Clinical Case 4

Question 1

hCG testing levels

when you should start seeing a gestational sac

Answer 1

1,500 you will see a gestational sac

Question 2

What is the value of doing a serum quantitative hCG over or in addition to a urine hCG

Answer 2

if >1500 then you should see a gestational sac
if rises very rapidly, then might be molar pregnancy
if rises slowly, might be abnormally slow pregnancy
–> Down

Question 3

What type of abdominal sound indicates there might be an obstruction

Answer 3

high pitched bowel sounds

Question 4

What is a heterotopic pregnancy

Answer 4

twins
1 intrauterine
1 extrauterine

Question 5

Most ectopic pregnancies occur where

Answer 5

in fallopian tubes

Question 6

When do ectopics normally present in menstrual cycle

Answer 6

6-8 weeks after last missed period

Question 7

When in ectopic pregnancy is there a risk of ectopic rupture

Answer 7

always!

even if urine hCG is

Question 8

How often should normal hCG levels double?

Answer 8

every 48 hours

if >66% increase, then the pregnancy is progressing

Question 9

Medical (non-surgical) treatment of ectopic pregnancy

Answer 9

MTX

Question 10

Ectopics can be a lot of wa-hoo. what should you remember to give to mom in the midst of all this

Answer 10

Rhogam if she is Rh -

protect future pregnancies