By Carlyle H. Chan
Delivering a finished evaluation of severe suggestions in a question and solution structure, this up to date variation is an invaluable research relief for college kids getting ready for the USMLE Step 2. All questions, 90 percentage of that are within the kind of case experiences, stick to USMLE Step 2 examination guidance. This package deal additionally encompasses a new CD-ROM. this beneficial disk types questions by means of either physique structures and USMLE different types, offers diagnostic suggestions, and allows online registration.
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Additional resources for Appleton & Lange's review for the USMLE step 2
If the uterus is found to be firmly contracted, then other factors, such as cervical or vaginal lacerations or a coagulopathy, must be sought. (Scott et al, pp 165–166) 68. (A) Immediate management is bimanual massage and compression of the uterine fundus by placing one fist into the anterior vaginal fornix and the other hand abdominally posterior to the uterus. The uterine massage is often enough to cause myometrial contractions and slowing of the bleeding. Oxytocin or an ergot alkaloid (eg, methylergonovine) should also be administered.
Obtaining a court order may fulfill the ethical principle of beneficence, a physician acting to do no harm and to help the patient. In this situation, the ethical (moral) decision is complicated by a conflict between beneficence and autonomy. However, proceeding with a cesarean section exposes the obstetrician to a legal charge of battery. Assigning her care to another physician is a standard and accepted solution when there is a moral conflict between patient and physician. However, this is not an acceptable option in an emergency situation.
However, proceeding with a cesarean section exposes the obstetrician to a legal charge of battery. Assigning her care to another physician is a standard and accepted solution when there is a moral conflict between patient and physician. However, this is not an acceptable option in an emergency situation. The obstetrician is at risk for abandonment. Though not a satisfying choice, the choice most ethically sound is to counsel her carefully, but eventually accede to her wishes. Placing her in the lateral position, giving her oxygen by mask, and providing adequate intravenous hydration should be instituted to minimize the risk of fetal hypoxia.