Ectopic pregnancy

And in the input text copy and paste the following text: Ectopic pregnancy is a condition where a fertilized egg implants outside the uterine cavity, most commonly in the fallopian tubes. This abnormal placement prevents the embryo from developing properly and can cause life-threatening complications if untreated. Risk factors include previous ectopic pregnancies, pelvic inflammatory disease, ...

Quiz Type

Practice

Subject

Obstetrics and gynaecology

Level

Level 400

Questions

15 questions

Created By

Ramat Debrah

Quick Rules

Time limit: 15 minutes
Multiple attempts are not allowed
All questions must be answered to submit

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Question 1 of 15

Question 1

Multiple choice

A 28-year-old woman presents with sharp abdominal pain and vaginal bleeding at 8 weeks of gestation. Given the symptoms and timing, which of the following is the most likely diagnosis?

Intrauterine pregnancy

Ectopic pregnancy

Correct

Threatened miscarriage

Molar pregnancy

Explanation

The timing of symptoms and specific presentation strongly suggest ectopic pregnancy, particularly given the abdominal pain and vaginal bleeding.

Question 2

Multiple choice

Which of the following risk factors is least associated with an increased likelihood of ectopic pregnancy?

Pelvic inflammatory disease

Previous ectopic pregnancy

Tubal surgery

First trimester glucose intolerance

Correct

Explanation

First trimester glucose intolerance is not a recognized risk factor for ectopic pregnancy, unlike the other options.

Question 3

Multiple choice

During a follow-up consultation, a patient expresses anxiety about the possibility of future fertility after experiencing an ectopic pregnancy treated with methotrexate. What is the best approach to address her concerns?

Assure her that future fertility is unlikely

Explain that methotrexate can affect future pregnancies

Reassure her that many women conceive successfully post-treatment

Correct

Advise her to pursue IVF for future attempts

Explanation

Most women regain the ability to conceive after treatment with methotrexate, and addressing her concerns positively can alleviate anxiety.

Question 4

Multiple choice

Cord blood measurement of hCG levels can be misleading. Considering this context, what is the most reliable method for confirming ectopic pregnancy?

Transabdominal ultrasound

Transvaginal ultrasound

Correct

CT scan of the abdomen

Laparoscopic examination

Explanation

Transvaginal ultrasound is the best method for diagnosing ectopic pregnancy, allowing for clearer visualization, especially in early pregnancies.

Question 5

Multiple choice

A 35-year-old woman with a history of tubal ligation presents with sudden onset shoulder tip pain and abdominal discomfort. What is your next step in investigating her condition?

Perform a routine Pap smear

Conduct a serum hCG test immediately

Correct

Schedule her for a laparotomy

Prescribe analgesics and discharge her

Explanation

Immediate testing for serum hCG levels can quickly indicate potential ectopic pregnancy, particularly considering her symptoms.

Question 6

Multiple choice

In managing ectopic pregnancies, which of the following treatments is contraindicated in the case of a ruptured ectopic pregnancy?

Methotrexate administration

Correct

Laparoscopic salpingectomy

Expectant management

Laparotomy

Explanation

Methotrexate is contraindicated in ruptured ectopic pregnancies as surgical intervention is usually required.

Question 7

Multiple choice

Which of the following findings on a transvaginal ultrasound is most indicative of an ectopic pregnancy?

Gestational sac within the uterus

Empty uterus with an adnexal mass

Correct

Cystic structures in the abdomen

Multiple gestational sacs on both sides

Explanation

An empty uterus along with the presence of an adnexal mass is highly suggestive of ectopic pregnancy.

Question 8

Multiple choice

In assessing a patient with suspected ectopic pregnancy, why is the measurement of serum hCG levels critical, and what would be considered abnormal in early pregnancy?

A level below 1000 mIU/mL is normal

A level greater than 1500 mIU/mL confirms intrauterine pregnancy

A doubling of the hCG level over 48 hours is expected

Correct

A stable hCG level indicates viable pregnancy

Explanation

In early pregnancy, hCG levels should double approximately every 48 hours; if levels do not rise appropriately, it may suggest abnormal placement of the embryo.

Question 9

Multiple choice

Considering the emotional implications of an ectopic pregnancy, which of the following strategies is essential when providing patient care post-diagnosis?

Encourage immediate return to regular activities

Offer psychologic support and referral as necessary

Correct

Suggest she not disclose her experience to friends or family

Inform her to avoid all future pregnancies

Explanation

Psychological support is crucial for patients post-ectopic pregnancy, helping them cope with the emotional impact.

Question 10

Multiple choice

A patient considering assisted reproductive technology (ART) in her next pregnancy expresses concern over the increased risk of ectopic pregnancy. How should you counsel her?

Reassure that ART carries no additional risk

Inform that ART slightly increases the risk, but many pregnancies are successful

Correct

Advise against using ART for future attempts

Suggest routine monitoring for every ART cycle

Explanation

While ART does slightly increase the risk for ectopic pregnancies, many individuals using ART can achieve successful outcomes.

Question 11

Multiple choice

Upon reviewing a patient history, what combination of factors would most support the diagnosis of ectopic pregnancy?

Being under 25 and having no previous surgeries

History of pelvic inflammatory disease with previous ectopic pregnancy

Correct

10-week gestation with routine ultrasound

Recent IUD insertion followed by a positive pregnancy test

Explanation

A history of pelvic inflammatory disease along with a previous ectopic pregnancy significantly raises the risk and supports the diagnosis.

Question 12

Multiple choice

During a surgical management of an ectopic pregnancy, what is the primary aim of the surgical approach in a ruptured case?

To preserve the fallopian tube at all costs

To ensure effective removal of ectopic tissue to prevent hemorrhage

Correct

To terminate the current pregnancy safely

To prevent future pregnancies altogether

Explanation

In ruptured ectopic pregnancy, the priority is to remove the ectopic tissue and control any hemorrhage, ensuring patient safety.

Question 13

Multiple choice

After the removal of an ectopic pregnancy, what recommendation should be prioritized in the patient's follow-up care?

Avoid all sexual activity for at least six months

Monitor hCG levels until they return to baseline

Correct

Schedule a hysterectomy to prevent future risks

Provide reassurance that future pregnancies are impossible

Explanation

Monitoring hCG levels is essential to ensure that all ectopic tissue has been removed and to establish a timeline for future attempts at conception.

Question 14

Multiple choice

What ethical considerations must be taken into account when discussing surgical options for ectopic pregnancies with patients?

Ensure the patient is fully informed about the risks and benefits of each option

Correct

Assume the patient prefers a particular surgical method based on common practice

Encourage the patient to follow the physician's recommendation without question

Rely solely on clinical guidelines without patient input

Explanation

Informed consent is crucial, ensuring that patients understand their choices and participate in the decision-making process.

Question 15

Multiple choice

A 30-year-old woman presents to the emergency department at 8 weeks gestation with sharp left abdominal pain and vaginal bleeding. A transvaginal ultrasound reveals an empty uterine cavity and an adnexal mass. Which of the following is the most appropriate initial management for this patient, considering the risk of tubal rupture and internal hemorrhage?

Immediate laparotomy to remove the ectopic mass

Administration of methotrexate to halt cell growth

Correct

Observation and follow-up ultrasound in one week

Prescribe analgesics and discharge with advice

Explanation

In cases of early detected ectopic pregnancy without significant complications, methotrexate is the appropriate management to stop cell growth and reduce the risk of tubal rupture and hemorrhage.