Kamsi
Forum Guru
Topics: 103
Posts: 347
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For each patient with vaginal bleeding, select the
most likely
diagnosis.
A
) Bacterial vaginosis
B
) Precocious puberty
C
) Urinary tract infection
D
) Vaginal foreign body
E
) Vaginal laceration
F
) von Willebrand's disease
21. A 12-year-old girl is brought to the physician
by her mother
because of heavy vaginal bleeding since her first
menstrual period began 1
week ago. She has to change sanitary pads every 2
hours, and her
mother is concerned that this is not normal. Her
blood pressure is 80/60 mm
Hg, and pulse is 110/min. Breast and axillary and
pubic hair
development are Tanner stage 4. Pelvic examination
shows normal external
genitalia, a small normal-appearing cervix, and a
small uterus. Her
hemoglobin level is 7 g/dL.
19.
A 27-year-old primigravid woman at 29 weeks' gestation
comes to the
emergency department because of a 24-hour history of
increasingly severe
right-sided abdominal pain and no appetite. She has
vomited twice over
the past 4 hours. She has not had vaginal bleeding.
Her temperature
is 38.2 C (100.8 F). Examination shows exquisite
tenderness of the
right lateral flank and the fundus. There are no
peritoneal signs. Bowel
sounds are absent. The fetal heart rate is 144/min.
Laboratory
studies show:
Hematocrit 37%
Leukocyte count 16,000/mm3
Serum
Total bilirubin 1.1 mg/dL
Amylase 32 U/L
Lactate dehydrogenase 110 U/L
Urine WBC 3–5/hpf
Which of the following is the most likely diagnosis?
A
) Abruptio placentae
B
) Appendicitis
C
) Cholelithiasis
D
) Colitis
E
) Pyelonephritis
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| sandra
Forum Guru
Topics: 201
Posts: 470
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f
b
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You become what you think you are!
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| Kamsi
Forum Guru
Topics: 103
Posts: 347
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Why not pyelonephritis in the 2nd Q
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| drdg
Forum Senior
Topics: 31
Posts: 176
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F
B
For the second question.
1. Since she is in the 28 week's gestation, the appendix can be pushed to the right lateral flank and the fundus.
2. Bowel sounds are absent.
3. Urine WBC 3–5/hpf, typically Pyelonephritis will result in more than 10/hpf wbc.
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| hanialkhadher
Forum Elite
Topics: 18
Posts: 258
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| titly
Forum Elite
Topics: 20
Posts: 303
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F
B
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we spend our days waiting for the ideal path to appear in front of us, but, what we forget is paths are made by walking, not by waiting. keep walking................................
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