28th June 2023

An 18-year-old female presents to the Emergency Department with lower abdominal pain.

An 18-year-old female presents to the Emergency Department with lower abdominal pain. Blood tests requested by the surgeons have shown a slightly raised CRP but normal white cell count. The surgical registrar apologises but he is stuck in theatre with a complex case. He reports that the ED team feel her abdomen is soft but very tender in the right iliac fossa. He feels an appendicitis is unlikely, although he will review when able, and is asking the medical team for an opinion. The 18-year-old has a past medical history of anorexia nervosa and reports never having menstruated, although she does report some intermittent spotting over the previous few weeks. Which additional test should be performed before further review?

Select the SINGLE most appropriate option from the list below. Select ONE option only.