🏥 USMLE Exam Prep

A 25-year-old woman presents with persistent lower abdominal pain, abnormal vaginal bleeding, and a positive urine pregnancy test. Her last menstrual period was 8 weeks ago. Transvaginal ultrasound shows an empty uterus and a complex adnexal mass. Her serum beta-hCG level is 3,000 mIU/mL. What is the most appropriate next step in management?

A Expectant management with close follow-up of beta-hCG levels
B Administer methotrexate intramuscularly
C Perform a dilation and curettage (D&C)
D Schedule an immediate diagnostic laparoscopy

✓ Correct Answer: Option B

This patient has a suspected ectopic pregnancy. Given the stable vitals, beta-hCG of 3,000, empty uterus, and adnexal mass, methotrexate is the most appropriate initial medical management for an unruptured ectopic pregnancy.

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