Contraception: ectopic risk with IUCD: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

OBG · Contraception: ectopic risk with IUCD

Sample item

A woman using a copper IUCD for 3 years has lower abdominal pain, missed period and a positive urine pregnancy test. What is the most important diagnosis to exclude first?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Ectopic pregnancy

Intrauterine devices lower the absolute risk of pregnancy and of ectopic pregnancy, but if conception does occur, a higher proportion are ectopic. A woman with an IUCD, amenorrhoea, pain and a positive test needs transvaginal ultrasound and hCG to exclude ectopic pregnancy. Delay may lead to rupture.

Option by option

  • A. Ectopic pregnancy (correct)

    Correct. A pregnancy with an IUCD has a higher chance of being ectopic.

  • B. Dysmenorrhoea

    Dysmenorrhoea does not explain a positive pregnancy test.

  • C. Pelvic congestion

    Pelvic congestion does not cause a positive test.

  • D. Mittelschmerz

    Mid-cycle pain is not associated with amenorrhoea and a positive test.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Ectopic pregnancy. Intrauterine devices lower the absolute risk of pregnancy and of ectopic pregnancy, but if conception does occur, a higher proportion are ectopic.

Why is "Dysmenorrhoea" not the answer?

Dysmenorrhoea does not explain a positive pregnancy test.

Why is "Pelvic congestion" not the answer?

Pelvic congestion does not cause a positive test.

Why is "Mittelschmerz" not the answer?

Mid-cycle pain is not associated with amenorrhoea and a positive test.

What concept does this question test?

It tests Contraception: ectopic risk with IUCD in OBG. A woman with an IUCD, amenorrhoea, pain and a positive test needs transvaginal ultrasound and hCG to exclude ectopic pregnancy. Delay may lead to rupture.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Contraception: ectopic risk with IUCD?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.