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CMS obs/gyn form 4 help please - mrmrpiro05
#1
hello every body i need help with this qs...

1) A 32 primigravida at 10 wks gestational age come for her first prenatal visit she has a history of 2-3 seizures yearly but she has had 2 seizure over the past 2 wks medications include phenytoin Examination shows a uterus consistent with a 10 wks her serum phenytoin is 5ug/ml (normal 10-20). which is the next step in mangement?

A)Routine prenata care
B)Add valporic acid to the medication regimen
C)Increasing her current medication
D)Switch to carbamazpinde (wrong)
E)Termination of pregnancy

2) A 25 yo women come with 4 wks history of rt sided pelvic pain she has been sexually active with 1 partner for 3 yrs they use condoms for contraception her LMP was 3 wks ago she is afebrile a pelvic exam shows a 12 cm cystic mobile rt adnexal mass. her serum CA 125 is 35 U/ml(n
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#2
sorry for q n 2 i do not what happen i write the whole q but i will submitted again

2) A 25 yo women come with 4 wks history of rt sided pelvic pain she has been sexually active with 1 partner for 3 yrs they use condoms for contraception her LMP was 3 wks ago she is afebrile a pelvic exam shows a 12 cm cystic mobile rt adnexal mass. her serum CA 125 is 35 U/ml(n
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#3
C first question

when pt has history of seizures and just planning pregnancy - then stop of teratogenic seizure meds and switch her to phenobarbital

if pt is already pregnant - just continue what she is on. In this case level of her phenytoin is very low and thats why she has seizures. Just increase her dose.
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#4
stop all*
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#5
thank you so much munchkino
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