Ectopic Pregnancy

EM Clerkship

Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD

Education, Science, Life Sciences, Courses, Health & Fitness, Medicine

5 • 795 Ratings

🗓️ 14 July 2019

⏱️ 16 minutes

🔗️ Recording | iTunes | RSS

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Summary

All women of childbearing age who present with abdominal pain need a pregnancy test a core teaching of EMergency medicine Ectopic pregnancy is the leading cause of maternal death in the first trimester History Abdominal pain present in 90% of cases Amenorrhea present in 70% of cases Vaginal bleeding present in 50% of cases The […]

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0:00.0	Hello, med students.
0:02.0	My name is Zach Olson, and thank you for downloading this week's episode of the EM Clerkship
0:08.0	podcast.
0:10.0	All right.
0:11.0	So we have covered the quadrant-based diagnoses, appendicitis, diverticulitis, biliary,
0:17.1	and pancreatitis.
0:18.4	We've covered our bowelis, bowel obstruction, bottle o'schemia,
0:22.0	bowel perforations, and bowel twisting, volvillus, volvili. This week is a big, big transition
0:29.6	on your differential because we are moving beyond GI causes of abdominal pain to another
0:36.1	big category, GU, genitoneary causes of abdominal pain to another big category,
0:41.5	GU, genitoneurinary causes of abdominal pain.
0:44.4	Still, critical diagnoses can't miss.
0:48.5	All is on your CDM fourth year recommended curriculum, so let's go.
0:50.2	Hello, Dr. Olson.
0:56.7	I have a 35-year-old female with no surgical history and no significant past medical history who presents with abdominal pain. She describes it as a continuous, suddenly worsening, lower
1:03.6	abdominal pain, and it's been worsening for about three days. She has had some vaginal
1:07.8	spotting. She denies fever, vomiting, vaginal discharge, stool changes, urinary symptoms, or any other symptoms at this time.
1:15.0	She is a febrile.
1:16.3	She doesn't have any tachycardia.
1:18.3	Vital signs are within normal limits.
1:19.9	On exam, she has moderate tenderness of the right lower quadrant with some voluntary guarding, but no involuntary guarding, no rebound.
1:28.5	I think it might be an ovarian cystic, actually, but we obviously have to rule out appendicitis,
	...

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