A 27-year-old woman, gravida 2, para 1, at 26 weeks' gestation comes to the emergency department because of vaginal bleeding and epistaxis for the past 2 days. She missed her last prenatal visit 2 weeks ago. Physical examination shows blood in the posterior pharynx and a uterus consistent in size with 23 weeks' gestation. Her hemoglobin concentration is 7.2 g/dL. Ultrasonography shows an intrauterine pregnancy with a small retroplacental hematoma and absent fetal cardiac activity. Further evaluation is most likely to show which of the following findings?
ADecreased fibrinogen concentration
BIncreased antithrombin concentration
CIncreased factor V concentration
DIncreased platelet count
EDecreased prothrombin time
A 28-year-old woman, gravida 1, para 0, at 32 weeks' gestation is evaluated for vaginal bleeding. Five days ago, she was admitted to the hospital and started on treatment for a deep vein thrombosis in the right leg. Her pulse is 125/min and blood pressure is 95/67 mm Hg. Physical examination shows large hematomas on the upper limbs and swelling in the right calf. There is a large amount of bright red blood in the vaginal vault. Laboratory studies show a hemoglobin of 8.9 mg/dL, platelet count of 185,000/mm3, and activated partial thromboplastin time of 160 seconds. Which of the following is the most appropriate pharmacotherapy to rapidly reverse this patient's coagulopathy?
AVitamin K
BProthrombin complex concentrate
CFresh frozen plasma
DProtamine sulfate
EAlteplase
A 25-year-old pregnant woman at 28 weeks gestation presents with a headache. Her pregnancy has been managed by a nurse practitioner. Her temperature is 99.0°F (37.2°C), blood pressure is 164/104 mmHg, pulse is 100/min, respirations are 22/min, and oxygen saturation is 98% on room air. Physical exam is notable for a comfortable appearing woman with a gravid uterus. Laboratory tests are ordered as seen below. Hemoglobin: 12 g/dL Hematocrit: 36% Leukocyte count: 6,700/mm^3 with normal differential Platelet count: 100,500/mm^3 Serum: Na+: 141 mEq/L Cl-: 101 mEq/L K+: 4.4 mEq/L HCO3-: 25 mEq/L BUN: 21 mg/dL Glucose: 99 mg/dL Creatinine: 1.0 mg/dL AST: 32 U/L ALT: 30 U/L Urine: Color: Amber Protein: Positive Blood: Negative Which of the following is the most likely diagnosis?
AHELLP syndrome
BAcute fatty liver disease of pregnancy
CPreeclampsia
DSevere preeclampsia
EEclampsia
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