Florida State Paramedic Practice Exam

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Which condition is indicated by right lower quadrant pain radiating to the right shoulder in a 22-year-old female?

Ovarian cyst
Appendicitis
Ectopic pregnancy
Uterine fibroids

The correct answer is: Ectopic pregnancy

The presentation of right lower quadrant pain that radiates to the right shoulder in a 22-year-old female is indicative of referred pain associated with ectopic pregnancy. This type of pain can occur due to irritation of the diaphragm, which is innervated by the same nerve roots as the shoulder (C3-C5). In the case of an ectopic pregnancy, particularly if it causes internal bleeding or the rupture of the fallopian tube, the resultant irritation can lead to shoulder pain. Additionally, ectopic pregnancy often presents with lower abdominal pain, which could begin in the right lower quadrant, especially if the ectopic site is on the right side. The combination of these symptoms is characteristic of this condition and aligns with the acute, potentially life-threatening nature of an ectopic pregnancy, necessitating immediate medical attention.