Author: Renee Haywood / Editor: Sarah Edwards / Codes: HC2, ObC11, ObC6, SLO1, SLO3 / Published: 05/12/2023
A 38-year-old female presents to the Emergency Department (ED) with a one-day history of vomiting and epigastric pain. She is 4 days post-partum. She has felt generally unwell with a headache that she attributes to lack of sleep caring for newborn child.
She has no significant past medical history, no medical issues during pregnancy and had an uncomplicated spontaneous vaginal delivery at term of her first child 3 days ago. She takes no regular medications.
On examination:
- Respiratory Rate of 16
- Oxygen saturations of 99% on air
- Blood pressure 179/101
- Pulse 83
On examination her abdomen is soft with RUQ and epigastric tenderness, with guarding and no rebound tenderness.
Her blood test results are shown below:

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Question 1 of 3
1. Question
What additional investigation should be done in the work up of this patient?
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2. Question
According to British NICE guideline which of the following medications can be used in treatment of this patient?
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3. Question
You have started treatment with Magnesium sulphate and Labetalol, while awaiting transfer to the Obstetric ward the lab contacts you and says the patient’s PT / PTT results are markedly prolonged, what condition is this significant for?
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