CASE 50
History: A 31-year-old woman presents with pelvic pain and vaginal bleeding and beta-human chorionic gonadotropin (HCG) of 4400 mIU/mL. She is 7 weeks pregnant based on menstrual history.
1. What should be included in the differential diagnosis for a woman with a positive beta-HCG and the image shown in Figure A? (Choose all that apply.)
A. Very early intrauterine pregnancy
B. Decidual reaction of an ectopic pregnancy
D. Normal intrauterine pregnancy of at least 5 weeks’ gestational age
2. What is the diagnosis for this patient with a positive beta-hCG based on evaluation of the ultrasound images?
C. Normal intrauterine pregnancy
D. Nonruptured ectopic pregnancy
3. How early does trophoblastic tissue produce beta-hCG?
A. Day 1
B. Day 8
C. Day 60
D. Day 90
4. What are the ultrasound findings after methotrexate therapy to treat an ectopic pregnancy?
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