fongch
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A healthy 37-year-old primigravid woman at 12 weeks' gestation comes for a routine prenatal visit. The pregnancy was achieved by in vitro fertilization. She does not use tobacco, alcohol, or drugs. She is a hematologist and work 10 to 12 hours daily. Two previous ultrasonographies have shown a triplet gestation. She weighs 66kg and is 178cm tall. Her BP is 116/70mmHg, pulse 72/min. Examination shows a uterus consistent in size w/ a 16 week gestation. Her pelvis is normal size. This patient is at greatest risk for which of the following?
A Abruptio placentae
B Hepatitis B
C HIV infection
D Preterm labor
E Uterine rupture
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| radonc
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D. Preterm labour, associated with multiple pregnancies.
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| fongch
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What about hepatitis B? since the Q mentioned that she is a hematologist?
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| radonc
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What about being a haematologist? Being a medical specialist in blood disorders does not make you prone to being Hep B positive, I hope not. In as much as if you do get into Radiation ocology that I will not grow a third head by the time I am forty.
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| Justice
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radonc wrote:What about being a haematologist? Being a medical specialist in blood disorders does not make you prone to being Hep B positive, I hope not. In as much as if you do get into Radiation ocology that I will not grow a third head by the time I am forty.
I agree with that... If the Pt was an infectious disease specialist, then I would say my "...well ..."... But, having a triplet in the uterus strongly suggests (D)
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| fongch
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I was quite sure that being routinely exposure to blood such as working in a dialysis center or being a hematologist is a risk factor for HBV infection. But I just not sure whether that's what is being asked in the question.
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| vradojc1
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So if you work as hematologist and your area of expertise is iron deficiency anemia...it's the same as saying that she is at risk of hypoglycemia since factitious disorders are more common among health care professionals.
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| fongch
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vradojc1 wrote:So if you work as hematologist and your area of expertise is iron deficiency anemia...it's the same as saying that she is at risk of hypoglycemia since factitious disorders are more common among health care professionals.
Nice one, but I am still quite convinced at what I said. I don't know the exact reason, though.
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| coolmavs
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Although what fongch states is true, I believe that this question is trying to target the fact that one of the most important complications of multiple pregnancies is PRETERM delivery...triplets ...32 wks would be the time that the delivery would be expected.
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| usmle12
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hey guys i just did nbme today n had same q n answered preterm labor hmm so hurray
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| fongch
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All right, I will follow the majority.
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| fongch
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Found this on eMedicine today
A high prevalence of low-birth weight infants, due to prematurity and intrauterine growth retardation (IUGR) and their associated complications, contribute to this problem. Twins have increased frequency of congenital anomalies, placenta previa, abruptio placenta, preeclampsia, cord accidents, and malpresentations, as well as asphyxia/perinatal depression, group B streptococcal (GBS) infections, hyaline membrane disease, and TTTS.
So maybe we should also consider A, anyone?
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| webjeee
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usmle12 wrote:hey guys i just did nbme today n had same q n answered preterm labor hmm so hurray
Hi, everybody who's taken step2, so how many NBMEcccsa questions could appear in real test?
usmle12, how many did you get?
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