ECTOPIC PREGNANCY

Decidua is endometrium that is hormonally prepared for pregnancy. Women with ectopic tubal pregnancy may pass a decidual cast.

True or False? Decidual sloughing may also occur with uterine abortion?

• True

• False

Answer explanation

p 834

Tissue must be carefully evaluated by the provider and then histologically fro evidence of a conceptus

With BhCG assay, the lower limit of detection for urine is_____

• <5 mIU/ml

• 20 to 25 mIU/ml

• 15 mIU/ml

• 30 to 35 mIU/ml

Answer explanation

p. 838

20-25mIU/ml - urine

< 5 mIU/ml - serum

What is the discriminatory BhCG level?

• <1500 to 2000 mIU/ml

• >500 to 1000 mIU/ml

• >1500 to 2000 mIU/ml

• <500 to 1000 mIU/ml

Answer explanation

Discriminatory zone level above which failure to visualize a uterine pregnancy indicates that the pregnancy either is not alive or is ectopic

Anechoic fluid collection which might normally suggest an early intrauterine gestational sac may also be seen with ectopic pregnancy? True or False

• True

• False

Answer explanation

p.840

pseudogestational sac and decidual cyst

What type of chemotherapy is Methotrexate?

• alkylating agent

• antitumor antibiotic

• antimetabolite

• plant alkaloid

Answer explanation

845

antimetabolite which binds to dihydrofolate reductase blocking the reduction of dihydrofolate to tetrahydrofolate

What is the dosage of MTX as a single dose medical treatment for ectopic pregnancy?

• 100 mg/m2 BSA Day 1

• 0.1 mg/kg

  Days 2,4,6,8

• 1 mg/kg

  Days 1,3,5,7

• 50mg/m2 BSA Day 1

Answer explanation

p. 846

An indication for additional dose of MTX for medical management of an ectopic pregnancy?

• If serum BhCG increases by 50% from day 4 to 7

• If serum BhCG does not decline by 15% from day 4 to 7

• If serum BhCG does not decline by 50% from day 4 to 7

• If serum BhCG increases by 15 % from day 4 to 7

Answer explanation

p 846

The following are contraindications to MTX administration EXCEPT

• Peptic ulcer disease

• Breastfeeding

• Active pulmonary disease

• NONE OF THE ABOVE

Answer explanation

P.846

The following are characteristics of a Cervical pregnancy EXCEPT:

• gestational tissue at the level of the lower uterine segment

• an hourglass uterine shape and ballooned cervical canal

• absent intrauterine gestational tissue

• portion of the endocervical canal between the gestation and the endoometrial canal

Answer explanation

857

gestational tissue at the level of the cervix

Cornerstone in the management of cervical pregnancy

• Medical using MTX

• Surgical

Answer explanation

857