医師国家試験 第112回 問107

救急外来に日本語を話せない40歳の外国人女性が来院した。病院に勤務してい る外国人医師が英語で医療面接と身体診察とを行い、記載した診療録の一部を示 す。 Presenting complaint: Severe lower abdominal pain. History of presenting complaint: Sudden onset of right lower abdominal pain 6 hours ago. Pain has been gradually worsening. Slight nausea but no vomiting or diarrhea. Last menstruation was 9 weeks ago. She noticed vaginal spotting* 3 days ago. Past medical and social history: Appendectomy at 18. Married. Examination: Temperature 36.3°C. Right lower abdominal tenderness without rebound tenderness. Bowel sounds are reduced. * vaginalspotting;少量の性器出血= 可能性の高い疾患はどれか。