This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
[{'content': 'True statement regarding ectopic pregnancy:a) Pregnancy test positiveb) hCG levels should be >1000 mlU/ml for earliest detection of gestational sac by TVSc) hCG levels should be <1000 mlU/ml for earliest detection of gestational sac by TVSd) Methotrexate is used \nSelect and explain. \nA. abd, B. bcd, C. abc, D. ab', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Lets see each option separately-\nOption a-\n“Urine pregnancy test - ELISA is sensitive to 10-50 MIU/ml and are positive in 95% of ectopic pregnancies.”\nDutta Obs. 7/e, p 182\n“Current serum and urine pregnancy test that use enzyme - linked immunosorbent assays (ELISA) for -hcG are sensitive of levels of 10 to 20 MIU/ml and are positive in greater than 99% of ectopic pregnancies.”\nWilliams Obs. 23/e, p 242,\nThus option ‘a’ is correct.\n“The lowest level of serum hCG at which a gestation sac is consistently visible using TVS (discriminatory zone) is 1500 IU/L. the corresponding value of serum hCG for TAS is 6000 IU/L. When the hCG value is greater than 1500 IU/L and there is an empty uterine cavity, ectopic pregnancy is more likely”.\nRef Dutta Obs. 7/e, p 183\n“A number of investigation have described discriminatory hCG levels above which failure to visualize a uterine pregnancy indicates with high reliability that pregnancy is not alive or ectopic. Banhart and colleagues (1994) reported that an empty uterus with serum hCG concentration 1500 MIU/ml was 100% accurate in excluding a live pregnancy.\'"\nWilliams Obs. 23/e, p 244\nThus option ‘b’ is correct and option ‘c’ incorrect.', 'role': 'assistant'}]