Early pregnancy: ruptured ectopic: 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 · Early pregnancy: ruptured ectopic

Sample item

A woman at 7 weeks of amenorrhoea has severe lower abdominal pain, BP 80/50 mm Hg, pulse 130/min and a positive urine pregnancy test. FAST shows free fluid in Morison's pouch. What is the next step?

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

The answer and the reasoning

B. Resuscitate and proceed to emergency laparotomy or laparoscopic salpingectomy

Haemodynamic instability with haemoperitoneum in a woman with positive pregnancy test is a ruptured ectopic until proven otherwise and needs urgent surgery with simultaneous resuscitation. Salpingectomy is preferred when the contralateral tube is healthy or bleeding is uncontrolled.

Option by option

  • A. Repeat hCG in 48 hours

    Waiting for repeat hCG endangers life.

  • B. Resuscitate and proceed to emergency laparotomy or laparoscopic salpingectomy (correct)

    Correct. Emergency surgery is life-saving.

  • C. Give methotrexate

    Methotrexate is contraindicated in instability.

  • D. Discharge with analgesia

    Discharge risks death from haemorrhage.

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 B, Resuscitate and proceed to emergency laparotomy or laparoscopic salpingectomy. Haemodynamic instability with haemoperitoneum in a woman with positive pregnancy test is a ruptured ectopic until proven otherwise and needs urgent surgery with simultaneous resuscitation.

Why is "Repeat hCG in 48 hours" not the answer?

Waiting for repeat hCG endangers life.

Why is "Give methotrexate" not the answer?

Methotrexate is contraindicated in instability.

Why is "Discharge with analgesia" not the answer?

Discharge risks death from haemorrhage.

What concept does this question test?

It tests Early pregnancy: ruptured ectopic in OBG. Salpingectomy is preferred when the contralateral tube is healthy or bleeding is uncontrolled.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Early pregnancy: ruptured ectopic?

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.