A pregnant patient at 5 weeks' gestation reports slight amount of vaginal bleeding. The clinician should recognize that the following laboratory test should be done:
A. Serial HCG levels over the next several days
B. Measurement of estrogen levels
C. Cervical mucus analysis
D. Pap smear for sexually transmitted infection
Question 2A pregnant patient at 6 months gestation who is 37 years old complains of urinary frequency, thirst, increased appetite, and candida vaginitis that is refractory to treatment.
The patient has a history of vaginal delivery of a 10-pound neonate 3 years ago. On physical examination, vital signs are T 98.6, pulse 88, resps 18/min, BP 120/70. On physical examination, heart has regular rate and rhythm at 88 beats/min, no S3, no murmurs. Lungs are clear to auscultation. Abdominal examination is negative. Uterus fundus is above umbilicus. Ankles: no edema. Dorsalis pedis pulses +2/4 bilaterally. Urine dipstick is negative for protein, + for glucose and + for ketones.
The clinician should:
A. Obtain a 3-hour glucose tolerance test
B. Order a Hgb A1c blood test
C. Obtain a fasting serum glucose
D. Order a 24-hour urine for creatinine, ketones, and glucose
Question 3Which of the following statements is true regarding gestational blood pressures?
A. Pre-eclampsia is diagnosed in pregnant women who have a BP greater than 130/80 mm Hg in the third trimester
B. Pre-eclampsia can occur even if the blood pressure is within the accepted normal range of BP
C. Gestational HTN is defined as a rise in systolic blood pressure of 15 mm Hg and a diastolic blood pressure rise of 30 mmHg
D. Gestational HTN is diagnosed if the patient has proteinuria and ankle edema regardless of BP measures
Question 4A pregnant patient at 24 weeks' gestation complains of shortness of breath on exertion, fatigue, weakness, and constant cravings for ice chips.
On physical examination, vital signs are T 98.6, pulse 100, resps 18/min, BP 120/ 70. On physical examination, heart has regular rate and rhythm at 100 beats/min, no S3, no murmurs. Lungs are clear to auscultation. Abdominal examination is negative. Uterus fundus is above umbilicus. Ankles: no edema. Dorsalis pedis pulses +2/4 bilaterally. Urine dipstick is negative for protein. Laboratory tests reveal CBC: Hgb 10 microcytic hypochromic RBCs. Which of the following conditions should be suspected?
A. Iron deficiency anemia
B. Folic acid deficiency anemia
C. Vitamin B12 deficiency anemia
D. None of the above
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