PAEA Emergency Medicine EOR Topics EXAM 2026-
2027 LATEST UPDATED VERSION 850 QUESTIONS
AND ANSWERS JUST RELEASED
what is the difference between a complete and missed spontaneous abortion?
-complete is when all POC (products of conception) are expelled; usually occurs w/ pain, cramps,
and bleeding
-if mother Rh- need to give RhoGAM in complete abortions
what is the difference between incomplete and inevitable spontaneous abortions? tx?
-while they both involve cervical dilation, bleeding, & cramping, incomplete expels some of the
POC (products of conception) while inevitable does not expel any POC.
-incomplete tx: RhoGAM (if indicated), pitocin, D&C in 1st tri, D&E in 2nd tri
-inevitable tx: RhoGAM (if indicated), suction curettage aka D&C in 1st tri, D&E in 2nd tri
what is the only type of spontaneous abortion where the pregnancy may still be viable?
threatened- pregnancy may progress or abortion may follow- just a wait and see issue so you
send them home to rest
it is the MC cause of 1st trimester bleeding
in a threatened spontaneous abortion s/sx are bloody vaginal d/c, spotting to profuse bleeding,
+/- contractions, uterus size compatible w/ dates, closed cervical os; are there POC (products of
conception) expelled? what can you check to see if pregnancy still progressing?
-no POC expelled
-serial B-hCG to see if doubling
,-remember to give RhoGAM if indicated
what is the MC cause of spontaneous abortion?
-fetal chromosomal abnormalities (50%)
-others include: maternal infxn, uterine defects, endocrine abnormalities, malnutrition,
immunologic, physical trauma, smoking, drug use, etc.
Dx/Tx? painful dark red vaginal bleeding in the 3rd trimester, contractions, fetal bradycardia,
possible shock symptoms, tender/rigid uterus
-dx: placental abruption (premature separation of placenta from uterine wall)
-tx: hospitalization for hemodynamic stabilization, immediate delivery usually by c/s
*DIC (disseminated intravascular coagulation) occurs in 10% of pts
what is the MC cause of placental abruption (premature separation of placenta from uterine
wall)?
-HTN
-others include: smoking, ETOH, cocaine, folate deficiency, high parity, AMA (advanced maternal
age), trauma, chorioamnionitis
Dx/Tx? sudden onset painless bright red vaginal bleeding in the 3rd trimester with nml fetal
heart tracing; on PE soft, non-tender uterus
-dx: placenta previa (diagnose by pelvic US- DO NOT do pelvic exam)
-tx: hospitalization for stabilization, bed rest, tocolytics (magnesium sulfate) to inhibit uterine
contraction, amniocentesis (to assess fetal lung maturity and give betamethasone if needed),
delivery when stable (if L:S >2 aka lungs matured, >36 wks gestation, blood loss >500mL) vaginal
if partial or marginal placenta, c/s if complete
,Image: Dx/Tx? sudden onset painless bright red vaginal bleeding in the 3rd trimester with nml
fetal heart tracing; on PE soft, non-tender uterus
what are the differences b/t marginal, partial and complete placenta previa?
-marginal- 2-3 cm of cervical os
-partial: covering cervix partially ahead of fetal presenting part
-complete: total coverage of cervical os
*can deliver vaginally w/ marginal or partial if fetus is matured but c/s indicated for complete
placenta previa
Image: what are the differences b/t marginal, partial and complete placenta previa?
what BP medications are contraindicated in pregnancy?
ACEi and ARBS
when is RhoGAM indicated?
in Rh- mothers @ 28 wks and w/i 72 hrs postpartum OR if any potential for mixing of fetal blood
(spontaneous abortion, vaginal bleeding, amniocentesis, abruption, placenta previa, etc.)
where is the MC site of ectopic pregnancies?
-98.3% in fallopian tubes (especially ampulla)
-1.4% in abdomen
-0.15% in ovary
-0.15% on cervix
Image: where is the MC site of ectopic pregnancies?
, what are some risk factors for ectopic pregnancy?
-previous abdominal surgery (adhesions)
-PID
-previous ectopic
-tubal ligation
-endometriosis
-IUD use
-assisted reproduction
what is the classic triad of sx's with ectopic pregnancy?
1. unilateral pelvic/abdominal pain
2. vaginal bleeding
3. + pregnancy (noticed by test or by amenorrhea)
how is a ectopic pregnancy (that has not ruptured) diagnosed and treated?
-Dx by serial quant B-hCG that do not double q 1-2 days & TVUS
-Tx: methotrexate (disrupts cell multiplication) w/ B-hCG monitoring for ≥15% drop OR
laproscopic salpingotomy or salpingectomy + RhoGAM if Rh-
MTX can be given in single/double or multiple doses (4) w/ Leucovorin (med to help protect
against harmful s/e of MTX)
-single/double dosing: monitor B-hCG on days 0, 4, 7 for a ≥15% drop
-multiple dosing (4 doses): monitor B-hCG on days 0, 1, 3, 5, 7 until ≥15% drop on 2 successive
draws
what are the indications/contraindications for giving MTX to tx an ectopic pregnancy?
