Approach to first trimester bleeding Quiz: Ace Your Exams
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A 26-year-old woman, G2P1, presents to the emergency department with progressive, right sided, lower abdominal pain for the past 18 hours and light vaginal spotting. The pain is sharp and intermittent. She does not have fever, chills, diarrhea, dysuria, dizziness, or shoulder pain. She has had mild nausea without vomiting for the past two weeks. Her last menstrual period was seven weeks ago. She is sexually active with one male partner without the use of contraception. Past surgical history is significant for appendectomy at age 10. She had one vaginal delivery two years ago and was treated for a chlamydia infection three years ago. Vital signs are within normal limits. Abdominal examination shows tenderness in the right lower quadrant without rebound or guarding. Pelvic examination reveals a 6 cm uterus, right adnexal fullness without a discrete mass, and cervical motion tenderness. Qualitative hCG is positive. Which of the following would most likely be seen with serial quantitative hCG testing?
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