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17 Cards in this Set

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