Ectopic Pregnancy Quiz: Can You Spot the Emergency?

1. What is the most common site of ectopic pregnancy implantation?

Fallopian tube

Ovary

Cervix

Abdominal cavity

2. Which of the following is the strongest risk factor for ectopic pregnancy?

Maternal age over 40

History of pelvic inflammatory disease

Smoking

Nulliparity

3. A patient presents with vaginal bleeding, pelvic pain, and a positive pregnancy test. Which imaging finding is most specific for ectopic pregnancy?

Empty uterine cavity with positive hCG

Gestational sac in the fallopian tube

Free fluid in the pelvis

Elevated hCG levels only

4. What does a discriminatory zone hCG level help determine in early pregnancy evaluation?

Whether the patient is at risk for preeclampsia

The minimum hCG needed to visualize a gestational sac on ultrasound

The exact gestational age of the fetus

Whether the pregnancy is viable

5. Which intrauterine device (IUD) type carries the highest relative risk of ectopic pregnancy if conception occurs?

Copper IUD

Levonorgestrel-releasing IUD

Both types carry equal risk

Neither type increases ectopic risk

6. A patient with confirmed ectopic pregnancy is hemodynamically stable with hCG

Emergency surgery

Methotrexate therapy

Expectant management only

Dilation and curettage

7. Methotrexate works in ectopic pregnancy by inhibiting which enzyme?

Dihydrofolate reductase

Aromatase

Acetylcholinesterase

Monoamine oxidase

8. Which of the following surgical approaches is preferred for hemodynamically unstable ectopic pregnancy?

Laparoscopy with salpingostomy

Laparotomy with salpingectomy

Expectant management

Ultrasound-guided aspiration

9. What is the primary advantage of salpingostomy over salpingectomy in ectopic pregnancy treatment?

Lower recurrence rate

Faster recovery time

Preservation of tubal patency

Lower operative cost

10. A patient treated with methotrexate for ectopic pregnancy requires monitoring. Which lab value is most important to follow?

Hemoglobin and hematocrit

Serial hCG levels

Liver and renal function

White blood cell count

11. Heterotopic pregnancy (intrauterine and extrauterine) occurs in what percentage of natural conceptions?

Less than 0.1%

1-2%

5-10%

15-20%

12. Which imaging modality is considered the gold standard for diagnosing ectopic pregnancy?

Transabdominal ultrasound

Transvaginal ultrasound

CT imaging

MRI

13. A patient with ruptured ectopic pregnancy presents with severe hypotension and tachycardia. What is the immediate priority?

Administer methotrexate

Obtain ultrasound confirmation

Resuscitation and emergency surgery

Discharge with outpatient follow-up

Submit

15. True or False: Patients with a history of ectopic pregnancy have approximately a 25% risk of recurrence in subsequent pregnancies.

True

False