Chapter 19 Ectopic Pregnancy Flashcards
Most common segment with ectopic pregnancy
A. ampulla
B. isthmic
C. fimbrial
D. interstitial
A. ampulla (70 percent) isthmic (12 percent) fimbrial (1 1 percent) interstitial tubal pregnancies (2 percent)
a condition in which epithelium-lined diverticula extend into a hypertrophied muscularis layer
Salpingitis isthmica nodosa
Clinical manifestation of ectopic pregnancy
- delayed menstruation
- pain (sharp, stabbing, or tearing )
- vaginal bleeding or spotting
discriminatory threshold
1500-2000mIU/mL
B-HCG level for PT +
urine: 20 to 25 mIU/mL
serum: =5 mIU/mL
Serum progesterone excludes ectopic pregnancy
> 25 ng/mL
TV-UTZ Gestational Sac
4 1/2 and 5 weeks
TV-UTZ yolk sac
5 and 6 weeks
TV-UTZ Fetal pole with cardiac activity
5 1/2 to 6 weeks
adnexal finding of an ectopic
Ring of fire doppler
Pericolic gutter near liver
Morison pouch
Methorexate MOA
blocking the reduction of dihydrofolate to tetrahydrofolate —> de novo purine and pyrimidine synthesis is halted, which leads to arrested DNA, RNA, and protein synthesis
Methotrexate side effects
bone marrow, gastrointestinal mucosa, and respiratory epithelium can also be harmed
Methotrexate single dose dosage
50mg/m2 BSA
Methotrexate multidose dosage
1mg/kg days 1,3,5,7
Leucovorin days 2,4,6,8