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A 28-year-old G0 woman whose last normal menstrual period was four weeks ago presents with a two-day history of spotting. She awoke this morning with left lower quadrant pain of intensity 4/10. She has no urinary complaints, no nausea or vomiting, and the remainder of the review of systems is negative. She has no history of sexually transmitted infections. She smokes one pack of cigarettes per day and denies alcohol or drug use. Her vital signs are: blood pressure 124/68, pulse 76, respirations 18, and temperature 100.2° F (37.9°C). On examination, she has mild left lower quadrant tenderness, with no rebound or guarding. Pelvic exam is normal except for mild tenderness on the left side. Quantitative Beta-hCG is 400 mIU/ml; progesterone 5 ng/ml; hematocrit 34

User Seliopou
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Final answer:

The most likely explanation for the woman's symptoms is ectopic pregnancy.

Step-by-step explanation:

The most likely explanation for the 28-year-old woman's symptoms is a condition called ectopic pregnancy. Ectopic pregnancy occurs when a fertilized egg implants and grows outside the uterus, typically in the fallopian tube. This can cause abdominal pain, spotting, and an elevated beta-hCG level. The mild left lower quadrant tenderness and positive pelvic exam findings further support this diagnosis.

User KpTheConstructor
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