q1 - guest1 - Printable Version +- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com) +-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1) +--- Forum: Step 1 (https://www.usmleforum.com/forumdisplay.php?fid=2) +--- Thread: q1 - guest1 (/showthread.php?tid=233494) |
q1 - guest1 - ArchivalUser - 10-20-2007 In the 25th week of pregnancy, a G1P0 woman develops increased blood pressure (160/95) and proteinuria. Physical examination demonstrates generalized edema, and serum chemistries demonstrate hyperuricemia and increased concentrations of liver enzymes. Which of the following usually provides definitive therapy for this patient's medical condition A. Anti-hypertensive medical therapy B. Delivery C. Low dose aspirin D. Oxygen supplementation E. Renal dialysis 0 - ArchivalUser - 10-20-2007 D. 0 - ArchivalUser - 10-20-2007 B..delivery.."most definitive" 0 - ArchivalUser - 10-20-2007 B 0 - ArchivalUser - 10-20-2007 i meant Delivery..had deplopia i guess..lol 0 - ArchivalUser - 10-20-2007 how come it be delivery this is hellp syndrome right? 0 - ArchivalUser - 10-20-2007 Explanation: The correct answer is B. The woman has preeclampsia, the features of which include proteinuria and increased blood pressure. A wide variety of other features of preeclampsia can also be seen, including excessive weight gain, generalized edema, ascites, hyperuricemia, hypocalciuria, increased plasma concentration of von Willebrand factor and cellular fibronectin, reduced plasma concentration of anti-thrombin III, thrombocytopenia, increased hematocrit, increased liver enzymes, intrauterine growth retardation, and intrauterine hypoxia. Modern theories suggest that the true primary lesion may involve the endothelium, and that medical control of hypertension (choice A) actually only treats a small part of the syndrome. At present, the only definitive therapy is delivery of the baby, and obstetricians often play a delicate game trying to delay delivery for a premature baby's sake as long as possible while judging the severity of the preeclampsia and its immediate risks to mother and fetus. Low dose aspirin (choice C) may have a modest effect in preventing pre-eclampsia, but this is not yet well established. Oxygen supplementation (choice D) is used in some cases of cerebral hemorrhage secondary to preeclampsia, but does not constitute definitive therapy. Renal dialysis (choice E) is usually not necessary in preeclampsia, although both renal cortical necrosis and renal tubular necrosis can occasionally occur in this disorder. 0 - ArchivalUser - 10-20-2007 delivery at 25th week..advisable?? 0 - ArchivalUser - 10-20-2007 bergkamp...in sever preeclampsia..the definitive treatment is termination of pregnancy regardless the gestational age..along with magnesium sulfate |