For a sexually active 16-year-old girl with lower abdominal cramps, what should be the next step?

• A. Pelvic examination
• B. Urinalysis
• C. Rectal examination
• D. Pregnancy test

Answer: (A)

In the case of a sexually active 16-year-old girl presenting with lower abdominal cramps, the next step should involve performing a pelvic examination. This approach is critical because it allows for a thorough assessment of possible gynecological issues that could be causing the symptoms.

The pelvic examination can help identify various conditions such as pelvic inflammatory disease (PID), ovarian cysts, or ectopic pregnancy, all of which might lead to abdominal pain in a sexually active female. Additionally, it provides an opportunity to assess for any signs of infection or other abnormalities that may require immediate attention.

While obtaining a pregnancy test is certainly an important consideration given her sexual activity, a pelvic examination can offer more immediate insights into the cause of her symptoms. In a clinical context, physical examination findings often take precedence in guiding further evaluations and management decisions. Therefore, performing the pelvic examination as the next step is the most appropriate course of action in this scenario.