USMLE ALGORITHMS: OBGYN - Bleeding less than 20 weeks

[munam87]

do you have these document posted somewhere? they're very helpful thanks!

[docnizzi]

First, thanks so much for this.

For the purposes of CCS (or even multiple choice), if all criteria are met for MTX except it's not mentioned whether Pt was on folic acid or not, is it best to go to assume yes and go to salpingostomy?

Unfortunately, my test is in two days so you may not see this on time, but I am curious and to help out those taking it later.

[LeSeigneurDuMalin]

The first step is not speculum exam, but rather "is the patient haemodynamically stable or not?". In the setting of abd. pain, PV bleeding, and +ve pregnancy test with a woman who is haemodynamically unstable => immediate laparotomy (or laparoscopy + drainage & diathermy) + salpingectomy. There is no time to do a TVUS or serum B-hCG.

Salpingectomy is preferred to salpingostomy, as it is associated with lower rates of persistent trophoblast (4% vs. 8%) and future ectopic pregnancy (8% vs. 18%)

[josephmedman]

@LeSeigneurDuMalin, i agree with you on the first comment, however I disagree with you on the second paragraph. As for as stabalization goes, Im doing the best I can to fit what I can in one page, and I am limited by youtube to less than a 10 minute clip. For USMLE, salpingostomy is standard of care before salpingectomy. Im not sure if it's a cost issue, but I will research the topic more.

[adaloveraf]

Thank you so much for posting! great help. : }

[Meetonceloveforlife]

Thank you very much!!! RN student...

[DrKtgoes2medschool]

is there a location to download the algorithms?

[josephmedman]

sorry, they are all copyrighted. The book will come out this fall. USMLE ALGORITHMS..look out for it..take care

[acadm]

you have some excellent algorithms here; what program do you use to create these?

[zomorod]

thank you so much for this , if you can provide us with the reference or source of your lectures would be more benificial .. any way I do really appreciate :)