Pick your poison
Is she even pregnant?
Tube it or loose it
They try to give me MTX, but I say no no no
Set it and forget it
100
How much should the HCG drop between day 4 and 7 after giving MTX?
15%
100
What HCG level is commonly considered the discriminatory zone?
3,500
100
Name the portions of the fallopian tube
Isthmus, ampulla, infundibulum
100
What 4 labs MUST you check prior to giving MTX
CBC
CMP
T&S
HCG
100
How long is the Mirena approved for for contraception?
8 years
200
How long should a woman wait to get pregnant after receiving MTX?
3 months
200
How soon should you repeat an HCG when someone has a PUL?
48h
200
What type of patient should have a salpingostomy?
Women who want future fertility and have a damaged contralateral tube
200
A ___ cm in size ectopic is a relative contraindication to MTX
4cm
200
What is the failure rate of the Mirena?
0.2%
300
What is the mechanism of action of MTX
folate antagonist
300
This type of pregnancy is in both the uterus AND the tube
Heterotopic
300
What is the name of the US finding that denotes hypervascularity around an adnexal mass?
Ring of Fire
300
Name THREE absolute contraindications to MTX
IUP
Immunodeficiency
Severe anemia, leukopenia, thrombocytopenia
Sensitivity to MTX
Active pulmonary disease
Active peptic ulcer disease
Liver disease
Renal disease
Breastfeeding
Ruptured ectopic
Hemodynamically unstable pt
Inability to follow up
300
What is the failure rate of the Paragard?
1-2%
400
What is the dose of MTX given on day 1 of the single dose regimen and two dose regimen
50mg/m2
400
If the initial HCG is > ____ you may want to think twice about giving MTX
**Hint- this is a relative contraindication to MTX
5,000
400
This US finding may be seen in the uterus in the setting of an ectopic. It sometimes confuses the picture that an IUP is forming
Double sac sign
400
Name TWO relative contraindications to MTX
Embryonic cardiac activity
HCG >5,000
Ectopic >4cm
Refusal to accept blood transfusion
400
What is the failure rate of nexplanon?
0.02%
500
How do you dose BOTH MTX and folinic acid in the fixed multiple-dose regimen
MTX 1mg/kg
Folinic acid 0.1 mg/kg
500
What is the risk of a recurrent ectopic if you have had one before??
What if you have had two??
10%
25%
500
When performing a salpingostomy, what can you inject into the tube to help prevent bleeding?
vasopressin
500
DOUBLE JEOPARDY
What animal has no nipples and feeds its offspring with milk that "oozes" through it's skin
Duck billed platypus
500
How much progesterone is in the Mirena?
52mg