more questions - charismatician

[ArchivalUser]

A 21 year old woman,G1P0 and 32 weeks pregnant c/o bilateral knee pain and hip pain.At 28 weeks she had contractions that were controlled with terbutaline.On further questioning she c/o SOB while lying flat.On PE her BP is 150/90 and she is tachycardic.Rest of exam is ok.
Labs are as follows:
esr 65
htc 31
hb 10
plt 300,000

1.which of the following measures should be your next step
A. ANA
B. Echo
C. AntidsDNA
D.Reassurance
E. V/Q scan

2.What accounts for the tachycardia

A. Anemia
B.cardiomyopathy
C.PE
D.Rheumatologic disease
E.Medication side effect

3.The woman asks about her BP
You tell her that:
A.mild hypertension is normally seen at this stage of pregnancy
B.She has preeclampsia
C.BP increases early in pregnancy but should normalize by 32 weeks
E.BP normally decreases in pregnancy

4.which of the following regarding the womans anemia is true?
A.her htc will likely increase on its own
B. she will require a transfusion
C. she has mild hemolysis
D.anemia is common secondary to decreased RBC mass
E.she will require iv iron supplementation

[ArchivalUser]

am sorry guys looks like the questions are too difficult.

[ArchivalUser]

B
A
E
E

[ArchivalUser]

DEEA

[ArchivalUser]

1.b 2d 3b 4a

[ArchivalUser]

A
E
E
E

[ArchivalUser]

a
a
e
c

[ArchivalUser]

caec ....thinking it is SLE but i know it dosent fit the picture entirely charismatician wats the correct answer

[ArchivalUser]

Ok. I already gave the answer but ill give it again.

1.D
2.E
3.E
4.A

All the symptoms described are normal in pregnancy.
Of course you should expect a pregnant woman to make those complaints especially in the third trimester when the spine,the hips and the knees have to support the enormous weight gained during pregnancy.Without other systemic symtoms rheumatologic disorder is unlikely.
Her SOB is due probably to the compression of the IVC by the uterus.Again she has no other symptoms like pedal edema,increased jvd or rales on lung exam to support peripartum cardiomyopathy.Her tachycardia is due to the terbutaline she was given.As for the anemia dont forget the physiologic anemia that takes place in pregnancy.
Bottom line with the exception of the terbutaline induced tachycardia and her high BP,all the symptoms are physiologic changes that take place in pregnancy.Your mom or granma can explain it better.