1. history of surgery on fallopian tubes, history of salpingitis, history of pelvic inflammatory disease, history of ectopic pregnancy, history of endometriosis etc.
2. Pain!
3. C – 15%
4. A is correct
- A pt who has fainted is not hemodynamically stable and the shoulder pain may indicate peritonitis. Both of these point toward a ruptured ectopic pregnancy.
- Methotrexate is the medical treatment for an ectopic pregnancy if the the patient is hemodynamically stable
- observation alone in a patient with these severe symptoms is not a good choice
- Methylprednisolone has no indication in this area
5. A is correct
- A small percentage of those with a threatened abortion will go on to spontanous abortion
- See the answer to A
- See the answer to A
- There is no correlation between vaginal discharge and Down syndrome
6. C is correct
- See the answer to C
- Methotrexate is used to medically treat an ectopic pregnancy
- The conents of uterus must be emptied otherwise they will become a reservoir for bacteria.
- At 12 weeks delivery of the uterine contents is not an option
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