Pregnancy Loss And Ectopic Pregnancy 1 Jeopardy Template

Epidemiology	Etiology/ Risk Factors	Work up	Medication management	Surgical Management
100 What is 10% Pregnancy loss occurs in ___ % of all recognized pregnancy	100 What is - Hx of Ectopic, - Tubal Damage - PID - Prior Pelvic tubal surgery - Tubal factor infertility - Multiple embryo transfers - Tobacco use - Age > 35 Name 3 risk factors for ectopic pregnancy	100 What is - Subchorionic hemorrhage - Slow fetal heart rate ___ has been associated with early pregnancy loss but not used to make a definitive diagnosis	100 What is - Methotrexate 50mg/m^2 IM. It is a folate antagonist! binds to the catalytic site of dihydrofolate reductase, interrupts the synthesis of purine nucleotides and the amino acids serine and methionine, thereby inhibiting DNA synthesis and repair and cell replication Medication for management of tubal ectopic pregnancy with dosing, and mechanism of action:	100 What is Hemodynamic instability! Reason to proceed to OR, DO NOT PASS GO, for patient with positive pregnancy test
200 What is 80% Approximately ___ % of all cases of pregnancy loss occurs in 1st trimester	200 What is - AMA - Prior pregnancy loss Name 2 risk factors for pregnancy loss	200 What is - Mass with hypoechoic area separate from the ovary, pseuodogestational sac - Definitive: GS with YS or embryo in adnexa What are suspicious findings for ectopic on Transvaginal Ultrasound	200 What is 800mcg What is the dose of misoprostol is used for early pregnancy loss	200 What is Doxycycline 200mg 1 hour before surgery What medication and dosage should you give prior to Suction curettage for early pregnancy loss?
300 What is 2% Ectopic pregnancy represents __% of all reported pregnancies	300 What is Ampulla Most common site of tubal ectopic pregnancy? Please draw on the board and label parts of tube!	300 What is - CRL of < 7mm and no heart beat - Mean sac diameter of 16-24 mm and no embryo - Absence of embryo with heartbeat 7-13 days after a scan that showed GS without a yolk sac - Absence of embryo with heart beat 7-10 day after a scan that showed a GS without a yolk sac - Absence of embryo for 6weeks or longer after LMP - Empty amnion (amnion seen adjacent to yolk sac, with no visible embryo) Enlarged yolk sac (> than 7mm) - Small gestational sac in relation to size of the embryo (less than 5mm difference between MSD and CRL Name 2 of the suspicious findings but not diagnostic of pregnancy failure	300 What is 200mg Oral What dose of mifeprostone can be used 24 hours before misoprsotol	300 what is Immediate completion Less follow up More predictable and faster complete evacuation If in office less costly than medical management Name 2 benefits of surgical management of Early pregnancy loss
400 What is Fallopian tube! 90%. Where is the most common site of ectopic pregnancies? And what percent of ectopic pregnancies are found here?	400 What is 50% ___ % of pregnancy loss comes from fetal chromosomal abnormalities	400 What is - CRL of 7mm or greater and no heartbeat - Mean sac diameter of 25mm or greater and no embryo -Absence of embryo with heartbeat 2 weeks of more after a scan that showed a gestational sac without a yolk sac - Absence of embryo with heartbeat 11days or more after a scan that showed a gestational sac with a yolk sac Name 2 of the diagnostic factors for pregnancy failure	400 What is Gastrointestinal (eg, nausea, vomiting, and stomatitis), mucosal/skin, abdominal pain, elevation of liver enzymes, alopecia, pneumonitis What are 4 potential side effects of methotrexate?	400 What is - High/increased BCHG values, cardiac activity What two findings make you more suspicious of medical management failure and might make you more inclined to suggest surgical management?
500 What is 2.7% Ectopic pregnancy represents __% of all pregnancy related deaths	500 What is 53% ___ % of pregnancies that occur with IUD in place are ectopic	500 What is Normal: depends on BhCG starting level <1500, inc 49% 1500-3000 33% >3000 33% EPL: 95% of women with decrease of 21-35% in 48hrs How do you expect the BhCG level to change over 48hrs in normal pregnancy, or decrease in EPL?	500 What is: Absolute: concern for poor follow up, rupture, hemodynamic, Intrauterine pregnancy, Evidence of immunodeficiency, Moderate to severe anemia, leukopenia, or thrombocytopenia, active pulm or peptic ulcer dx, clinically important hepatic or renal dysfunction, breastfeeding, Relative: BhCG > 5000, cardiac activity, size >4cm, refusal to accept blood transfusion Name 4 absolute contraindications and 2 relative contraindications for MTX	500 What is If the contralateral tube is gone/damaged and patient desires future fertility When might you recommend salpingostomy vs salpingectomy?

Pregnancy Loss and Ectopic Pregnancy

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