A female reports in OPD with history of severe pain in lower abdomen and dizziness for 4 hours. On enquiring she informs that she is overdue for menstruation by 15 days, The probable reason could be:

Question

Question

This question was previously asked in

KGMU Nursing Officer 2023 Memory-Based Previous Year Paper

Answer 1

Correct Answer: Ectopic pregnancy

Rationale:

An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tube. This condition can lead to severe complications if not diagnosed and treated promptly.
The patient’s symptoms of severe lower abdominal pain, dizziness, and a missed menstrual period are classic signs of an ectopic pregnancy. The pain is often localized to one side and may be accompanied by vaginal spotting or bleeding.
Dizziness or fainting can occur due to internal bleeding caused by rupture of the ectopic pregnancy, which is a medical emergency.
Ultrasound and serum beta-hCG levels are diagnostic tools used to confirm ectopic pregnancy. If untreated, it can lead to life-threatening complications such as hemorrhage.
Management typically includes medical intervention with methotrexate (if identified early) or surgical removal of the ectopic pregnancy in cases of rupture.

Explanation of Other Options:

Missed abortion

Rationale: A missed abortion refers to the death of the fetus in the uterus without expulsion of the products of conception. Patients may report absence of symptoms like bleeding or cramping, but often do not present with acute abdominal pain or dizziness as seen in this case.
Missed abortion is typically diagnosed via ultrasound, showing a non-viable fetus with absent cardiac activity.

Molar pregnancy

Rationale: Molar pregnancy (hydatidiform mole) is characterized by abnormal growth of trophoblastic tissue, leading to a non-viable pregnancy. Patients may present with symptoms like uterine enlargement greater than expected for gestational age, vaginal bleeding, or excessively high beta-hCG levels.
However, molar pregnancy does not typically cause severe acute lower abdominal pain or dizziness, as seen in this case.

Septic abortion

Rationale: Septic abortion occurs when an infection complicates a miscarriage or induced abortion. Symptoms include fever, chills, abdominal pain, and foul-smelling vaginal discharge. While abdominal pain is a feature, septic abortion does not explain the patient’s dizziness or missed period as prominently as ectopic pregnancy.

Conclusion:

Among the given options, ectopic pregnancy is the most probable cause for the patient’s symptoms of severe lower abdominal pain, dizziness, and a missed menstrual period. Early diagnosis and intervention are critical to prevent life-threatening complications.