1.
The following is/are considered a positive finding in ectopic pregnancy:
Correct Answer
D. All of the above
Explanation
All of the above are considered positive findings in ectopic pregnancy. Cervical excitation refers to tenderness or pain upon palpation of the cervix, which can indicate an ectopic pregnancy. A positive urine test, specifically a pregnancy test, indicates the presence of the pregnancy hormone hCG, which can be elevated in ectopic pregnancy. PV bleeding, or vaginal bleeding, is another common symptom of ectopic pregnancy. Therefore, all three options are positive findings associated with ectopic pregnancy.
2.
Case: A patient who is gravida 8 presents with a missed period of 7 weeks. P.V. bleeding. Cervical excitation, lower abdominal pain, fainting 2 times yesterday. Your diagnosis is:
Correct Answer
B. Ectopic pregnancy
Explanation
Based on the symptoms presented by the patient, such as missed period, PV bleeding, cervical excitation, lower abdominal pain, and fainting, the most likely diagnosis is ectopic pregnancy. Ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, typically in the fallopian tube. This can cause vaginal bleeding, abdominal pain, and other symptoms. Pancreatitis is inflammation of the pancreas and would not typically present with these symptoms. Abortion refers to the intentional termination of a pregnancy, which is not indicated in this case. None of these is not a valid diagnosis as the symptoms point towards ectopic pregnancy.
3.
Ectopic pregnancy can be reliably diagnosed by:
Correct Answer
B. Laparoscopy
Explanation
Laparoscopy is the most reliable method for diagnosing ectopic pregnancy. It is a minimally invasive surgical procedure that allows the doctor to directly visualize the reproductive organs and identify any abnormalities, such as a pregnancy outside of the uterus. Ultrasound (US) can also be used to detect an ectopic pregnancy, but it may not always provide a clear diagnosis. Pregnancy tests and HSG (hysterosalpingogram) are not specific diagnostic tools for ectopic pregnancy and may only provide indirect indications. Therefore, laparoscopy is the preferred method for accurate diagnosis.
4.
Which type of the following ectopic pregnancies would rupture earlier:
Correct Answer
A. Isthmus
Explanation
The isthmus is the narrowest part of the fallopian tube, and it is less capable of expanding to accommodate a growing embryo compared to other parts of the tube. Therefore, an ectopic pregnancy in the isthmus is more likely to rupture earlier than in other locations.
5.
Regarding ectopic pregnancy, which is true:
Correct Answer
B. Shoulder tip pain is an important symptom.
Explanation
Shoulder tip pain is an important symptom in ectopic pregnancy. This pain occurs due to the irritation of the diaphragm caused by the blood from a ruptured fallopian tube. It is a significant symptom that can help in identifying ectopic pregnancy, along with other signs such as vaginal bleeding and lower abdominal pain. Bleeding may or may not precede pain in ectopic pregnancy, so it is not always a consistent symptom. Therefore, the correct answer is that shoulder tip pain is an important symptom.
6.
Which of the following is not a sign of ruptured ectopic pregnancy:
Correct Answer
B. Heavy vaginal bleeding
Explanation
Heavy vaginal bleeding is not a sign of ruptured ectopic pregnancy. Ruptured ectopic pregnancy typically presents with symptoms such as fast thready pulse, rebound tenderness of the abdomen, positive cervical excitation, and cold and clammy extremities. However, heavy vaginal bleeding is more commonly associated with miscarriage or other gynecological conditions.
7.
The most common cause of ectopic pregnancy:
Correct Answer
B. Inflammation of the tubes
Explanation
Inflammation of the tubes, also known as salpingitis, is the most common cause of ectopic pregnancy. This condition occurs when the fallopian tubes become inflamed and blocked, preventing the fertilized egg from reaching the uterus. Inflammation of the tubes can be caused by various factors such as sexually transmitted infections, pelvic inflammatory disease, or previous surgeries. This inflammation disrupts the normal movement of the egg and increases the chances of it implanting outside the uterus, leading to an ectopic pregnancy.
8.
Regarding interstitial ectopic pregnancy:
Correct Answer
A. Bleeds heavily
Explanation
Interstitial ectopic pregnancy refers to the implantation of a fertilized egg within the interstitial segment of the fallopian tube. This type of ectopic pregnancy is considered to be more dangerous than ampullary ectopic pregnancy because it has a higher risk of rupture and hemorrhage. Therefore, it is expected to cause heavy bleeding. Salpingectomy, which is the removal of the affected fallopian tube, is the recommended surgical treatment for interstitial ectopic pregnancy. It is important to note that interstitial ectopic pregnancy is less common than ampullary ectopic pregnancy, but it is more life-threatening.
9.
The commonest surgical procedure used to treat ruptured tubal pregnancy:
Correct Answer
C. Salpingectomy
Explanation
Salpingectomy is the surgical procedure commonly used to treat a ruptured tubal pregnancy. It involves the removal of the fallopian tube that is affected by the pregnancy. This procedure is often preferred over other options like salpingostomy (which involves making an incision in the fallopian tube to remove the pregnancy) because it reduces the risk of future ectopic pregnancies and allows for examination of the removed tissue for further analysis. Total hysterectomy, salpingo-oophorectomy, and electrical cauterization are not typically used for treating ruptured tubal pregnancies.
10.
In an ectopic pregnancy, which of the following is always important:
Correct Answer
D. Pregnancy test
Explanation
A pregnancy test is crucial in diagnosing an ectopic pregnancy as it confirms the presence of pregnancy. Once pregnancy is confirmed, further investigations, such as ultrasound, can be conducted to determine the location of the pregnancy. Symptoms like amenorrhea, pain before vaginal bleeding, shoulder tip pain, and a decidual cast may occur, but the pregnancy test is the essential first step in identifying an ectopic pregnancy.