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Ectopic pregnancy — MCCQE Part 1 MCQ

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HardPelvic PainEctopic pregnancyMCCQE Part 1

A 28-year-old woman presents with 7 weeks of amenorrhoea, vaginal spotting, and left pelvic pain. BP is 105/68 mmHg, pulse 98/min, beta-hCG is 1800 IU/L, and transvaginal ultrasound shows no intrauterine pregnancy with a left adnexal mass. What is the most likely diagnosis?

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Correct answer: C — Ectopic pregnancy

Positive pregnancy test, pelvic pain, bleeding, no intrauterine pregnancy, and an adnexal mass are most consistent with ectopic pregnancy. Threatened miscarriage would usually have an intrauterine pregnancy at the appropriate discriminatory context. PID and ovarian cyst can cause pain but do not explain the pregnancy-related ultrasound pattern. Ectopic pregnancy requires urgent gynaecology involvement because rupture can be catastrophic.

Reference: SOGC ectopic pregnancy guidance