Ruptured Ectopic Pregnancy: A Case of Shock and Shoulder-Tip Pain
A branching clinical case simulation for a patient presenting with right iliac fossa pain, shoulder-tip pain, light-headedness. Take a history, examine, investigate, diagnose and treat while the patient responds to every decision, then see the score by clinical domain with the reasoning for each mark.
Year 4medium20 min5 stages
- Patient
- 31 years, female
- Presenting complaint
- Right iliac fossa pain, shoulder-tip pain, light-headedness
- Decision stages
- History, Examination, Investigations, Diagnosis, Treatment
The presentation
A 31-year-old woman presents to the emergency department with a 6-hour history of sharp right iliac fossa pain that started suddenly. She now feels light-headed and has developed a pain over her right shoulder tip. She is pale and clammy. She is 7 weeks amenorrhoeic. You are the junior doctor in the emergency department; your senior is in the acute take room.
What this case teaches
Suspect ruptured ectopic pregnancy in any woman of childbearing age with abdominal pain and shock; resuscitate; obtain a pregnancy test and ultrasound; involve gynaecology urgently; give anti-D where indicated.
How the case unfolds
- 1Focused HistoryHistory
- 2Examination FindingsExamination
- 3InvestigationsInvestigations
- 4DiagnosisDiagnosis
- 5Immediate ManagementTreatment
The decisions available at each stage, and what each one costs or earns, appear when you run the case.
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A free account opens the simulator: the patient's observations move with your decisions, and every choice is scored and explained.
Taught in
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.