A patient comes with 6 weeks amenorrhoea and features of shock-

Ans. is 'a' i.e., Ectopic pregnancy Clinical features of ectopic pregnancyo Classical triad is abdominal pain (100%), amenorrhea (75%) & vaginal bleeding (70%).o Amenorrhea usually of short period (6-8 weeks)o Abdominal pain it is acute, agonising & colicky. Located in lower abdomen: unilateral, bilateral or may be generalised.Sometimes the pain may also be referred to shoulder,o Vaginal bleeding may be slight & continuous,o Vomiting & fainting attack.Signso General look (diagnostic)- Patient is quite & conscious, perspires & looks blanched,o Pallor - Severe & proportionate to the amount of internal haemorrhageo Features of shock - Rapid & feeble pulse, hypotension cold & clammy extremities.o Abdominal examination (lower abdomen) - tense, tumid, tender. No mass felt. Shifting dullness present. Muscle guard is usually absento Pelvic examination - Less informative. Vaginal mucosa is blanched white uterus may b normal in size or bulky. Extreme tenderness on fornix palpation or on cervical movements. The uterus floats as if in the water.