Exam (elaborations)
OBSTETRICS ECTOPIC PREGNANCY PRACTICE EXAM WITH CORRECT ANSWERS 2024
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OBSTETRICS ECTOPIC PREGNANCY PRACTICE EXAM WITH CORRECT ANSWERS 2024
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OBSTETRICS ECTOPIC PREGNANCY PRACTICE EXAM WITHCORRECT ANSWERS 2024
1. What is ectopic pregnancy?: Implantation of placenta anywhere outside
uterine cavity (i.e. normal fertilization + implantation, just in the wrong place)
2. What are the two outcomes of an ectopic pregnancy?: Spontaneous
abortion versus grow and rupture
3. Expected outcome of untreated ruptured ectopic pregnancy?: Maternal
death
4. In an ectopic pregnancy, is the gestation salvageable?: No
5. Where is the most common site for an ectopic pregnancy? What sites are
less common?: Fallopian tube (95-99%). Other sites: cervix, ovarian,
peritoneal 6. Within the fallopian tube, what are the possible sites for
ectopic pregnancy implantation? What are there relative frequencies?:
70% ampullary / 12% isthmus / 11% fimbriae
7. Broadly, what increases the risk of ectopic pregnancy?: Anything that
obstructs the fallopian tube (prevents blastocyst from exiting uterine tube)
8. Risk factors for ectopic pregnancy?: (1) Prior ectopic (10% for one, 25%
for >1). (2) Salpigectomy/salpingotomy. (3) PID. (4) IVF. (5) Cigarette
smoking. (6) Advanced age.
9. Pt presents with delayed period and vaginal spotting. What do you need
to rule out?: Ectopic pregnancy. This would be classic presentation for an
unruptured ectopic. This patient could also just be pregnant.
10. 25yo female presents with sudden onset intense abdominal pain and
guarding. What do you need to rule out?: Ruptured ectopic pregnancy
11. Symptoms of ectopic pregnancy without tubal rupture?: Vague
abdominal plan + little bleeding (spotting) + delayed menstruation
1/5
, 12. Symptoms of ectopic pregnancy after tubal rupture?: Peritonitis
(rebound tenderness + involuntary guarding + abdominal pain). Can also
have copious vaginal bleeding, shoulder pain on inspiration (2/2
diaphragmatic irritation) + signs of blood loss (orthostasis, frank
hypotension, blood loss anemia).
13. Where does bleeding typically occur in a ruptured ectopic pregnancy?
Why?: Into peritoneal cavity becuase mesothelial lining envelops most of the
uterine tube
14. Expected outcome of ruptured ectopic pregnancy without surgical
intervention? Why?: Fatal bleeding because abdomen/pelvis can contain
entire circulating volume and won't tamponade bleeding
15. How can ectopic pregnancy be definitively diagnosed?: TVUS to see
gestation
16. What is the order in which you would expect to see embryonic stages on
transvaginal ultrasound?: Chorionic cavity --> yolk salk --> embryo +
amnion
17. What is the earliest gestational age when you would expect to be able to
see the chorionic cavity on TVUS?: 4.5 weeks
18. Patient presents after a positive home urinary pregnancy test. Next
step?: Transvaginal ultrasound
19. Patient presents after a positive home urinary pregnancy test. TVUS
shows intrauterine pregnancy. Next step?: Send to OB
20. Patient presents after a positive home urinary pregnancy test. TVUS
shows ectopic pregnancy. Next step?: Treat it
21. Patient presents after a positive home urinary pregnancy test. TVUS
does not identify an intrauterine or ectopic pregnancy. Next step?: Get
serum b-hCG 22. Patient presents after a positive home urinary
pregnancy test. TVUS does not identify an intrauterine or ectopic
2/5
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