Ectopic pregnancy

Question 1

Clinical presentation of ectopic prengnancy

Answer 1

Vaginal bleeding
Lower abdominal pain unilateral intially, back or pelvic pain
Shoulder pain
Syncopal attacks - haemoperitoneum
Symptoms of hypovolaemic shock

Question 2

Vital signs ectopic pregnancy

Answer 2

Hypotension
Tachycardia
General - pale, increase CRT

Question 3

Abdo plapation ectopic pregnancy

Answer 3

Uterus not enlarged
Tenderness
Guarding

Question 4

Speculum - ectopic

Answer 4

os closed, minimal bleeidng

Question 5

Bimanual examination of the uterus ectopic pregnancy

Answer 5

Cervical excitation
Uterus not enlarged
Possible adnexal mass

Question 6

Investgiations for ectopic

Answer 6

PREGNANCY TEST
transvaginal US
Blood beta hCG
Diagnostic laprascopic

Question 7

What see on transvaginal US ectopic

Answer 7

Empty uteris
Free fluid esp in puch of douglas
Gestation sac in adnexa

Question 8

What is threshold value for blood beta hCG and when sus ectopic with that

Answer 8

> 1,500mlU but TV US doesnt show intrauterine gestational sac ectopic suspected

Question 9

Managment of ectopic

Answer 9

Stabilise patinet
Surgical - salpingectomy/salpingotomy either by laparotomy/laparoscopy
Medical - IM methotrexate direct into tubal pregnancy

Question 10

What symptoms can ectopic present with that don’t expect

Answer 10

Neurological like dizzy

Question 11

Type of pain in ectopic

Answer 11

Constant dull pain in background, worse at radnome points when starting to rupture
Irritation of diaphragm therefore phrenuc nerve -> refer to shoulder
Irritation of peritoneum - pain on passing bowels

Question 12

What is bimanual exam looking at

Answer 12

Size of the uterus

Question 13

Chronic vs acute pain

Answer 13

PID - actue
Endometriosis - chronic