Question

28 yo female, presents to ED with nausea, vomiting, abdominal pain. No sick contacts, no chronic medical conditions, has been undergoing ovulation induction for infertility treatment. Last hCG injection was 7 days ago. LMP was 3 weeks ago. Hypotensive, tachy, tachypneic, decreased lung sounds at the bases. Labs show increased hematocrit, and WBC, beta hCG of 1102 IU/L. Pelvic ultrasound shows small uterus with thin endometrium. Bilateral enlarged ovaries with multiple cysts and large amount of fluid in abdomen. Diagnosis?

Answer 1

The diagnosis for this patient is Ovarian Hyperstimulation Syndrome (OHSS), a potential complication of ovulation induction therapy. Symptoms include abdominal pain, nausea, vomiting, and enlarged ovaries with multiple cysts. Treatment involves supportive care and monitoring.

Step-by-step explanation:

The diagnosis for this patient is Ovarian Hyperstimulation Syndrome (OHSS). OHSS is a potential complication of ovulation induction therapy, which involves receiving hormonal treatments to stimulate ovulation. Symptoms include abdominal pain, nausea, vomiting, and enlarged ovaries with multiple cysts. The patient's decreased lung sounds and fluid in the abdomen suggest a more severe form of OHSS called the fluid overload type.

The treatment for OHSS typically involves supportive care, including fluid and electrolyte management, pain control, and monitoring. In severe cases, hospitalization may be required.

This patient's symptoms are consistent with OHSS due to the recent ovulation induction therapy and the presence of enlarged ovaries with multiple cysts on ultrasound. Prompt medical attention is necessary to ensure appropriate management.