ECTOPIC PREGNANCY: QUESTIONS AND ANSWERS
LATEST UPDATE (GRADED A+)
Culdocentesis
______ is employed to detect blood in the cul-de-sac
bleeding from an unruptured or ruptured tubal pregnancy orrrrrr a ruptured ovarian cyst
on culdocentesis what could blood in the cul-de-sac indicate?
Tranvaginal ultrasound
however, culdocentesis is only done if you want to be fancy.,,, findings of tubal or ovarian bleeding are
easily be demonstrated on?
Methotrexate (MTX)
medical treatment for ectopic pregnancy?
laparoscopy, exploratory laparotomy, salpingectomy/salpingostomy
surgical treatment for ectopic pregnancy?
dihydrofolate reductase
Methotrexate is an antimetabolite the binds to the catalytic site of _______
of purine nucleotides and the amino acids serine and methonine thus inhibiting DNA synthesis, repair,
and cell replication
because MTX binds to the catalytic site of dihydrofolate reductase, it interrupts the synthesis of what?
bone marrow, buccal and intestinal mucosa, respiratory epithelium, malignant cells, and trophoblastic
tissue
Methotrexate affects actively proliferating tissues such as?
gestational trophoblastic disease, ectopic pregnancy
systemic methotrexate has been used to treat _______ since 1956 and first used to treat _________ in
1982
71.2% to 94.2%
the overall success for treatment of ectopic pregnancy using systemic methotrexate in observational
studies ranges from ____ to ____
treatment regimen used, gestational age, and hCG level
success of MTX depends on?
folic acid
, MTX is a _______ antagonist.
it inhibits DNA synthesis and cell reproduction, primarily in actively proliferating cells such as
malignant cells, trophoblasts, and fetal cells
because MTX is a folic acid antagonist, what dies it inhbit?
relatively low (50 mg/m2 or 1 mg/kg)
the dose of MTX used to treat ectopic pregnancy is ______.
malignancies
high dose MTX (>500 mg/m2) is used to treat some ______.
-hemodynamically stable
-patient that is willing and able to comply with posttreatment follow-up
-BHCG<5000 mlU/mL
-no fetal cardiac activity
-ectopic mass size less than 3 to 4 cm
optimal candidates for MTX therapy?
-breastfeeding
-overt or lab evidence of immunodeficiency
-alcoholism, alcoholic liver dz, chronic liver dz
-preexisting blood dyscrasias such as bone marrow hypoplasia, leukopenia, thrombocytopenia, or
significant anemia
-known sensitivity to MTX
-active pulmonary dz
-peptic ulcer dz
-hepatic, renal or hematologic dysfunction
what are absolute contraindications for MTX?
-hemodynamic instability
-impending or ongoing rupture of ectopic mass
LATEST UPDATE (GRADED A+)
Culdocentesis
______ is employed to detect blood in the cul-de-sac
bleeding from an unruptured or ruptured tubal pregnancy orrrrrr a ruptured ovarian cyst
on culdocentesis what could blood in the cul-de-sac indicate?
Tranvaginal ultrasound
however, culdocentesis is only done if you want to be fancy.,,, findings of tubal or ovarian bleeding are
easily be demonstrated on?
Methotrexate (MTX)
medical treatment for ectopic pregnancy?
laparoscopy, exploratory laparotomy, salpingectomy/salpingostomy
surgical treatment for ectopic pregnancy?
dihydrofolate reductase
Methotrexate is an antimetabolite the binds to the catalytic site of _______
of purine nucleotides and the amino acids serine and methonine thus inhibiting DNA synthesis, repair,
and cell replication
because MTX binds to the catalytic site of dihydrofolate reductase, it interrupts the synthesis of what?
bone marrow, buccal and intestinal mucosa, respiratory epithelium, malignant cells, and trophoblastic
tissue
Methotrexate affects actively proliferating tissues such as?
gestational trophoblastic disease, ectopic pregnancy
systemic methotrexate has been used to treat _______ since 1956 and first used to treat _________ in
1982
71.2% to 94.2%
the overall success for treatment of ectopic pregnancy using systemic methotrexate in observational
studies ranges from ____ to ____
treatment regimen used, gestational age, and hCG level
success of MTX depends on?
folic acid
, MTX is a _______ antagonist.
it inhibits DNA synthesis and cell reproduction, primarily in actively proliferating cells such as
malignant cells, trophoblasts, and fetal cells
because MTX is a folic acid antagonist, what dies it inhbit?
relatively low (50 mg/m2 or 1 mg/kg)
the dose of MTX used to treat ectopic pregnancy is ______.
malignancies
high dose MTX (>500 mg/m2) is used to treat some ______.
-hemodynamically stable
-patient that is willing and able to comply with posttreatment follow-up
-BHCG<5000 mlU/mL
-no fetal cardiac activity
-ectopic mass size less than 3 to 4 cm
optimal candidates for MTX therapy?
-breastfeeding
-overt or lab evidence of immunodeficiency
-alcoholism, alcoholic liver dz, chronic liver dz
-preexisting blood dyscrasias such as bone marrow hypoplasia, leukopenia, thrombocytopenia, or
significant anemia
-known sensitivity to MTX
-active pulmonary dz
-peptic ulcer dz
-hepatic, renal or hematologic dysfunction
what are absolute contraindications for MTX?
-hemodynamic instability
-impending or ongoing rupture of ectopic mass
