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NBME 17 Answers

nbme17/Block 4/Question#10 (7.6 difficulty score)
A 32-year-old woman, gravida 2, para 1, at 7 ...
Ectopic pregnancyπŸ”

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submitted by bingcentipede(219),

There are a lot of hints in the stem to suggest ectopic pregnancy:

-Severely increased B-hCG (meaning there is a pregnancy of some type, versus none in normal women) -lower quadrant pain (either side; why appendicitis is on the differential diagnosis if it's right side) (probably the strongest hint here) -Empty uterus on ultrasound -Sudden onset abdominal pain

passplease  ectopic pregnancy presents with a lower-than expected rise in hcg (as seen in this question) +2  
passplease  the empty uterus is what helped me differentiate. A molar pregnancy should have an enlarged uterus. +2