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Ruptured ectopic pregnancy — ABEM Board MCQ

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HardOB/GYN emergenciesRuptured ectopic pregnancyABEM Board

A 28-year-old woman presents as triage level 2 with lower abdominal pain and light vaginal bleeding. Last menstrual period was 7 weeks ago. BP is 98/60 mm Hg, beta-hCG is 2,800 mIU/mL, and transvaginal ultrasound shows no intrauterine pregnancy and moderate free fluid. Which of the following is the most likely diagnosis?

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

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Correct answer: D — Ruptured ectopic pregnancy

Pregnancy of unknown location above the discriminatory zone with free fluid and hemodynamic symptoms is concerning for ruptured ectopic pregnancy.

Reference: ACOG ectopic pregnancy guidance; ABEM EM Model