Obstetrics & Gynecology>>>>>Sexual Abuse and Intimate Partner Violence
Question 1#

A 20-year-old woman presents to your office with a chief complaint of abdominal pain. Upon further questioning, the woman reveals that she was sexually assaulted at a party 3 weeks ago by a male friend whom she recently started dating. She tells you that she has not revealed this to anyone else, and has not informed the police because she was drinking. Her abdominal and pelvic examinations are normal.

Which of the following is the best management to offer this patient?

a. Counsel patient to sue the male friend
b. Provide an antidepressant
c. Provide emergency contraception
d. Test for and treat sexually transmitted infections
e. Order CT of the abdomen and pelvis

Correct Answer is D

Comment:

The physician’s responsibility in the care of a rape victim includes medical, medical-legal, and emotional support. The physician’s medical responsibilities include treatment of injuries, testing, and prevention and treatment of both infections and pregnancy. This patient has a normal examination, and a CT is not indicated. She should be tested for sexually transmitted infections and given prophylactic antibiotics to treat such diseases. A pregnancy test should be performed, and if negative, she should be offered emergency contraception. Since emergency contraception should be given within 72 hours of the event, this patient is not a candidate for emergency contraception. Even though there can be longstanding psychological consequences of rape, antidepressants are not indicated at this time for this patient.