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NEET PG / USMLE – MCQ 17

15 August 2011 25 Comments

A 25-year-old woman is brought to the emergency department 1 hour after she fainted. She has had mild intermittent vaginal bleeding,sometimes associated with lower abdominal pain, during the past 3 days. She has had severe cramping pain in the right lower abdomen for 12 hours. She has not had a menstrual period for 3 months; previously, menses occurred at regular 28-day intervals. Abdominal examination shows mild tenderness to palpation in the right lower quadrant. Bimanual pelvic examination shows a tender walnut-sized mass in the right parametrium. Which of the following is the most likely diagnosis?
A. Appendicitis
B. Cancer of the ovary
C. Ectopic pregnancy
D. Endometriosis
E. Ovarian cyst
F. Placenta previa

Correct answer : C. Ectopic pregnancy

The history is typical of ruptured ectopic pregnancy. Excluding other options:
-Appendicitis and endometriosis does not cause amenorrhoea
-Torsion of ovarian cyst / tumour in pregnancy can present as a case of acute abodomen, but does not cause bleeding
-Placenta previa causes painless vaginal bleeding

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25 Comments »

  • Mansingh parihar said:

    Ruptured ovarian cyst?

    # 15 August 2011 at 4:53 pm
  • Priyanka Bhagde said:

    C. Ectopic pregnancy

    # 15 August 2011 at 4:54 pm
  • Kartick said:

    Ectopic pregnancy

    # 15 August 2011 at 4:57 pm
  • Dr vaibhav said:

    ectopic pregnancy

    # 15 August 2011 at 5:01 pm
  • Shrikant said:

    C)Ectopic pregnancy

    # 15 August 2011 at 5:21 pm
  • umesh said:

    E.Ovarian cyst.

    # 15 August 2011 at 6:25 pm
  • neethukgowda said:

    ectopic pregnancy

    # 15 August 2011 at 8:58 pm
  • kalpesh said:

    Ectopic pregnancy

    # 15 August 2011 at 11:13 pm
  • Lakshmi said:

    C .ectopic pregnancy

    # 15 August 2011 at 11:18 pm
  • ramya said:

    the ans should be ectopic pregnancy given the profile but marital status not mentioned n d also torsion ovarian cyst is a possibility but im not sure wether it presents with amenorrohea but polymenorrohea can be present.

    # 15 August 2011 at 11:32 pm
  • PRI said:

    ectopic pregnancy

    # 15 August 2011 at 11:33 pm
  • Ashwin said:

    Ectopic Pregnancy

    # 15 August 2011 at 11:35 pm
  • 86 said:

    ectopic pregnancy

    # 15 August 2011 at 11:39 pm
  • anon said:

    Ruptured Ectopic pregnancy, option c.

    # 16 August 2011 at 12:06 am
  • Dr.rahul said:

    Ectopic pregnancy>endometriosis

    # 16 August 2011 at 1:00 am
  • gunjan said:

    c

    # 16 August 2011 at 1:28 am
  • Shivam said:

    Ectopic pregnancy

    # 16 August 2011 at 7:24 am
  • chintan patel said:

    C

    # 16 August 2011 at 8:32 am
  • Pooja said:

    ectopic pregnancy

    # 16 August 2011 at 9:30 am
  • pearl said:

    ectopic preg?

    # 16 August 2011 at 9:49 am
  • vijay said:

    E .ovarian cyst

    # 16 August 2011 at 11:08 am
  • DR JASEENA KM said:

    ectopic pregnancy

    # 16 August 2011 at 12:50 pm
  • DR PAWAN JHALTA said:

    this is is a case of ectopic pregnancy as there is amn for 3 months and classical features

    # 16 August 2011 at 1:31 pm
  • Vasudha said:

    Definitely Ruptured ectopic

    # 23 August 2011 at 4:45 pm
  • nishchint said:

    c.ectopic pregnancy only

    # 14 November 2011 at 1:39 am

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