Presentation
A 27-year-old woman presents with sudden severe right lower quadrant pain that began 1 hour ago, followed by a brief syncopal episode. Her last menstrual period was 7 weeks ago, and she reports light vaginal spotting. She has a history of chlamydial pelvic inflammatory disease and uses no contraception.
Initial observations
- T 37.0°C
- HR 122
- BP 88/54
- RR 20
- SpO2 99% on room air
diffuse abdominal tenderness with rebound
What is the most appropriate initial diagnostic test?