USMLE Forum Archives - USMLE Step 3 - Obstetrics- Platelet: 50,000, BP: 150/95
Obstetrics- Platelet: 50,000, BP: 150/95
harry206 - 05-12-09 08:59
A 21-year-old African-American primigravida is brought to the emergency room ten minutes after delivery of an infant at home. She received no prenatal care. Her past medical history is insignificant. Her blood pressure is 150/95 mmHg and heart rate is 100/min. Physical examination reveals an enlarged, tender liver and 2+ symmetrical edema of the lower extremities. Platelet count is 50,000 cells/µL and schistocytes are present on a peripheral blood smear. AST and ALT are elevated. Urine is positive for 2+ proteins. Which of the following is the best next step in the management of this patient?
harry206 - 05-12-09 08:59
A 21-year-old African-American primigravida is brought to the emergency room ten minutes after delivery of an infant at home. She received no prenatal care. Her past medical history is insignificant. Her blood pressure is 150/95 mmHg and heart rate is 100/min. Physical examination reveals an enlarged, tender liver and 2+ symmetrical edema of the lower extremities. Platelet count is 50,000 cells/µL and schistocytes are present on a peripheral blood smear. AST and ALT are elevated. Urine is positive for 2+ proteins. Which of the following is the best next step in the management of this patient?
The correct answer and explanation will be available after you answer.
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#1
Re: Obstetrics- Platelet: 50,000, BP: 15 usmlefever3 - 05-12-09 09:13 My answer is: c.
the patient has preeclampsia with HELP syndrome.the management should aim to lower the blood presure
#2
Re: Obstetrics- Platelet: 50,000, BP: 15 meduploader - 05-12-09 13:40 My answer is: a.
HELLP syndrome.
#5
Re: Obstetrics- Platelet: 50,000, BP: 15 zkadhem - 05-12-09 23:11 ouh yes....remove the placenta ...
#19
Re: Obstetrics- Platelet: 50,000, BP: 15 bobby - 08-06-10 22:11 Indeed Magnesium Sulfate infusion is imperative to prevent seizure onset, but isn't it true that the only effective treatment is delivery of the baby and placenta which is the root cause of the Pre Eclampsia. Also like to add that HELLP Syndrome may present post partum in 8% of cases. Here I guess its important to start Magsulf infusion and at the same time make preparations to deliver the placenta (for which we may wait upto 30 minutes for spontaneous expulsion), the pt came in 10 minutes after birth of baby.
#21
Re: Obstetrics- Platelet: 50,000, BP: 15 babbu5508 - 09-30-10 00:52 My answer is: b.
postpartum pre-eclampsia...start mgso4 to prevent a seizure and prepare for removal of placenta(might expel meanwhile)..
#24
Re: Obstetrics- Platelet: 50,000, BP: 15 drnoor50 - 10-21-10 22:03 My answer is: a.
Baby delivery is most Imp,.
#27
Re: Obstetrics- Platelet: 50,000, BP: 15 safsaf - 11-17-10 11:05 My answer is: d.
safsaf my answer is d
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