2027 LATEST UPDATED VERSION 850 QUESTIONS
AND ANSWERS JUST RELEASED
what is the difference between a complete and missed spontaneous abortion?
-complete is when all POC (products of conception) are expelled; usually occurs w/ pain, cramps,
and bleeding
-if mother Rh- need to give RhoGAM in complete abortions
what is the difference between incomplete and inevitable spontaneous abortions? tx?
-while they both involve cervical dilation, bleeding, & cramping, incomplete expels some of the
POC (products of conception) while inevitable does not expel any POC.
-incomplete tx: RhoGAM (if indicated), pitocin, D&C in 1st tri, D&E in 2nd tri
-inevitable tx: RhoGAM (if indicated), suction curettage aka D&C in 1st tri, D&E in 2nd tri
what is the only type of spontaneous abortion where the pregnancy may still be viable?
threatened- pregnancy may progress or abortion may follow- just a wait and see issue so you
send them home to rest
it is the MC cause of 1st trimester bleeding
in a threatened spontaneous abortion s/sx are bloody vaginal d/c, spotting to profuse bleeding,
+/- contractions, uterus size compatible w/ dates, closed cervical os; are there POC (products of
conception) expelled? what can you check to see if pregnancy still progressing?
-no POC expelled
-serial B-hCG to see if doubling
,-remember to give RhoGAM if indicated
what is the MC cause of spontaneous abortion?
-fetal chromosomal abnormalities (50%)
-others include: maternal infxn, uterine defects, endocrine abnormalities, malnutrition,
immunologic, physical trauma, smoking, drug use, etc.
Dx/Tx? painful dark red vaginal bleeding in the 3rd trimester, contractions, fetal bradycardia,
possible shock symptoms, tender/rigid uterus
-dx: placental abruption (premature separation of placenta from uterine wall)
-tx: hospitalization for hemodynamic stabilization, immediate delivery usually by c/s
*DIC (disseminated intravascular coagulation) occurs in 10% of pts
what is the MC cause of placental abruption (premature separation of placenta from uterine
wall)?
-HTN
-others include: smoking, ETOH, cocaine, folate deficiency, high parity, AMA (advanced maternal
age), trauma, chorioamnionitis
Dx/Tx? sudden onset painless bright red vaginal bleeding in the 3rd trimester with nml fetal
heart tracing; on PE soft, non-tender uterus
-dx: placenta previa (diagnose by pelvic US- DO NOT do pelvic exam)
-tx: hospitalization for stabilization, bed rest, tocolytics (magnesium sulfate) to inhibit uterine
contraction, amniocentesis (to assess fetal lung maturity and give betamethasone if needed),
delivery when stable (if L:S >2 aka lungs matured, >36 wks gestation, blood loss >500mL) vaginal
if partial or marginal placenta, c/s if complete
,Image: Dx/Tx? sudden onset painless bright red vaginal bleeding in the 3rd trimester with nml
fetal heart tracing; on PE soft, non-tender uterus
what are the differences b/t marginal, partial and complete placenta previa?
-marginal- 2-3 cm of cervical os
-partial: covering cervix partially ahead of fetal presenting part
-complete: total coverage of cervical os
*can deliver vaginally w/ marginal or partial if fetus is matured but c/s indicated for complete
placenta previa
Image: what are the differences b/t marginal, partial and complete placenta previa?
what BP medications are contraindicated in pregnancy?
ACEi and ARBS
when is RhoGAM indicated?
in Rh- mothers @ 28 wks and w/i 72 hrs postpartum OR if any potential for mixing of fetal blood
(spontaneous abortion, vaginal bleeding, amniocentesis, abruption, placenta previa, etc.)
where is the MC site of ectopic pregnancies?
-98.3% in fallopian tubes (especially ampulla)
-1.4% in abdomen
-0.15% in ovary
-0.15% on cervix
Image: where is the MC site of ectopic pregnancies?
, what are some risk factors for ectopic pregnancy?
-previous abdominal surgery (adhesions)
-PID
-previous ectopic
-tubal ligation
-endometriosis
-IUD use
-assisted reproduction
what is the classic triad of sx's with ectopic pregnancy?
1. unilateral pelvic/abdominal pain
2. vaginal bleeding
3. + pregnancy (noticed by test or by amenorrhea)
how is a ectopic pregnancy (that has not ruptured) diagnosed and treated?
-Dx by serial quant B-hCG that do not double q 1-2 days & TVUS
-Tx: methotrexate (disrupts cell multiplication) w/ B-hCG monitoring for ≥15% drop OR
laproscopic salpingotomy or salpingectomy + RhoGAM if Rh-
MTX can be given in single/double or multiple doses (4) w/ Leucovorin (med to help protect
against harmful s/e of MTX)
-single/double dosing: monitor B-hCG on days 0, 4, 7 for a ≥15% drop
-multiple dosing (4 doses): monitor B-hCG on days 0, 1, 3, 5, 7 until ≥15% drop on 2 successive
draws
what are the indications/contraindications for giving MTX to tx an ectopic pregnancy?
