Early pregnancy: ultrasound and hCG: 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.

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OBG · Early pregnancy: ultrasound and hCG

Sample item

A woman with 6 weeks of amenorrhoea and serum hCG of 3000 mIU/mL has an empty uterus on transvaginal scan and a complex adnexal mass. What is the most likely diagnosis?

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

The answer and the reasoning

B. Ectopic pregnancy

The discriminatory zone is the hCG level (about 1500 to 2000 mIU/mL) above which an intrauterine gestational sac should be seen on transvaginal ultrasound. Absence of a sac with a higher hCG and an adnexal mass strongly suggests ectopic pregnancy.

Option by option

  • A. Hydatidiform mole

    A mole shows a snowstorm pattern within the uterus.

  • B. Ectopic pregnancy (correct)

    Correct. No intrauterine sac above the discriminatory level plus adnexal mass fits ectopic.

  • C. Complete abortion

    A complete abortion would show a falling hCG and history of tissue passage.

  • D. Normal intrauterine pregnancy

    A normal pregnancy would show a sac at this hCG level.

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, Ectopic pregnancy. The discriminatory zone is the hCG level (about 1500 to 2000 mIU/mL) above which an intrauterine gestational sac should be seen on transvaginal ultrasound.

Why is "Hydatidiform mole" not the answer?

A mole shows a snowstorm pattern within the uterus.

Why is "Complete abortion" not the answer?

A complete abortion would show a falling hCG and history of tissue passage.

Why is "Normal intrauterine pregnancy" not the answer?

A normal pregnancy would show a sac at this hCG level.

What concept does this question test?

It tests Early pregnancy: ultrasound and hCG in OBG. Absence of a sac with a higher hCG and an adnexal mass strongly suggests ectopic pregnancy.

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 Early pregnancy: ultrasound and hCG?

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.