416.A 30-year-old woman with no prior pregnancies presents to the ED
with diffuse pelvic pain and vaginal spotting. The following transvaginal
ultrasound is performed and shown below. What is the minimum β-hCG
level needed to obtain this sonographic image?
448 Emergency Medicine
a. 1000 mIU/mL
b. 950 mIU/mL
c. 1500 mIU/mL
d. 4000 mIU/mL
e. 6500 mIU/mL
417.A 32-year-old G2P1001 presents to the ED with severe abdominal
pain and vaginal bleeding. She reports that she is currently in her third
trimester and that she has been diagnosed and treated for preeclampsia. Her
vitals are significant for a BP of 195/100 mm Hg. Upon physical examination,
her abdomen is distended and hard to the touch. Given this patient’s history
and physical examination, what emergent intervention is most appropriate?
a. Ultrasound
b. Pelvic examination
c. Tocolytics
d. Blood transfusion
e. Maternal/fetal monitoring with possible delivery
(Reproduced, with permission, from Knoop KJ, Stack LB, Storrow AB. Atlas of Emergency Med-
icine. New York, NY: McGraw-Hill, 2002: 645.) (Courtesy of Michael J. Lambert, MD, RDMS.)