Fertilization begins when sperm binds to the corona radiata of the egg. Once the sperm enters the cytoplasm, a cortical reaction occurs which prevents other sperm from entering the oocyte. The oocyte then undergoes an important reaction. What is the next reaction that is necessary for fertilization to continue?
AThe second meiotic division
BDegeneration of the sperm tail
CRelease of a polar body
DFormation of the spindle apparatus
EAcrosome reaction
A 25-year-old woman is brought to the emergency department by her roommate with severe right lower quadrant pain for the last 8 hours. The pain is progressively getting worse and is associated with vomiting. When you ask the patient about her last menstrual period, she tells you that although she stopped keeping track of her cycle after undergoing surgical sterilization 1 year ago, she recalls bleeding yesterday. The physical examination reveals a hemodynamically stable patient with a pulse of 90/min, respiratory rate of 14/min, blood pressure of 125/70 mm Hg, and temperature of 37.0°C (98.6°F). The abdomen is tender to touch (more tender in the lower quadrants), and tenderness at McBurney's point is absent. Which of the following is the best next step in the management of this patient?
AComplete blood count
BUrinalysis
CFAST ultrasound scan
DAppendectomy
EUrinary human chorionic gonadotropin (hCG)
A 30-year-old woman comes to the primary care physician because she has felt nauseous and fatigued for 3 weeks. Menses occur at irregular 24- to 33-day intervals and last for 4–6 days. Her last menstrual period was 7 weeks ago. Her temperature is 37°C (98.6°F), pulse is 95/min, and blood pressure is 100/70 mm Hg. Pelvic examination shows an enlarged uterus. Her serum β-hCG concentration is 96,000 mIU/mL (N < 5). An abdominal ultrasound is shown. Which of the following is the most likely diagnosis?
APartial hydatidiform mole
BBicornuate uterus pregnancy
CAbdominal pregnancy
DComplete hydatid mole
EDichorionic-diamniotic twins
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