تصفح
دخول
تسجيل
نسيتها؟

pregnant woman with nasal bleed


pregnant woman with nasal bleed


حالة سريرية

الوصف الكامل Background
A 26-year-old woman who is 36 weeks pregnant is evaluated because of right-sided abdominal pain. The patient has had mild preeclampsia for 4 weeks. She vomited twice this morning but is able to drink liquids. She also developed a nosebleed this morning.

On physical examination, blood continues to ooze from her nostrils. Temperature is normal, pulse rate is 105/min, and blood pressure is 135/85 mm Hg. Abdominal examination discloses right upper quadrant tenderness and uterine enlargement consistent with gestational age. There is 2+ bilateral lower extremity edema.

Laboratory Studies
Hemoglobin

7.7 g/dL (77 g/L)
Leukocyte count

9500/μL (9.5 × 109/L)
Platelet count

45,000/μL (45 × 109/L)
Serum aspartate aminotransferase

160 U/L
Serum alanine aminotransferase

172 U/L
Serum total bilirubin

4.8 mg/dL (82.08 μmol/L)
Serum direct bilirubin

0.9 mg/dL (15.39 μmol/L)
INR

1.0
Partial thromboplastin time

Normal
Urinalysis

2+ protein

كتابة حرة وطرح موضوع النقاش!

what's the most likely diagnosis?

dr.tabban's picture
by


HELLP syn

Fouad's picture
Fouad
بعد التخرج


متلازمةhellp

a.m.a's picture
a.m.a
طبيب مقيم


Hellp

qusei


Help syndrome

moonberg's picture
moonberg
بعد التخرج


waiting for explanation

KMG's picture
KMG
طبيب مقيم

great.
and the most appropriate next step at this time is?

A Prompt delivery of the infant
B Endoscopic retrograde cholangiopancreatography
C Administration of a corticosteroid
D Administration of acyclovir
E Administration of magnesium sulfate

dr.tabban's picture
dr.tabban


خطيييييييييييي بطيييييييييييييييييء ما بصيييييرMad Mad Mad

moonberg's picture
moonberg
بعد التخرج


a

moonberg's picture
moonberg
بعد التخرج

Quote:
A Prompt delivery of the infant

بتوقع عمر الجنين مناسب للولادة

a.m.a's picture
a.m.a
طبيب مقيم


A Prompt delivery of the infant

qusei


a

Fouad's picture
Fouad
بعد التخرج

Quote:
بتوقع عمر الجنين مناسب للولادة

الجنين لازم نولده حتى لو عمره مو مناسب للولادة.....

Fouad's picture
Fouad
بعد التخرج


yes
correct, patient has HELLP syndrome (hemolysis, elevated liver enzymes, low platelets). The treatment of choice is prompt delivery of the infant. Following delivery, the mother's condition often resolves within 48 hours. Since the patient is in her 36th gestational week, delivery would most likely be safe for both the mother and the infant.

dr.tabban's picture
dr.tabban


A

Quote:
بتوقع عمر الجنين مناسب للولادة

ليش اذا ما كان مناسب ما منلجأ لل INFANT DELIVERY ؟؟

BY THE WAY
على مهلكم شوي يادوب عم نلحق قراية

SINA's picture
SINA
طالب دراسات عليا
ابق على تواصل مع حكيم!
Google+