Obstetric imaging: ectopic pregnancy: practice question

A Radiology 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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Radiology · Obstetric imaging: ectopic pregnancy

Sample item

A woman with amenorrhoea, pelvic pain and a positive urine pregnancy test has transvaginal ultrasound showing an empty uterus, an adnexal mass with a ring of fire sign and free fluid in the pouch of Douglas. What is the diagnosis?

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

The answer and the reasoning

A. Ectopic pregnancy

A pregnancy test positive with no intrauterine gestational sac and an adnexal mass (tubal ring) with peripheral vascularity (ring of fire) is ectopic until proven otherwise. Free fluid suggests rupture or leakage. The discriminatory serum hCG level is about 1500 to 2000 mIU/mL for a sac at transvaginal ultrasound.

Option by option

  • A. Ectopic pregnancy (correct)

    Correct. An empty uterus with an adnexal ring and free fluid indicates ectopic pregnancy.

  • B. Threatened miscarriage

    A threatened miscarriage has an intrauterine sac.

  • C. Corpus luteum cyst without pregnancy

    A corpus luteum is possible but in a woman with positive test and free fluid, ectopic is first suspected.

  • D. Hydatidiform mole

    A mole shows a snowstorm pattern within the uterus.

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.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Ectopic pregnancy. A pregnancy test positive with no intrauterine gestational sac and an adnexal mass (tubal ring) with peripheral vascularity (ring of fire) is ectopic until proven otherwise.

Why is "Threatened miscarriage" not the answer?

A threatened miscarriage has an intrauterine sac.

Why is "Corpus luteum cyst without pregnancy" not the answer?

A corpus luteum is possible but in a woman with positive test and free fluid, ectopic is first suspected.

Why is "Hydatidiform mole" not the answer?

A mole shows a snowstorm pattern within the uterus.

What concept does this question test?

It tests Obstetric imaging: ectopic pregnancy in Radiology. Free fluid suggests rupture or leakage. The discriminatory serum hCG level is about 1500 to 2000 mIU/mL for a sac at transvaginal ultrasound.

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 Obstetric imaging: ectopic pregnancy?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.