## **Core Concept**
The clinical presentation suggests a case of **ectopic pregnancy**, a pregnancy complication where the embryo implants outside the uterus, commonly in the fallopian tube. This condition is a leading cause of maternal morbidity and mortality in early pregnancy. The management involves stabilizing the patient and addressing the ectopic pregnancy.

## **Why the Correct Answer is Right**
The correct approach for managing a suspected ectopic pregnancy, especially with hemodynamic stability (as indicated by a blood pressure of 100/80 mmHg), involves **medical management** or **expectant management** initially, but given the presence of a 5 x 5 cm adnexal mass and symptoms, surgical intervention is often required. The most appropriate immediate plan is usually **surgical exploration**, specifically **laparoscopy**, to confirm the diagnosis and treat the ectopic pregnancy. This approach allows for the preservation of fertility, if desired, and is suitable for patients who are hemodynamically stable.

## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is not provided, but typically, incorrect options might include expectant management alone for a patient with a large adnexal mass and symptoms, which would not be appropriate given the high risk of rupture.
- **Option B:** Similarly, this option is not provided, but it might represent an inappropriate choice such as immediate medical management without surgical intervention for a large mass.
- **Option C:** Without specifics, it's hard to address, but if it suggests a delay in surgical intervention or inappropriate use of medical therapy for a large adnexal mass with symptoms, it would be incorrect.

## **Clinical Pearl / High-Yield Fact**
A key point to remember is that **ectopic pregnancy** should be considered in any woman of childbearing age presenting with abdominal pain and amenorrhea. The combination of **transvaginal ultrasound** showing an adnexal mass and **elevated beta-hCG** levels (not provided but often part of the diagnostic workup) aids in diagnosis. For a hemodynamically stable patient with a confirmed ectopic pregnancy and an adnexal mass, **laparoscopic surgery** is often the preferred treatment to remove the ectopic pregnancy while preserving the ovary and, if possible, the fallopian tube.

## **Correct Answer:** D. Laparoscopy.