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| Dec 08, 2007 12:34 am |
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| well, doc, i appreciate the mental assaults :) i think we've already stirred this place up a bit so i guess others should try to voice out their say |
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| Dec 08, 2007 12:35 am |
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| well shes not pregnant she gave birth .. |
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| Dec 08, 2007 12:36 am |
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| oh, lol... my advice to the rest of the world... pay heed! :) over and out... :) |
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| Dec 08, 2007 12:40 am |
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| * fades away like the last breath of life* |
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| Dec 08, 2007 10:10 pm |
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| gave birth 4 days ago .. complaining of abdominal pain still !! |
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| Dec 14, 2007 06:37 am |
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hi! new guy here.... let me give it a try
Doc, did she delivered via NSVD or CS? |
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| Dec 20, 2007 12:25 pm |
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| Dec 25, 2007 10:57 pm |
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doc, i need to know the following info about the patient for a quick assessment...
History
the abdominal pain
- what quadrant/area of the abdomen does it hurt?
- when did it start? is it right after delivery or before the delivery or maybe 4days after delivery?
- are there any radiations?
- has she taken any meds since then?
Physical exam
- is there tendernes upon palpation?
- is there rebound tenderness?
- any discharges seen in the vagina? im thinking of an STD cause probably the pain is due to PID
- whats the findings on speculum examination?
on the delivery
- is the baby term?
- apgar score of the baby?
- did the baby survive the first 48 hours of birth?
for the labs
i need the results for...
cbc, u/a would do for now.
i like this kind of case based approach... hope we'll have more of these after this case. :) |
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Dec 31, 2007 03:36 pm
Edited : Dec 31, 2007 03:37 pm |
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Marvin said:
doc, i need to know the following info about the patient for a quick assessment...
History
the abdominal pain
- what quadrant/area of the abdomen does it hurt? ULQ and URQ
- when did it start? is it right after delivery or before the delivery or maybe 4days after delivery? 3/4 days after
- are there any radiations? none
- has she taken any meds since then? no she finished her prenatals, she takes a multivitamin
Physical exam
- is there tendernes upon palpation? no
- is there rebound tenderness? no
- any discharges seen in the vagina? im thinking of an STD cause probably the pain is due to PID none
- whats the findings on speculum examination? nothing/normal
on the delivery
- is the baby term? yes
- apgar score of the baby? 10
- did the baby survive the first 48 hours of birth? yes
for the labs
i need the results for...
cbc, u/a would do for now. cbc and u/a normal
i like this kind of case based approach... hope we'll have more of these after this case. :)
Yea this is fun, feel free to make up one of your own, for others to guess at ! |
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| Jan 08, 2008 10:03 pm |
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sorry for the late reply doc... this clerkship rotation is really draining some of my internet time.
seems to me that my differentials are really far from what i expected before. Before i was thinking of PID 2ndary to STI. but now i change my plan.
Here are my initial orders while on the ER. Hope im doing this right. hehehe! :)
Put the patient of IV D5LR KVO
Ketorolac 1 amp now
Paracetamol 300mg IVTT now
monitor v/s q 1 hour and record pls
monitor I and O q 1 hour and record pls (catheter as needed)
refer
Additional History:
- Did the patient underwent Dilatation and curettage after delivery?
- was the placenta retained after the deliver?
- Where there complications during the delivery?
- Was the patient in pre-eclampsia/eclampsia/pregnacy induced HPN during the pregnancy?
- is she a diagnosed hypertensive? is she compliant to meds?
- is the patient dypneic? is the patient pale? is the patient cyanotic?
PE:
the latest vital signs pls... BP, HR, RR, O2sat and temp
fundoscopic exam results?
liver span?
is the pain dermatomal in distribution? or is it confined on the anterior abdomen?
Additional labs:
thoracoabdominal CT
at this time im entertaining post partum abdominal aortic aneurysm r/o STI
or i can do this the easy way. i can just refer this to an OB or an IM resident. hehehe! :) |
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