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Lorazepam
6%
3/52
Magnesium
27%
14/52
Phenobarbital
65%
34/52
Phenytoin
0%
0/52
Propofol
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This woman is likely suffering from eclampsia given her urine dipstick positive for hCG and protein in the setting of hypertension and seizures. Magnesium sulfate infusion can help both prevent and treat eclamptic seizures. Eclampsia is a life-threatening complication of pregnancy characterized by tonic-clonic seizures. It usually occurs in women who experience preeclampsia during pregnancy which usually presents with hypertension and proteinuria. Risk factors for developing preeclampsia/eclampsia include preexisting hypertension, diabetes mellitus, autoimmune disorders, preexisting renal disease, a family history of preeclampsia, obesity, multiple gestation, or a previous pregnancy complicated by preeclampsia/eclampsia. Any patient with severe preeclampsia or eclampsia should immediately be given magnesium, blood pressure medications (such as labetalol or nifedipine), and have the fetus delivered. Incorrect Answers: Answers 1, 3, 4, & 5: Lorazepam followed by phenytoin, then phenobarbital, and finally propofol would be the order in which medications would be given in status epilepticus (assuming no response to the previous medication). It is likely this patient has been pregnant for several months, and this has not been detected given her morbid obesity. Her positive hCG and proteinuria support a diagnosis of eclampsia. Bullet Summary: Magnesium is appropriate treatment and prevention of seizures in preeclampsia/eclampsia.
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