Wow I did my pediatrics rotation and was so happy with the content and now i'm about to start gynecology and here you are with great content as well 🎉 thank you so much !
(On Friday/Saturday of March 31[1st of April], 2023). On the Matter of Obstetrics-Gynecology and the Pathology of Eclampsia (Hypertension, Proteinuria and Seizures and the Alloimmunogeneicity Therein) by MD Paul W. Bolin (CRASH! Medical Review Series Editor-in-Chief): 1) Rh Negativity is Dead or Dying. Estimates go as far as 94% Rh Positive to 6% D Antigen Negative!. 1) Pathogenesis of Eclampsia follow the Hypertension of Pregnancy (Possibly due to a Immune Mechanism) to Pre-eclampsia (Hypertension with Renal Signs of Proteinuria) to Eclampsia (CNS Involvement with Seizures). 2) Epidemiology of Eclampsia (Ex): 1) Severe Pre-eclampsia Specificity 75%; 2) a) 25% Prenatal Seizures; b) 50% Peripartum; c) 25% of Seizure Pathology within Postpartum Period; 3) 2% Maternal Mortality Rate; a) Fetal Mortality within the Ratio of 1:14 Births; 3) Signs and Symptoms (SSx): 1) Seizures; 2) History of Pre-eclampsia; Fetal Manifestations: 1) Intrauterine Growth Retardation (IUGR); 2) Oligohydramnios (Insufficient Placental Amniotic Fluid; 3) Abnormal Fetal Oxygenation (Fetal Hypoxia); 4) Eclampsia Prodrome: 1) Headache (83%); 2) Hyperreflexia (80%); 3) Marked Proteinuria (53%); 4) Generalized Edema (49%); 5) Visual Disturbances (44%); 6) Right Upper Quadrant (RUQ) or Epigastric Pain (19%); 4) Diagnosis (Dx): 1) Clinical Diagnosis; 2) Onset of Seizures; 5) Treatment (Tx): 1) Supportive (Hypertension and Hypoxia); 2) 100% Oxygen Supplementation; 3) Anti-Epileptic Agents Specific To Eclampsia (FDA-Approved Pharmacotherapy; 6) Management (Mx): 1) Magnesium Sulfate (Anti-Epileptic Drug Class) is First Line; 2) Benzodiazepines and Phenytoin Second Line for Refractory-Relapse Scenario; 3) Anti-Hypertensives via IV Labetalol with the Understanding a Rapid BP Drop can Result in Inadequate Fetal Perfusion (uteroplacental) and result in Fetal Asphyxiation (Less than 160/110 Goal); 4) Cardiotocometry for Fetal Monitoring; 5) Definitive Management is Delivery Pending Stabilization (Hypoxia and Seizure Control); 6) Betamethasone (Post 32-34 Week Gestation) is Corticosteroid (Anti-inflammatory Maternally and Obstetrically allows for Surfactant Release, A Pulmonal Lubricant allowing Better Transition to Respiration Ventilation; 7) Nulla Per Os (NPO); 8) Anesthesiology Preparatives are Judicious Procedural Precautions (Include your Friendly Anesthesiologist at once); 9) Postpartum Management Magnesium Sulfate Continuation 12-24 Hours SP Partum; 10) Magnesium Sulfate is the Modality of Seizure Therapeutics Exclusively in Postpartum Phase; 7) Hypertension Disorder Types in Pregnancy: 1) Chronic Hypertension (CH) when there is no Evidence of Proteinuria or Trace Proteinuria (< 300 mg/D) before 20th Week of Gestation Mark; If Proteinuria is Above 300 mg/D, then Diagnosis of Chronic Hypertension with Superimpose Pre-Eclampsia follows; 2) Gestational Hypertension beyond the 20th Week of Gestation if no Proteinuria or Trace Proteinuria (< 300 mg/D); 3) Proteinuria Beyond the 20th Week: 1) Mild-Pre-eclampsia if there is minimal Symptoms; 2) If Symptoms are Severe, Severe Pre-Eclampsia Diagnosis is made and Precaution therein follow; 3) Eclampsia is the Presence of Proteinuria Criteria and Seizures; 4) Complications (Cx) Therein: 1) Microangiopathic Hemolytic Anemia (MAHA) is Hemolysis and Anemia (CBC shows Anemia Profile) and Peripheral Blood Smear (PBS shows Schistocytes); 2) Liver Inflammation (Hypertransaminasemia or Elevated Liver Enzymes; LFTs); and 3) Thrombocytopenia (CBC showing Low Platelet Counts); 4) This Laboratorial/Clinical Scenario is better understood as HELLP Syndrome; Goodness, My First Neonatorum Diathesis; Just Kidding. The Postpartum Scenario was Detrimental and Prognostic Death Assurance to Both Mother and Neonate. It is only the Judicious and Pathognomonic Perspicacity of UltraAge Therapeutics and Diagnositics Therein that allowed a known Alloimmunogeneic Wicked Start to End Benign via immunogeneicregulation of Personal Ideation and Development otherwise Patented Chemical Therapeutics of Personal Propriety--I cound say Patents Pending but they are not (Available to GMOs). MD Paul W. Bolin, es geht gut aber man muesse lernen was Wert Das Leben habt. Heil!
Wow I did my pediatrics rotation and was so happy with the content and now i'm about to start gynecology and here you are with great content as well 🎉 thank you so much !
