SESSION 1

Case 1

APGO OBJECTIVE # 16  Ectopic Pregnancy

A 25 y/o G2P2002 with an LMP 6 weeks ago presents to the ER with vaginal bleeding and RLQ pain.  Her history is significant for Chlamydia.  What is the differential diagnosis?  How would you make the diagnosis and manage an ectopic pregnancy?  The pregnancy is highly desired.

RATIONALE:  Ectopic pregnancy is a leading cause of maternal morbidity and mortality in the United States.  Early diagnosis and management may not only save lives, but may also preserve future fertility.

The student will be able to:

A.        Develop a differential diagnosis of first trimester bleeding

B.         List risk factors predisposing patients to ectopic pregnancy

C.        Describe symptoms and physical findings suggestive of ectopic pregnancy

D.        Understand methods and tests used to confirm the diagnosis of ectopic pregnancy

E.         Explain treatment options

SESSION 1

Case 2

APGO OBJECTIVE #17  Spontaneous Abortion

A 35 y/o G1 at 8 weeks EGA presents to your office for her first prenatal visit complaining of vaginal bleeding and abdominal pain.  Speculum exam reveals a closed cervix with blood at the os.  How would you rule out a miscarriage and manage the pregnancy?

RATIONALE:  Bleeding is common in early pregnancy.  A logical approach to its evaluation may not only affect the outcome of the pregnancy, but also will help to reassure the patient.

The student will be able to:

A.        Develop a differential diagnosis for the first-trimester bleeding

B.         Distinguish the types of spontaneous abortion

C.        Define recurrent abortion

D.        Recognize the signs of a missed abortion

E.         List complications of spontaneous abortion

F.         List causes and complications of septic abortion