USMLE Forum Archives - USMLE Step 3 - Obstetrics- BP 220/110
Obstetrics- BP 220/110
harry206 - 05-12-09 11:39
A 22-year-old primigravida is hospitalized at 34 weeks gestation because of blurred vision, headache, and pain in the right upper quadrant of the abdomen. Her temperature is 36.7 C (98 F), blood pressure is 220/110 mmHg, pulse is 80/min, and respirations are 20/min. The fundoscopic exam is normal. On examination, you note swelling of both her hands and her face, bilateral exaggeration of deep tendon reflexes with clonus, and a positive Babinski. The pelvic exam shows 50% effacement, and 3 cm dilation of the cervix. While getting IV access, the patient started to have generalized tonic-clonic seizures. An airway is secured, and breathing is present. Urinalysis revealed proteinuria of 3+ .
Which of the following is the most effective strategy to decrease this patient"s risk for developing further complications?
harry206 - 05-12-09 11:39
A 22-year-old primigravida is hospitalized at 34 weeks gestation because of blurred vision, headache, and pain in the right upper quadrant of the abdomen. Her temperature is 36.7 C (98 F), blood pressure is 220/110 mmHg, pulse is 80/min, and respirations are 20/min. The fundoscopic exam is normal. On examination, you note swelling of both her hands and her face, bilateral exaggeration of deep tendon reflexes with clonus, and a positive Babinski. The pelvic exam shows 50% effacement, and 3 cm dilation of the cervix. While getting IV access, the patient started to have generalized tonic-clonic seizures. An airway is secured, and breathing is present. Urinalysis revealed proteinuria of 3+ .
Which of the following is the most effective strategy to decrease this patient"s risk for developing further complications?
The correct answer and explanation will be available after you answer.
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#10
Re: Obstetrics- BP 220/110 ysemak - 01-14-10 19:07 My answer is: b.
the most definite treatment is delivery, but in this scenario I would go for operative delivery
#11
Re: Obstetrics- BP 220/110 ysemak - 01-14-10 19:11 I think this p-t with seizure, only 50% effacement, and only 3 cm dilation of the cervix will not survive vaginal delivery.
Any other suggestions?
#12
Re: Obstetrics- BP 220/110 oldman - 01-19-10 18:46 My answer is: c.
answers do not include cesarean section, what is the most effective strategy for this patient
#34
Re: Obstetrics- BP 220/110 babbu5508 - 09-30-10 15:52 My answer is: b.
mgso4 is the most effective strategy to decrease this patient"s risk for developing further complications...start immediately and plan for delivery
#37
Re: Obstetrics- BP 220/110 kwasiprince - 10-01-10 08:50 My answer is: b.
this patient is not stable(with tonic clonic seizures) so i will abort the seizures first with Mag sulfate!
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