TEALE FENNING

schizoprincess · Joined: 22 Jul 2007 Posts: 13 Location: MALAYSIA

A 28 year old had amniocenthesis at 18weeks ( 2 weeks ago) for a raised serum test. She presented with absent fetal movements for 2 days and fetal heart could not be located on Sonicaid or ultrasound.
a) what symptoms and signs of genital sepsis would u look for ( 6 marks)
b)Shortly after admission, she goes in septicaemic shock. Briefly discuss features associated with this complication (6 marks)
c) discuss the guiding principles of antibiotic therapyb for this patient and her long term management (8 marks)

bluesky · Guest

what symptoms and signs of genital sepsis would u look for

Patient can present with constant abdominal pain not relieved with analgeisa, vaginal discharge which may be offensive and feeling of being unwell. There can be a history of pyrexia although not a constant feature. Patient can give history of headche,backache, nausea vomiting diarrhoea feeling hot and cold, sweating. She can have tachycardia, tachyapnoea, temp may be elevated to 38C, exam may reveal abdominal tenderness, guarding, Per speculum exam may reveal vaginal discharge.

bluesky · Guest

)Shortly after admission, she goes in septicaemic shock. Briefly discuss features associated with this complication (6 marks)

She can have pulse more than 90/min, R/R more than 20/min, hypotension. Temperature can be elevated to 38C but hypothermia can be seen in some cases. Abnormalities of liver function tests, renal fuction tests can be seen with metabolic acidosis and raised lactate. Oliguria can be seen commonly. Bleeding and coagulation abnormalities carry a bad prognosis. Hypoxia and multiple organ failure lead to increased mortality.

rpwalavalkar · Posted: Sat Feb 28, 2009 10:22 pm Post subject:

bluesky,

I will mention BP, urine output, O2 sats, peripheral cyanosis, etc for stem 1.

and urine output and o2 sats with stem 2 too.
_________________
Dr Miss. Raj Walavalkar MBBS MRCOG
TealeFenning Administrator
SR O&G Wessex Region