CASE #1.

A 20 yr old G1P0, 30 weeks AOG came to the ER due to BP elevation at 180/100. She has
regular prenatal check-ups, and her blood pressure levels have always been within normal limits.
On history, she reported experiencing headaches, blurring of vision and dizziness since
yesterday, and she has right upper quadrant pain that started a few hours ago. No contractions
reported

On abdominal exam: fundic height 26cm, fetal heart tone 140 bpm;
estimated fetal weight 1000 grams.
Leopold’s maneuvers:
LM1 breech
LM2 fetal back right
LM3 cephalic
LM4 unengaged

IE: deferred

She came in with initial CBC and liver function tests done from another hospital:
hemoglobin 145 mg/dl; hematocrit 0.4
platelet 100
AST: 100 Units/L (elevated)
ALT: 150 units/L (elevated)

1. what is your initial diagnosis? (Pls give a complete diagnosis nomenclature)

2. what initial laboratory requests will you request to confirm or rule out diagnosis
3. What is/are your differential diagnosis?
4. Explain the pathophysiology of this condition; pls include explanation for the clinical
signs and symptoms
5. suppose you are the OB GYN on duty at the ER, how will you manage this case? Pls
outline the management from ER to admission at the wards.
6. what other laboratory test do you think are very important in managing this case?
7. how will you monitor the baby?
8. will you deliver the baby? if yes, when?
9. What are the possible complications of her condition?