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Four hours after undergoing a cesarean delivery at term followed by tubal ligation, a 37-year-old woman, gravida 2, para 2, has dizziness and confusion. The operation was uncomplicated, and blood loss is estimated to be 800 mL. Patient-controlled epidural analgesia has been moderately effective for pain. Her blood pressure now is 80/40 mm Hg, decreased from 120/72 mm Hg intraoperatively, and pulse is 152/min, increased from 96/min intraoperatively. Breath sounds are decreased bilaterally. No murmurs are heard. Abdominal examination shows distention and tenderness. Bowel sounds are absent. The incision is intact with no drainage. She is disoriented to person, place, and time. Her hematocrit is 23%; preoperative hematocrit was 35%. Which of the following is the most likely cause of the hemodynamic changes?
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A 13-year-old boy is brought to the physician by his mother for an examination prior to participation in sports. He has no history of serious illness and takes no medications. His maternal and paternal grandfathers have hypertension and type 2 diabetes mellitus. The patient is at the 95th percentile for height and above the 95th percentile for weight and BMI. His temperature is 36.7°C (98.1°F), pulse is 84/min, respirations are 16/min, and blood pressure is 130/83 mm Hg (95th percentile). Examination shows no abnormalities. In addition to recommending participation in sports, which of the following is the most appropriate pharmacotherapy?
A) ACE inhibitor
B) β-Adrenergic blocker
C) Calcium channel blocker
D) Thiazide diuretic
E) No pharmacotherapy is indicated
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Please provide options for first one, although to me it reads to be intra abdominal bleeding
second one is E
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Yash please why is the anser E? Any explanation?
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teenager, without risk factor (but bmi) would give non pharma a try first (exercise and weight reduction,,,)
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Hi can someone email me NBME offline forms 3, 6, and 7 please!
akeelk1786
Thanks
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first question its post operative intraabdominal hge....
