. Speculum examination shows a closed cervical os. Bimanual examination reveals right adnexal tenderness and a palpable fullness. She reports no syncope or shoulder pain. What is the best initial investigation?

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