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20th OBGYN ORAL EXAM REVIEW ORAL SIMULATION 3 weeks age of gestation The patient was lost to follow up. During the interim, she became not compliant to medications and noted progression of proptosis. She came back at 36 weeks age of gestation with irregular contractions, agitation, palpitations, tremors and difficulty of breathing. On examination: BP 130/80 mmHg, HR 120 bpm, RR 28 cpm, Temp 390C, (+) exophthalmos, (+) diffusely enlarged thyroid, fundic height compatible with age of gestation, FHT 150s. On IE: cervix is 4 cms dilated, 50% effaced, intact BOW Laboratory Results: Blood type: B + Complete blood count: HBsAg: Nonreactive VDRL: Nonreactive Rubella IgG: Reactive HIV 1 and 2: Nonreactive FBS: 90 mg/dL Urine culture: No growth after 2 days Papsmear: Negative for intraepithelial lesion and malignancy Thyroid Function Tests: TSH: 0.0005 mIU/mL FT4 29.7 pm TRAb: Elevated
20th OBGYN ORAL EXAM REVIEW ORAL SIMULATION 4 ANSWER/ POINT SCORE 4. WHAT IS THE DIAGNOSIS? (1.0 POINT/S) (0.33 point each) ● Pregnancy uterine 36 weeks age of gestation by amenorrhea, cephalic in preterm labor ● Graves’ disease in storm ● G1P0

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