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A 25-Year-Old Woman Was Seen in the Emergency Department Complaining

Question 2

Multiple Choice

A 25-year-old woman was seen in the emergency department complaining of severe pain in the right iliac region. Just before admission she had fainted. On physical examination, her abdominal wall was extremely tender on palpation in the lower right quadrant, and some rigidity and guarding of the lower abdominal muscles were noticed. A vaginal examination revealed a rather soft cervix with a circular external os. A tender "dough-like" mass could be felt through the posterior fornix. The patient had missed her last period.
-The following statements concerning this patient are correct except which?


A) A diagnosis of ruptured ectopic pregnancy was made.
B) Tubal pregnancies commonly occur where the ampulla narrows to join the isthmus.
C) Each uterine tube is situated in the base of the broad ligament.
D) An ectopic tubal pregnancy almost invariably results in rupture of the tube with severe intraperitoneal hemorrhage.
E) Tubal rupture occurs as a result of the eroding action of the trophoblast.
F) Once a tubal pregnancy dies the decidual lining of the uterus begins to be shed because of lack of hormonal support, and this causes vaginal bleeding.
G) The dough-like mass is produced by the accumulation of blood in the pouch of Douglas.

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