Complete doctor PLAB1 series (Gynaecology)
#Gynaecology
A 51-year-old woman in her 12th week of an assisted-conception triplet pregnancy presents to accident and emergency with severe nausea and vomiting. She has mild lower abdominal and back pains. Urine dipstick shows blood –ve, protein –ve, ketones ++++, glucose +. What is the most appropriate management plan?
a. Intravenous crystalloids and doxycycline, urgent ultrasound assessment
b. Discharge with 1 week’s course of ciprofloxacin
c. Referral to the medics for investigation of viral gastroneteritis
d. Intravenous crystalloids, oral antiemetics
e. Referral to the surgeons for investigation of appendicitis
aNS: d. Intravenous crystalloids, oral antiemetics