pain in onse side of abdomen since the side that has the tube will pain
Guarding, in contrast, is a voluntary contraction of the abdominal wall musculature to avoid pain. Thus, guarding tends to be generalized over the entire abdomen, whereas rigidity involves only the inflamed area. Guarding can often be overcome by having the patient purposely relax the muscles; rigidity cannot be.
Cvx motion tenderness ⇒ can be blood behind the uterus (puch of douglas)
whetehr ectopic or something else. whether ruptred or not
bagel sign = mass (lack) surrounded by a ring of vascularity
there can be a mass in the uterus but that can be a psedogestaitional sack (look for double decidua)
most definitive is a gestational sac with cardiac actvity but thats rare
LESS THAN 5000 is on lower side
requires cmpliance because weekly followup
avoid nasaids to avoid hampering renal excretion
no sutures in salpingostomy to avoid fibrouds adhesioms and increased chances of actopics later
blood in peritoneal cavity also haemoperitoneum
how you eneter the abdomen depends on whether shes stable or not
Lecture 2
PID is the most common risk fcator but isnt the one to giive the highest risk
2 events that can happen ⇒ tubal abortion and tubal rupture
Even though intersititial is the smallest..its the last to rupture because it is supported by the muscles there
first us is a grey scan. the second is a doppler.
CYST WILL SHOW UP n the utrasound and will bled near menses?
3 possibilities of pregnancy of nknown location
must keep monitoring if less than 3500 and if doubles then could be an intrauterine preganncy but even if doubles and doubles and crosses 3500 and still nothing seen in the uterus then consider ectopic and methotrexate.
So the threshold to take action and methotrexate is 3500.
