Discipline "General medical practice No. 1"
Practical exam (stage 1)
SITUATIONAL TASK №36
A 24-year-old pregnant woman came to the reception with complaints of periodic bloody discharge from the genital tract.
From anamnesis: menstruation from the age of 14, established immediately, 4-5 days, after 28-29 days, regular, painless, moderate. Sexual life since the age of 21, married. Gynecological diseases chronic salpingitis, received a course of treatment with good effect.
Objectively: the condition is satisfactory, the skin and visible mucous membranes are clean. The mammary glands are soft, painless. Ps 78 beats per minute, blood pressure - 110/75 mmHg. The skin and visible mucous membranes are pink, clean. The mammary glands are soft, painless. Colostrum is released from the nipples. The abdomen is soft, painless, enlarged due to a pregnant uterus. Urination is free, painless. The stool is normal.
Gynecological status: the external genitalia are developed correctly, the hair is of the female type. The pregnant woman was not examined by a doctor.
Ultrasound of the pelvic organs: ultrasound revealed that the size of the fetus corresponds to 20 weeks of pregnancy. The placenta is located on the anterior wall of the uterus with a transition to the posterior wall, ”0" degree of maturity, 2.2 cm thick. There is a moderate amount of amniotic fluid, the heartbeat is determined.
Test results:
Full CBC - RBC 4,8*1012 г/л, Hb 100 г/л, WBC – 4,5х109/л, EO – 5%, NEUT - 5%, LYM – 34%, MON -10%, ESR – 15 мм/час.
UA – Color light yellow, clear, SG - 1022, PRO – abs, RBC - abs, LEU до 4-5 hpf.
Questions:
1. Preliminary diagnosis?
2. Examination plan?
3. Interpretation of test results.
4. Differential diagnosis and final diagnosis.
5. Treatment tactics
Discipline "General medical practice No. 1"
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