A 35 year old G1P0 woman who has not received prenatal care presents at 34 weeks of gestation. She has no prior medical history, but she is obese. She presents because of leg swelling, back pain, right upper quadrant abdominal pain, headache, gastroesophageal reflux, and fatigue. Her blood pressure is 150/100. Her labs show a hemoglobin of 10, platelets of 150,000, a normal creatinine, and normal liver function tests.
Challenge: What parts of her presentation makes this disease "severe"?
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I put together these medical challenges. The cases are hypothetical and do not necessarily represent actual or typical presentations of medical diseases. Disclaimer is at the bottom of this page.
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2 comments:
Refresher III
Pre-eclampsia with severe features is characterized by one or more of the following: new onset cerebral or visual disturbances (photopsia, scotomata, cortical blindness, retinal vasospasm, severe headache, altered mental status), hepatic abnormalities (severe persistent right upper quadrant or epigastric pain, serum transaminase concentrations over twice normal), systolic blood pressure >160, diastolic blood pressure >110, platelets <100,000, progressive renal insufficiency, or pulmonary edema. The new criteria do not include proteinuria >5g/24h or fetal growth restriction.
Source: UpToDate.
This a e HELLP-Syndrome as we call it here. Hemolysis, Elevated Liver and Low Plateletts,
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