🏥 USMLE Exam Prep

A 28-year-old woman, 6 weeks amenorrheic, presents with sudden onset unilateral lower abdominal pain and vaginal spotting. Her last menstrual period was 6 weeks ago. Her blood pressure is 90/60 mmHg, heart rate 105 bpm. A urine pregnancy test is positive. What is the most appropriate next diagnostic step?

A Pelvic ultrasound
B Quantitative beta-hCG
C Laparoscopy
D Dilation and curettage

✓ Correct Answer: Option A

Given the symptoms (amenorrhea, pain, spotting, positive pregnancy test) and hemodynamic instability suggestive of rupture, an ectopic pregnancy is highly suspected. A transvaginal pelvic ultrasound is the most appropriate immediate diagnostic step to confirm pregnancy location.

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