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Haemorrhoids Management — MRCGP AKT MCQ

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HardGastroenterologyHaemorrhoids ManagementMRCGP AKTUKMLAPARA

A haemodynamically stable woman has a 28-mm unruptured tubal ectopic pregnancy with no fetal heartbeat, no significant pain and serum hCG 3,200 IU/L. She can return reliably for follow-up and has no methotrexate contraindication. Which treatment discussion follows NICE guidance?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Offer a choice of methotrexate or surgery after counselling

Explanation lettering: D = shown as B · E = shown as D · B = shown as E

E is correct. With hCG from 1,500 to below 5,000 IU/L, no significant pain, an unruptured mass below 35 mm, no visible fetal heartbeat and reliable follow-up, NICE advises offering a choice of methotrexate or surgery after discussing benefits and risks. A is not the sole option at this hCG. B removes a valid choice. C treats 1,500 as a mandatory surgical threshold. D selects an operation without the fertility and contralateral-tube discussion.

Reference: NICE NG126: ectopic pregnancy recommendations: https://www.nice.org.uk/guidance/ng126/chapter/Recommendations GMC: PA registration assessment content map: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/pa-and-aa-prequalification-education-framework/pa-registration-assessment-content-map