A 34-year-old woman at 38 weeks gestation is evaluated for a severe headache. Her only medication is a prenatal vitamin. Neurologic and cardiopulmonary examination is normal. She h... A 34-year-old woman at 38 weeks gestation is evaluated for a severe headache. Her only medication is a prenatal vitamin. Neurologic and cardiopulmonary examination is normal. She has a gravid uterus and 2+ edema of the lower extremities. No petechiae or ecchymoses are seen (see lab results and report). Peripheral smear: Occasional fragmented erythrocytes without platelet clumping. Which of the following is the most appropriate management? A. High-dose dexamethasone B. Emergent delivery C. Plasma exchange D. Eculizumab
Understand the Problem
The question describes a clinical scenario of a pregnant woman at 38 weeks gestation presenting with a severe headache. The question requires identifying the most appropriate management based on the given clinical findings. The answer is provided (Emergent delivery), this is most likely a homework question.
Answer
Emergent delivery is the answer.
The final answer is B. Emergent delivery
Answer for screen readers
The final answer is B. Emergent delivery
More Information
Based on the information provided, the most appropriate management is emergent delivery. The patient is at 38 weeks gestation and has a severe headache, 2+ edema, and fragmented erythrocytes. These findings may indicate pre-eclampsia with severe features or HELLP syndrome, which require prompt delivery.
Tips
It is important to consider the gestational age of the patient, as well as the presence of any other symptoms or signs that may indicate a more serious condition.
Sources
- PDF - Step 3 Sample Questions November 2020 - usmle - usmle.org
- PDF - Sample Test Questions - Step 3 - usmle - usmle.org
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