Vaginal Bleeding 447414.A 22-year-old woman presents to the ED with vaginal bleeding that
began earlier in the day. She reports that her last menstrual period was 3 weeks
ago. She denies any metromenorrhagia in the past. Upon physical examination,
her cervical os is closed with clots in the posterior vaginal vault. There is no
adnexal or cervical motion tenderness. She has mild abdominal cramps but
no localizing pain. Her pregnancy test is negative. Given this patient’s clinical
presentation, what is the most likely diagnosis?
a. Threatened abortion
b. Normal menstrual flow
c. Ectopic pregnancy
d. Dysfunctional uterine bleeding
e. PID
415.A 26-year-old G1P1001 presents to the ED with vaginal spotting for the
last 3 days with occasional left-sided pelvic pain. Her physical examination
includes a closed cervical os, scant blood within the vaginal vault withleft
adnexal tenderness. Given this patient’s history and physical examination,
you suspect an ectopic pregnancy. In addition to a quantitative β-hCG,
which of the following laboratory tests may prove helpful in the evaluation
of this patient?
a. Estrogen level
b. Follicle-stimulating hormone (FSH) level
c. Thyrotropin (TSH) level
d. Progesterone level
e. CBC