Dr Paul, you are the GOAT ❤️
Dr Paul Bolin- You made my medical school years easy. Thank you so much❤
Dr Paul, you are an inspiration to a young Doc like I am. Thank you for this educative initiative.
(On Friday/Saturday of March 31[1st of April], 2023). On the Matter of Obstetrics-Gynecology and the Pathology of Eclampsia (Hypertension, Proteinuria and Seizures and the Alloimmunogeneicity Therein) by MD Paul W. Bolin (CRASH! Medical Review Series Editor-in-Chief): 1) Rh Negativity is Dead or Dying. Estimates go as far as 94% Rh Positive to 6% D Antigen Negative!. 1) Pathogenesis of Eclampsia follow the Hypertension of Pregnancy (Possibly due to a Immune Mechanism) to Pre-eclampsia (Hypertension with Renal Signs of Proteinuria) to Eclampsia (CNS Involvement with Seizures). 2) Epidemiology of Eclampsia (Ex): 1) Severe Pre-eclampsia Specificity 75%; 2) a) 25% Prenatal Seizures; b) 50% Peripartum; c) 25% of Seizure Pathology within Postpartum Period; 3) 2% Maternal Mortality Rate; a) Fetal Mortality within the Ratio of 1:14 Births; 3) Signs and Symptoms (SSx): 1) Seizures; 2) History of Pre-eclampsia; Fetal Manifestations: 1) Intrauterine Growth Retardation (IUGR); 2) Oligohydramnios (Insufficient Placental Amniotic Fluid; 3) Abnormal Fetal Oxygenation (Fetal Hypoxia); 4) Eclampsia Prodrome: 1) Headache (83%); 2) Hyperreflexia (80%); 3) Marked Proteinuria (53%); 4) Generalized Edema (49%); 5) Visual Disturbances (44%); 6) Right Upper Quadrant (RUQ) or Epigastric Pain (19%); 4) Diagnosis (Dx): 1) Clinical Diagnosis; 2) Onset of Seizures; 5) Treatment (Tx): 1) Supportive (Hypertension and Hypoxia); 2) 100% Oxygen Supplementation; 3) Anti-Epileptic Agents Specific To Eclampsia (FDA-Approved Pharmacotherapy; 6) Management (Mx): 1) Magnesium Sulfate (Anti-Epileptic Drug Class) is First Line; 2) Benzodiazepines and Phenytoin Second Line for Refractory-Relapse Scenario; 3) Anti-Hypertensives via IV Labetalol with the Understanding a Rapid BP Drop can Result in Inadequate Fetal Perfusion (uteroplacental) and result in Fetal Asphyxiation (Less than 160/110 Goal); 4) Cardiotocometry for Fetal Monitoring; 5) Definitive Management is Delivery Pending Stabilization (Hypoxia and Seizure Control); 6) Betamethasone (Post 32-34 Week Gestation) is Corticosteroid (Anti-inflammatory Maternally and Obstetrically allows for Surfactant Release, A Pulmonal Lubricant allowing Better Transition to Respiration Ventilation; 7) Nulla Per Os (NPO); 8) Anesthesiology Preparatives are Judicious Procedural Precautions (Include your Friendly Anesthesiologist at once); 9) Postpartum Management Magnesium Sulfate Continuation 12-24 Hours SP Partum; 10) Magnesium Sulfate is the Modality of Seizure Therapeutics Exclusively in Postpartum Phase; 7) Hypertension Disorder Types in Pregnancy: 1) Chronic Hypertension (CH) when there is no Evidence of Proteinuria or Trace Proteinuria (< 300 mg/D) before 20th Week of Gestation Mark; If Proteinuria is Above 300 mg/D, then Diagnosis of Chronic Hypertension with Superimpose Pre-Eclampsia follows; 2) Gestational Hypertension beyond the 20th Week of Gestation if no Proteinuria or Trace Proteinuria (< 300 mg/D); 3) Proteinuria Beyond the 20th Week: 1) Mild-Pre-eclampsia if there is minimal Symptoms; 2) If Symptoms are Severe, Severe Pre-Eclampsia Diagnosis is made and Precaution therein follow; 3) Eclampsia is the Presence of Proteinuria Criteria and Seizures; 4) Complications (Cx) Therein: 1) Microangiopathic Hemolytic Anemia (MAHA) is Hemolysis and Anemia (CBC shows Anemia Profile) and Peripheral Blood Smear (PBS shows Schistocytes); 2) Liver Inflammation (Hypertransaminasemia or Elevated Liver Enzymes; LFTs); and 3) Thrombocytopenia (CBC showing Low Platelet Counts); 4) This Laboratorial/Clinical Scenario is better understood as HELLP Syndrome; Goodness, My First Neonatorum Diathesis; Just Kidding. The Postpartum Scenario was Detrimental and Prognostic Death Assurance to Both Mother and Neonate. It is only the Judicious and Pathognomonic Perspicacity of UltraAge Therapeutics and Diagnositics Therein that allowed a known Alloimmunogeneic Wicked Start to End Benign via immunogeneicregulation of Personal Ideation and Development otherwise Patented Chemical Therapeutics of Personal Propriety--I cound say Patents Pending but they are not (Available to GMOs). MD Paul W. Bolin, es geht gut aber man muesse lernen was Wert Das Leben habt. Heil!