Ectopic pregnancy


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Ectopic pregnancy

Reproductive system

Male and female reproductive system disorders

Precocious puberty

Delayed puberty

Klinefelter syndrome

Turner syndrome

Androgen insensitivity syndrome

5-alpha-reductase deficiency

Kallmann syndrome

Male reproductive system disorders

Hypospadias and epispadias

Bladder exstrophy


Penile cancer


Benign prostatic hyperplasia

Prostate cancer


Inguinal hernia




Testicular torsion

Testicular cancer

Erectile dysfunction

Male hypoactive sexual desire disorder

Female reproductive system disorders


Ovarian cyst

Premature ovarian failure

Polycystic ovary syndrome

Ovarian torsion

Krukenberg tumor

Sex cord-gonadal stromal tumor

Surface epithelial-stromal tumor

Germ cell ovarian tumor

Uterine fibroid



Endometrial hyperplasia

Endometrial cancer


Cervical cancer

Pelvic inflammatory disease


Female sexual interest and arousal disorder

Orgasmic dysfunction

Genito-pelvic pain and penetration disorder


Fibrocystic breast changes

Intraductal papilloma

Phyllodes tumor

Paget disease of the breast

Breast cancer

Hyperemesis gravidarum

Gestational hypertension

Preeclampsia & eclampsia

Gestational diabetes

Cervical incompetence

Placenta previa

Placenta accreta

Placental abruption



Potter sequence

Intrauterine growth restriction

Preterm labor

Postpartum hemorrhage


Congenital toxoplasmosis

Congenital cytomegalovirus (NORD)

Congenital syphilis

Neonatal conjunctivitis

Neonatal herpes simplex

Congenital rubella syndrome

Neonatal sepsis

Neonatal meningitis


Gestational trophoblastic disease

Ectopic pregnancy

Fetal hydantoin syndrome

Fetal alcohol syndrome

Reproductive system pathology review

Disorders of sex chromosomes: Pathology review

Prostate disorders and cancer: Pathology review

Testicular tumors: Pathology review

Uterine disorders: Pathology review

Ovarian cysts and tumors: Pathology review

Cervical cancer: Pathology review

Vaginal and vulvar disorders: Pathology review

Benign breast conditions: Pathology review

Breast cancer: Pathology review

Complications during pregnancy: Pathology review

Congenital TORCH infections: Pathology review

Disorders of sexual development and sex hormones: Pathology review

Amenorrhea: Pathology Review

Testicular and scrotal conditions: Pathology review

Sexually transmitted infections: Warts and ulcers: Pathology review

Sexually transmitted infections: Vaginitis and cervicitis: Pathology review

HIV and AIDS: Pathology review

Penile conditions: Pathology review


Ectopic pregnancy


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USMLE® Step 1 questions

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High Yield Notes

9 pages


Ectopic pregnancy

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USMLE® Step 1 style questions USMLE

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A 25-year-old woman comes to the office due to vaginal bleeding and abdominal pain for the past 2 days. The patient’s last menstrual cycle was 6 weeks ago. She is sexually active with her male partner of 2 years, and they have been using the withdrawal method as contraception. Medical history is unremarkable other than an episode of pelvic pain 2 years ago that resolved spontaneously without treatment. Temperature is 37.0°C (98.6°F), pulse is 80/min, and blood pressure is 135/85 mmHg. Serum hCG is positive, measuring 1200 mIU/mL. Transvaginal ultrasound shows an empty, normal-appearing uterus and no other abnormalities. Physical examination shows mild lower right adnexal tenderness but is otherwise unremarkable. Which of the following is the underlying cause of this patient’s presentation?

External References

First Aid








Abdominal pain

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appendicitis differential diagnosis p. 392

Chlamydia trachomatis p. , 147

hCG in p. 658

Kartagener syndrome p. 47

methotrexate for p. 448

salpingitis and p. 182


ectopic pregnancy p. NaN


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Pelvic inflammatory disease (PID) p. 182

ectopic pregnancy p. 666


ectopic pregnancy and p. NaN


Content Reviewers

Rishi Desai, MD, MPH


Kaia Chessen, MScBMC

Charles Davis, MD

Evan Debevec-McKenney

Tanner Marshall, MS

In ectopic pregnancy, ectopic means “out of place,” so an ectopic pregnancy means that a pregnancy occurs somewhere other than in the uterine cavity.

In order for an ectopic pregnancy to take place, a couple of things need to happen differently from the normal process of a pregnancy.

First, following ovulation, the egg must be fertilized and come to rest somewhere other than the endometrium of the uterine cavity.

Next, when it arrives at this destination, it must implant on a surface with a rich enough blood supply to support a developing embryo.

Ectopic pregnancies have been known to occur on various surfaces, including the ovaries, intestines, and most commonly, in the ampulla of the Fallopian tube.

After implantation, the embryo begins developing and growing just like it would in a normal pregnancy.

Over time, a few different things can happen. Sometimes the tissue can no longer provide a sufficient blood supply for the embryo, leading to its death.

On the other hand, if the tissue can supply the embryo with sufficient blood, then hormones from the corpus luteum and placenta can lead to a missed menstrual period and other body changes like nausea and fullness of breasts, which are typically seen in early pregnancy.

If the ectopic pregnancy occurs in the ampulla of the fallopian tube, it eventually runs out of space.

Slowly the ectopic pregnancy stretches the nerve fibers within the wall of the fallopian tube, causing lower abdominal pain.

Eventually, the expansion causes damage to the wall of the ampulla, potentially rupturing the fallopian tube.

A ruptured ectopic can also lead to massive hemorrhaging into the abdominal cavity, and the blood can irritate the peritoneum which can cause referred pain to the shoulder.


  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Does This Woman Have an Ectopic Pregnancy?" JAMA (2013)
  6. "Diagnosing ectopic pregnancy and current concepts in the management of pregnancy of unknown location" Human Reproduction Update (2013)
  7. "Ectopic pregnancy" The Lancet (2005)

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