A 31-year-old woman presents with two days of right iliac fossa pain and light vaginal spotting. Her last menstrual period was six weeks ago and a home pregnancy test is positive. Her pulse is 82/min and blood pressure 118/76 mmHg, and there is mild right iliac fossa tenderness without guarding. Transvaginal ultrasound shows an endometrial thickness of 13 mm with no gestational sac, a 25 mm inhomogeneous mass adjacent to but separate from the right ovary, and a trace of free fluid in the pouch of Douglas. Serum beta-hCG is 3400 IU/L. Which one of the following is the most likely diagnosis?
Keep going — a set of ten like this one, one at a time.
Practise moreMore from Obstetrics and Gynaecology
See allA 32-year-old woman attends for the result of her first cervical screening test under the renewed National Cervical Screening Program. She is asymptomatic and h…
Clinical rotations · common
A 24-year-old woman with seven weeks of amenorrhoea and a positive home pregnancy test presents with two days of left-sided lower abdominal pain and light vagin…
Pre-internship · middle twist
A 34-year-old woman at 33 weeks in her third pregnancy, who smokes and has chronic hypertension, presents with two hours of constant severe abdominal pain that…
Pre-internship · middle twist
A 31-year-old woman in her first pregnancy presents at 36 weeks with a frontal headache and "flashing lights" for six hours. Her blood pressure was 11…
Pre-internship · common
A 32-year-old woman shares a bedroom with her partner, who has been admitted with laboratory-confirmed meningococcal meningitis. She has no fever or rash and fe…
Clinical rotations · middle twist