A 32-Year-Old Primigravida at 18 Weeks Gestation Is Evaluated in the Emergency

question 448

Multiple Choice

A 32-year-old primigravida at 18 weeks gestation is evaluated in the emergency department for increasing confusion and incoherence.  Her husband says that she has become increasingly unsteady while standing and has fallen twice.  The patient was previously seen in the emergency department for nausea and vomiting and was treated with intravenous fluids and antiemetics.  Although she continues to take oral antiemetics, she has had persistent vomiting and has lost 7 kg (15.4 lb) of her prepregnancy weight.  Blood pressure is 110/60 mm Hg and pulse is 98/min.  Fetal heart tones are 155/min.  Physical examination shows nystagmus but no scleral icterus.  Pupils are equal and reactive to light and accommodation.  Abdominal examination shows epigastric pain but no rebound or involuntary guarding.  The patient has trace pedal edema over her bilateral lower extremities and bilaterally absent ankle reflexes.  Laboratory results are as follows: Which of the following is the most likely diagnosis in this patient?

• A)Acute fatty liver of pregnancy
• B)HELLP syndrome
• C)Late neurosyphilis
• D)Thiamine deficiency
• E)Vitamin B₁₂ deficiency

Understand the relationship between leader behaviors (such as consideration and initiating structure) and various outcomes (e.g., job satisfaction, leader effectiveness).

Describe different leader behaviors including reward, punishment, participative, and transactional behaviors, and their effects on employee attitudes.

Grasp the key principles of the trait theory of leadership and its limitations.

Understand the role of contingency factors in leadership effectiveness, particularly in Fiedler's Contingency Theory.

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Definitions:

Exponential Decay

A process of reduction in quantity where the decrease is proportional to the current value, often used in science and finance to describe rapidly decreasing phenomena.

Compound Interest

The calculation of interest for deposits or loans that takes into account both the starting principal and previously accrued interest.

Exponential Decay

A process described by a decrease in quantity at a rate proportional to its current value, often observed in radioactive decay and depreciation of assets over time.

Complex Arithmetic

Mathematical operations that involve complex numbers, including addition, subtraction, multiplication, and division, where complex numbers are numbers with both real and imaginary parts.