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Questions and Answers
What is the most likely differential diagnosis for the pregnant lady with vaginal bleeding and abdominal distension?
Which investigation is used to assess the discriminative zone of serum ß-hCG in early pregnancy?
What is one of the key factors considered for the 'EXPECTANT' management approach in this case?
Which condition can co-exist with a viable intrauterine pregnancy as a result of IVF treatment?
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What is the primary purpose of conducting an infection screen in this scenario?
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What is the optimal rise of serum ß-hCG that should be assessed in early pregnancy?
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What must be identified in a transvaginal ultrasound to confirm a viable intrauterine pregnancy?
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Which infection is not typically screened for in a pregnant lady with vaginal bleeding and abdominal distension?
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What investigation is used to assess whether the discriminative zone of serum ß-hCG (1000-1500IU/L) is reached?
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What factors are considered for initiating 'EXPECTANT' management?
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What should be assessed to determine if 'EXPECTANT' management is appropriate?
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Which condition can co-exist with a viable intrauterine pregnancy as a result of IVF treatment?
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What must be assessed in the bloods investigation for a pregnant lady presenting with vaginal bleeding and abdominal distension?
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The ______ barked
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The ______ meowed
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Study Notes
Pregnancy Complications
- The most likely differential diagnosis for a pregnant lady with vaginal bleeding and abdominal distension is an ectopic pregnancy.
- Serum β-hCG investigation is used to assess the discriminative zone in early pregnancy.
Expectant Management Approach
- One of the key factors considered for the 'EXPECTANT' management approach is the presence of a viable intrauterine pregnancy.
- Factors considered for initiating 'EXPECTANT' management include the presence of a viable intrauterine pregnancy, low serum β-hCG levels, and minimal symptoms.
Infection Screening
- The primary purpose of conducting an infection screen in this scenario is to identify potential infections that may be contributing to the vaginal bleeding and abdominal distension.
- Chlamydia is typically screened for in a pregnant lady with vaginal bleeding and abdominal distension.
- HIV is not typically screened for in a pregnant lady with vaginal bleeding and abdominal distension.
β-hCG Levels
- The optimal rise of serum β-hCG that should be assessed in early pregnancy is 66% every 48 hours.
- The discriminative zone of serum β-hCG is reached at 1000-1500 IU/L.
Ultrasound Investigation
- A transvaginal ultrasound must identify a fetal heartbeat to confirm a viable intrauterine pregnancy.
Co-Existing Conditions
- A heterotopic pregnancy can co-exist with a viable intrauterine pregnancy as a result of IVF treatment.
Blood Investigations
- Serum β-hCG levels and full blood count should be assessed in the bloods investigation for a pregnant lady presenting with vaginal bleeding and abdominal distension.
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Description
This quiz covers a case of a pregnant woman at 8 weeks of IVF pregnancy presenting with vaginal bleeding and abdominal distension. Questions include the differential diagnosis for the symptoms and the investigations required to assess the condition.
