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MRCOG PART 2 SBAs and EMQs

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notes328
EMQ1470
SBA2076
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answer essay 364

answer essay 364 Posted by suha F.

A.the causes could be excess blood loss inta  operative that cause hypovolaemia and renal hypoperfusion  2nd  urinary tract injury in big or multiple fibroid

B. I will assess woman general condition first pulse b.p. O2 saturation and theen review the note legnth of surgery any difficulty arise asit raise posibility of U.T. injury location of fibroid No. and size of fibroid also monitoring of the pt along surgery as may be wrong estimation  of BL. loss 

C. The drop in hb cnfirm that the cause related to blood loss so iwill start monitoring of pt hand in hand with resustation as mandated by her general condition and labortry finding best cared in HDU. with MDT. including anaesthesia consultant gynaecologist iwill notify haematotogist and blood bank .according to finding decision of re-laparotomy should be at seniors level and if pt. condition allow shoud be explaind to her otherwise surgeon will act inthe best interest of the pt post op. should becared in HDU. with monitoring of input output chart  incident report form shoud be filled regarding re-laparotomy and pt debriefed