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Ectopic pregnancy — MCCQE Part 1 MCQ

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HardPelvic PainEctopic pregnancyMCCQE Part 1

A 29-year-old woman presents with right pelvic pain and light vaginal bleeding. Her last menstrual period was 7 weeks ago, blood pressure is 108/68 mmHg, and cervical motion tenderness is present. Urine pregnancy test is positive, beta-hCG is 1850 IU/L, and transvaginal ultrasound shows no intrauterine pregnancy. What is the most appropriate investigation?

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

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Correct answer: E — Urgent gynaecology assessment with repeat quantitative beta-hCG and transvaginal ultrasound pathway

Pregnancy with pelvic pain, bleeding and no intrauterine pregnancy at this beta-hCG level is a pregnancy of unknown location with ectopic pregnancy risk, requiring urgent gynaecology-directed follow-up and repeat testing. Reassurance is unsafe because ectopic pregnancy can rupture. Contraception or UTI treatment does not address the immediate risk.

Reference: SOGC ectopic pregnancy guidance