34 week pregant with lower abdominal pain! - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 06-16-2011
1TA2B's Avatar
USMLE Forums Guru
 
Steps History: CK Only
Posts: 475
Threads: 39
Thanked 351 Times in 169 Posts
Reputation: 374
ObGyn 34 week pregant with lower abdominal pain!

A 25-year-old woman, gravida II para 0 at 34 weeks, complaining of cramping intermittent pain in her lower abdomen. No vaginal bleeding or any recent trauma or dysuria. She is tachycardic, tachypnic, blood pressure 130/80 mm Hg, and afebrile. On physical examination, tenderness on palpitation of the fundus. Ultrasound is negative for abnormality. What is her most likely diagnosis?

A. Acute appendicitis
B. Placenta accreta
C. Placenta previa
D.
Placental abruption
E.
Vasa previa
__________________
Skill+Hardwork+Preparation=Success
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

Reply With Quote Quick reply to this message



  #2  
Old 06-16-2011
USMLE Forums Newbie
 
Steps History: CK Only
Posts: 2
Threads: 1
Thanked 1 Time in 1 Post
Reputation: 11
Default

placental abruption
Reply With Quote Quick reply to this message
The above post was thanked by:
1TA2B (06-16-2011)
  #3  
Old 06-17-2011
1TA2B's Avatar
USMLE Forums Guru
 
Steps History: CK Only
Posts: 475
Threads: 39
Thanked 351 Times in 169 Posts
Reputation: 374
Default

Could it be non-obs related cause-appendicitis?
__________________
Skill+Hardwork+Preparation=Success
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

Reply With Quote Quick reply to this message
  #4  
Old 06-17-2011
cool_atomic's Avatar
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 472
Threads: 29
Thanked 224 Times in 135 Posts
Reputation: 247
Default

cramping abdominal pain=uterine origin?
appendicitis has diffuse pain and peritoneal signs not essentially intermittent in character. Fever is also absent.
so my answer is placental abruption.
Reply With Quote Quick reply to this message
The above post was thanked by:
1TA2B (06-18-2011)
  #5  
Old 06-18-2011
bassatom's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 260
Threads: 28
Thanked 156 Times in 54 Posts
Reputation: 166
Send a message via Skype™ to bassatom
Default

Quote:
Originally Posted by cool_atomic View Post
cramping abdominal pain=uterine origin?
appendicitis has diffuse pain and peritoneal signs not essentially intermittent in character. Fever is also absent.
so my answer is placental abruption.
Also the pain is fundal, no sono abnormality
Placental abruption it is
Reply With Quote Quick reply to this message
  #6  
Old 06-23-2011
1TA2B's Avatar
USMLE Forums Guru
 
Steps History: CK Only
Posts: 475
Threads: 39
Thanked 351 Times in 169 Posts
Reputation: 374
Default

Yes. Placenta abruption.
__________________
Skill+Hardwork+Preparation=Success
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

Reply With Quote Quick reply to this message
  #7  
Old 06-23-2011
kemoo's Avatar
USMLE Forums Guru
 
Steps History: 1+CK+CS
Posts: 378
Threads: 161
Thanked 102 Times in 51 Posts
Reputation: 116
Default

but abruptio placenta cause bleeding

if not mean concealed ( but blood pressure normal )

can you explain please ?thanks
Reply With Quote Quick reply to this message
  #8  
Old 06-24-2011
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 91
Threads: 3
Thanked 120 Times in 47 Posts
Reputation: 130
Default

Quote:
Originally Posted by kemoo View Post
but abruptio placenta cause bleeding

if not mean concealed ( but blood pressure normal )

can you explain please ?thanks
Occasionally, a woman with placental abruption will present with only preterm labor, and no vaginal bleeding. "Concealed" hemorrhage occurs in as many as 10 to 20 percent of abruptions. In these cases, all or most of the blood is trapped between the fetal membranes and decidua, rather than escaping through the cervix and vagina [14,21]. Therefore, even small amounts of vaginal bleeding in the setting of abdominal pain and uterine contractions should prompt close maternal and fetal evaluation for placental abruption.
Source: UptoDate

Btw, another life-threatening (and high yield) concern in the setting of placenta abruption would be the development of DIC.
Reply With Quote Quick reply to this message



Reply

Tags
ObGyn-, Step-2-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Left lower quadrant abdominal pain good_boy_1234 USMLE Step 2 CK Forum 2 09-26-2010 09:47 AM
Irregular vaginal bleeding and lower abdominal pain khushboo USMLE Step 1 Forum 4 06-04-2010 09:44 PM
28 Year Old with Right Lower Abdominal Pain? Yallah USMLE Step 1 Forum 5 03-24-2010 11:15 AM
Right Lower Abdominal Pain Sarah-cali USMLE Step 1 Forum 3 12-20-2009 09:02 AM
Old man with lower back pain rasheed USMLE Step 1 Classic Clues 0 08-21-2009 11:25 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)