Jeopardy
Ultrasound Ectopic
Q $100
Q $100
Q $200
Q $200
Q $300
Q $300
Q $400
Q $500
Abortion
Q $100
Quant BhCG TnT
Q $100
Q $100
Q $200
Q $200
Q $300
Q $300
Q $300
Q $400
Q $400
Q $400
Q $400
Q $500
Q $500
Q $500
Q $500
Final Jeopardy
$100 Question from H1
What is the first sign of an
intra-uterine pregnancy on
trans-vaginal ultrasound??
$100 Answer from H1
Gestational sac with a
double decidual reaction
$200 Question from H1
You should be able to see
a gestational sac at what BhCG
level (i.e. the “discriminatory
level”)??
$200 Answer from H1
1500-2000 mIU/ml
$300 Question from H1
If the quant BhCG is > 1500- 2000
mIU/ml and you see this, you should be
concerned about…..
$300 Answer from H1
An ectopic pregnancy
$400 Question from H1
You see on ultrasound this picture.
This is consisent with a …
$400 Answer from H1
A molar pregnancy/
Gestational Trophoblastic
Disease
$500 Question from H1
The appearance of fluid in
the uterus rules out an ectopic.
True or False
$500 Answer from H1
False – an intrauterine fluid
collection can be a pseudo-sac
suggestive of an ectopic pregnancy
$100 Question from H2
Name another location
other than in the tubes, that a
patient can have an ectopic pregnancy.
$100 Answer from H2
Implantation can occur in
the cervix, in the cornua of the
uterus, or rarely on the bladder
or bowel.
$200 Question from H2
Risk factors for ectopic pregnancy include
tubal surgery of any kind, h/o previous PID,
h/o DES exposure and ……??
$200 Answer from H2
h/o previous ectopic
$300 Question from H2
This ultrasound picture shows a
normal IUP with the right ovary?
True or false??
$300 Answer from H2
False. This is a picture of
an ectopic in the R tube with
a pseudosac in the uterus.
$400 Question from H2
IUDs increase your risk of having
an ectopic pregnancy.
True or False
$400 Answer from H2
False. Rate of ectopic pregnancy
in women using an IUD is 1/10 the
rate in women who are not using
any type of contraceptive.
$500 Question from H2
The risk of recurrence in a patient
who has had a previous ectopic treated
with methotrexate is??
A.5%
B. 15%
C. 25%
D. 50%
$500 Answer from H2
B. 15%
$100 Question from H3
A patient had a documented
IUP and has just undergone
a miscarriage. Her uterus is
empty, cervix closed, minimal
bleeding. This is called a….
$100 Answer from H3
Completed Abortion
$200 Question from H3
Missed abortions normally have
passed tissue and have an open
cervix.
True or False
$200 Answer from H3
False – a missed abortion
will normally not have passed
tissue and the cervix will appear
closed.
$300 Question from H3
What percentage of women
who have any spotting in a
known pregnancy will miscarry?
A.
B.
C.
D.
10%
50%
70%
90%
$300 Answer from H3
B. 50%
$400 Question from H3
If a patient has a threatened
abortion however on ultrasound
done between 7-11 weeks, has a
IUP with +FHM, what is her chance
of miscarriage??
A. 3-7%
C. 50-60%
B. 20-25%
D. 90%
$400 Answer from H3
A. 3-7%
$500 Question from H3
G3P2 @ 8 5/7 weeks by first tri
U/S comes into TnT with vaginal
bleeding, cramping, and passing
clots. Her os is open and there are
products of conception in the os.
TVUS shows remaining products in
the uterus. This is a …..
$500 Answer from H3
Incomplete Abortion
$100 Question from H4
You should be able to see
a gestational sac at what BhCG
level?
$100 Answer from H4
1500-2000 mIU/ml
$200 Question from H4
A quant BhCG will increase
by at least “X” % every 48
hours in most normal
pregnancies.
A.10%
C. 53%
B. 27%
D. 77%
$200 Answer from H4
C. 53%
$300 Question from H4
You are following quant BhCGs
on a patient and on Monday it was
350 mIU/ml and on Wednesday it
was 672 mIU/ml. This is consistent
with a “normal rate of rise.” True or
False.
$300 Answer from H4
True
$400 Question from H4
Patient comes in to TnT with vag
bleeding at approx 6 weeks by
uncertain LMP. At quant BhCG
should you see first signs of an IUP?
$400 Answer from H4
1500-2000 mIU/ml
$500 Question from H4
You are following a patient
after a presumed completed ab.
Her quant BhCG will normally
Decrease by “X” % in 48 hours.
$500 Answer from H4
50%
$100 Question from H5
A patient comes in to TnT
with first trimester bleeding and
you are concerned re: an ectopic.
What is an important social
question to ask this patient??
$100 Answer from H5
Is this a “desired” pregnancy??
$200 Question from H5
Patient in testing and triage with + preg test and
first trimester bleeding and no documented IUP
on quick TVUS in triage. We have no blood work
on her at all in the computer. What three labs
should you get on her ?
$200 Answer from H5
Patient in TnT has a missed ab and is
considering either miso or a MVA.
Where can you send her for f/u??
$300 Question from H5
Center for Reproductive
Health (505) 925-4455
$300 Answer from H5
Diagnostic Imaging will see
Your patient in TnT without a
Quant BhCG??
True or False??
$400 Question from H5
Your patient in TnT has a quant
BhCG of 1500 and a gestational sac
in her uterus however it appears
abnormal. DI ultrasound shows no
masses in her adnexa. This is a
desired pregnancy. Your f/u plan
is…
$400 Answer from H5
Have her f/u at CRH in 2 days
with a repeat stat quant BhCG the am
of her appt, s it is back by the time she
is seen.
$500 Question from H5
You have a patient that you
cannot figure out if she has a viable,
however early, pregnancy versus
a missed ab versus an ectopic. Who
do you call???
$500 Answer from H5
Call Larry Leeman, or if unavailable
can call the reproductive health MD
on call.
Final Jeopardy
The prevelance of an ectopic
Pregnancy in women going to
the ER for first trimester
bleeding is…???
Final Jeopardy Answer
6-16%