02-20-2008, 06:20 PM
A 30-year old woman has irregular menses. She reports that her last menstrual period (LMP) was 8 weeks ago. She has been experiencing vaginal spotting and left lower quadrant pain. She is afebrile. She has a normal size uterus and mild tenderness in the right lower quadrant with no rebound tenderness. A human chorionic gonadotropin (hCG) beta-subunit level of 1400 mIU/ml is reported in her records from an obstetrics visit 2 days ago. Which of the following is the appropriate management?
A. Perform a pelvis ultrasound
B. Perform a culdocentesis
C. Repeat hCG measurement in 1 week
D. Repeat hCG measurement in 24 hours
E. Refer for diagnostic laparoscopy
A. Perform a pelvis ultrasound
B. Perform a culdocentesis
C. Repeat hCG measurement in 1 week
D. Repeat hCG measurement in 24 hours
E. Refer for diagnostic laparoscopy