A 28-year-old primigravid woman at 35 weeks' gestation comes to the physician with a 5-day history of epigastric pain and nausea that is worse at night. Two years ago, she was diagnosed with a peptic ulcer and was treated with a proton pump inhibitor and antibiotics. Medications include folic acid and a multivitamin. Her pulse is 90/min and blood pressure is 130/85 mm Hg. Pelvic examination shows a uterus consistent in size with a 35-week gestation. The abdomen is tender over the right upper quadrant, but no rebound or guarding is present. Hemoglobin is 8 g/dL. Urinalysis shows 3+ protein. Which of the following associated laboratory changes are most likely to be seen in this patient?

Question

A 28-year-old primigravid woman at 35 weeks' gestation comes to the physician with a 5-day history of epigastric pain and nausea that is worse at night. Two years ago, she was diagnosed with a peptic ulcer and was treated with a proton pump inhibitor and antibiotics. Medications include folic acid and a multivitamin. Her pulse is 90/min and blood pressure is 130/85 mm Hg. Pelvic examination shows a uterus consistent in size with a 35-week gestation. The abdomen is tender over the right upper quadrant, but no rebound or guarding is present.  Hemoglobin is 8 g/dL.  Urinalysis shows 3+ protein.  Which of the following associated laboratory changes are most likely to be seen in this patient?

Quizplus · Accepted Answer

Eductional Objective: HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count) syndrome is a thrombotic microangiopathic disorder that causes microangiopathic hemolytic anemia (eg, increased indirect bilirubin levels), thrombocytopenia, and hepatocellular injury (eg, increased alanine aminotransferase).  Patients may have hypertension and right upper quadrant pain with nausea/vomiting.

A 28-Year-Old Primigravid Woman at 35 Weeks' Gestation Comes to the Physician