Module 1: Cases for Discussion

Cases for Small Group Discussion
For the following clinical scenarios, the learner should be able to answer these questions:

1) What’s the most appropriate next step for the assessment/plan of this patient?
2) If an Ultrasound is indicated, which one would you order and why?
3) What are you looking for in the US? What result are you expecting?
4) Describe the sonographic findings/describe the images. 


Case 1
21y/o Nulligravid presents to your office complaining of amenorrhea, LMP was 9 weeks ago. Denies any symptom. She is sexually active with 2 year boyfriend and uses condoms occasionally for birth control. She refers this is the first time this happens since she always has regular menstrual periods. 

Case 2
34y/p G2P0010 with an IUP 12wks based on LMP presents to the clinic for Prenatal Care visit. She reports some pelvic cramping associated with bleeding around 2 weeks ago, for which she went to ER, but they said “everything was fine”. She denies any medical condition, but has history of a SAB at 8 weeks 3 years ago, and was on Depo for birth control. 

Case 3
27y/o G3P1011 at 37 weeks gestational age, with Morbid Obesity and C-HTN presenting with profuse vaginal bleeding. She denies pelvic pain or contractions. Reports +FM and denies previous LOF.

Case 4
36y/o G3P2002 at 32 weeks pregnant with history of Gestational Diabetes on previous pregnancy comes to clinic for a routine PNV. On physical exam you find a fundal height greater than dates. On her chart you noticed that her last baby had a birth weight of 10lbs and was delivered by C/S. 

Case 5
41y/o G2P0101 at 19 weeks of gestational age who presents to your office to discuss her 1rst trimester US results which showed like a "fat pad" at fetus neck area, per patient report. She has family history of a baby born with some “heart anomaly”. 




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