advanced obstetrics for paramedic
Order Description
Submission Assignment: There are six questions to answer
Question 1: (30 marks)
The Site of implantation of an Ectopic Pregnancy determines presentation.
The signs and symptoms of a patient will vary depending on the site of the ectopic pregnancy.
Some ectopic pregnancies present earlier than others, some present with peritonitis and not others, there is PV bleeding in some cases but not others, etc
Explain how the different sites of possible ectopic pregnancy implantation will influence the patient’s presentation.
Include the anatomical structure of the fallopian tube with regard to the ectopic pregnancy implantation.
Tabulate this answer:
Compare the various implantation sites with the differences in history, period of amenorrhoea, symptoms and physical signs.
Question 2: (20 marks)
Statistics of perinatal Morbidity and Mortality in Australia.
What are the latest Australian statistics on Maternal Perinatal morbidity and mortality? List the main causes of maternal mortality and morbidity.
Question 3: (30 marks)
Thromboembolism in the puerperium:
Discuss the relevance of thromboembolism in the puerperium to the Extended Care paramedic.
Answer this question under the following headings: incidence, risk factors, symptoms, signs, differential diagnosis, and appropriate management.
Question 4: (35 marks)
Scenario: You are dispatched to a university residence. When you arrive on scene your are escorted to a room where a female student is lying in bed crying. She is a 20
year old second year university student living in the university residence. She is complaining of feeling unwell and having severe abdominal pain. She tells you she
has had abdominal pain for ‘a while’ but now she cannot handle the pain anymore. The pain started in the right iliac fossa. The pain has increased in severity and
nothing seems to take the pain away. The pain is continuous and the only way she can cope with the pain is to lie very still and not move.
On questioning, she tells you that she can’t be pregnant as she had her period 6 days ago. It was a normal period for her although slightly heavier than usual. She
bled for 4 days, no clots, and stopped bleeding the day before yesterday. She has noticed an unusual offensive vaginal discharge the past 2 days.
She is not taking any form of Oral contraception but she is careful and her new boyfriend is mostly happy to use a condom.
She had her appendix removed when she was 14 years old, but there is no other significant Medical, Surgical or Family History. No history of trauma.
She is not allergic to anything and is not on any medication.
She admits she is a smoker and smokes about 8- 10 cigarettes a day. She also admits to being a social drinker, having a few drinks when the residence has a party.
On Examination: Your patient is distressed and in obvious pain. She looks ill and feverish.
Radial Pulse: 96 beats/min -regular in rate and rhythm
BP: 120/80 mmHg Right arm, patient supine
RR: 16 breaths/min
GCS: 15/15
Temperature: 38.2 degrees Celsius
Colour: she is not pale, not jaundiced, and has good peripheral perfusion
Head & neck examination: No abnormalities detected except her tongue appears furred
Abdominal examination: Abdomen does not appear distended. Her abdomen is tender on palpation and there is guarding and rebound tenderness. You are unable to listen for
bowel sounds as your patient complains when you place your stethoscope on her abdomen.
Resp/ CVS/ MSS/ Neuro Systems- All normal-nothing abnormal detected
4.1. What is in your differential Diagnosis? Explain why you are considering the various diagnoses.(10 marks)
4.2. What other relevant questions would you like to ask your patient? Explain the reasoning behind why you are asking the particular question. (10 marks)
4.3. What is your working diagnosis in this patient? What is the cause of her condition? Give as much detail as possible.(10 marks)
4.4 How would you manage this patient?(5 marks)
Question 5: (25 marks)
Vaccines in pregnancy: The Australian Perspective
List the Vaccines which are safe and necessary in pregnancy.
Include indications, benefits and potential side effects/complications.
Tabulate this answer
Question 6: (20 marks)
Female Malignancies
List the various Cancers of the Female Genital Tract affecting Australian women. Include the prevalence of each cancer (i.e. 1 in 7 women affected, 1 in 25 women
affected, etc)
How could each of these cancers present in the emergency setting? i.e. What would be a reason a paramedic would be dispatched to each of these patients?
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