Which clinical feature most reliably differentiates a tubo-ovarian abscess (TOA) from uncomplicated PID?

• A Bilateral adnexal tenderness on bimanual examination
• B Elevated CRP and leucocytosis
• C Cervical motion tenderness
• D A palpable pelvic mass on bimanual examination or imaging ✓

Explanation

A palpable adnexal mass (confirmed on ultrasound or CT as a complex cystic-solid structure with thick walls and internal debris) distinguishes TOA from uncomplicated PID. Bilateral tenderness, elevated inflammatory markers, and cervical motion tenderness are features of PID itself and do not differentiate it from TOA. TOA requires prolonged IV antibiotics and consideration of drainage if no improvement within 72 hours, unlike uncomplicated PID.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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