Sudden Severe Right Iliac in Obstetrics & Gynecology — 28yo Woman | General Gynecology | SMLE Q#416

SMLE Question #416

Obstetrics & Gynecology General Gynecology
Last updated: February 2026
A 28-year-old woman presents with sudden severe right iliac fossa pain for 4 hours and lightheadedness. Her last menstrual period was 6 weeks ago with mild spotting for several days. She is sexually active without contraception. She is pale and diaphoretic. Abdominal exam shows right iliac fossa tenderness with guarding. Pelvic exam shows cervical motion tenderness and a slightly enlarged, tender right adnexal mass. What is the most likely diagnosis?

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