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17 Cards in this Set
- Front
- Back
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defin ectopic preg
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any preg that implants outside the uterine cavity
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most common place for ectopic
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ampulla
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other places for implantation
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ovary
fimbria interstitial (fundus) abdominal tubal rupture rupture into broad ligament cervical |
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most common RF for ectopic
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PID*
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other RF for ectopic
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prior ectopic
IUD tubal/pelvic surg (adhesion) DES (diethylstilbestrol) exposure in utero |
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incidence of ectopic
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1 in 100
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classic sx triad of ectopic
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1. amenorrhea
2. light vaginal bl 3. lower abd/pelvic pain |
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what test given to any women w/ abd pain
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preg test
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PE what may be palpated
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pelvic or adnexal mass
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ruptured ectopic sx
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sudden, sharp abd pain w/ ORTHOSTATIC HYPOTENSION, tachy, generalized abd/adnex tender w/ rebound tender, shoulder pain, SHOCK
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DDx of ectopic
if preg + hx of STD general abd pain |
SAB
molar preg ruptured corpus luteum cyst PID appy, pyelo, adn torsion, pancreatitis, diverticulitis, regional ileitis, ulcerative colitis |
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Pt has +b-hCG, in absence of uterine preg (u/s). what do you suspect?
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ectopic
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how do you dx ectopic w/ b-hCG?
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meas b-hCG, follow rate of rise:
levels lower than expected for nml preg, prolonged doubling times (nml 2d) |
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progesterone levels: hi, lo, nml? specific for meas?
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lo <15, not specific
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how do you look for uterine preg?
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if b-hCG 5000, transabd U/S
if b-hCG 1500, transvag U/S |
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how to dx hemoperitoneum? sensitive/specific for ectopic?
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>5cc nonclot bl on culdocentesis
not good for dx ectopic |
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definitive dx by what 3
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laparoscopy
larparotomy U/S visualization |
