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Questions

Which of the following best depicts the frequency of fetal congenital malformations in patients with poorly controlled diabetes (A1C > 9.5%) at conception and early gestation?

A. 3%

B. 5%

C. 10%

D. >20%

D. Women with poorly controlled diabetes (A1C > 9.5%) have a significantly increased risk of fetal congenital malformation, which occur at approximately 22%.

A, B, and C are incorrect. The baseline malformation rate in the general population is approximately 3%.

Which of the following statements best describes the potential risks and benefits of inhaled corticosteroid use for asthma management during pregnancy?

A. Inhaled corticosteroids were associated with an increased incidence of cleft palate in animal studies

B. Pregnant women using an inhaled corticosteroid should be converted to budesonide, the preferred agent in pregnancy

C. The risk of poor maternal and fetal health outcomes is greater with uncontrolled asthma than with exposure to most asthma medications during pregnancy

D. Uncontrolled asthma impacts maternal health, but does not impact fetal health

C. Most therapies are well tolerated, and are safer for mother and fetus than uncontrolled asthma.

A. Cleft palate in animal studies was associated with zileuton, not inhaled corticosteroids

B. The risk of deterioration in asthma control outweighs the benefits of changing to budesonide. Although budesonide is the preferred agent, if a patient is stable on a different ICS they should continue that therapy.

D. Uncontrolled asthma impacts fetal health, and may lead to babies who are small for their gestational age.

A patient has not experienced a seizure for the past 3 years on her current dose of lamotrigine. Which of the following would you recommend to optimize her medication regimen prior to pregnancy?

A. Change from lamotrigine to valproic acid

B. Add topirimate as a second adjunctive agent

C. Empirically increase lamotrigine

D. Check a baseline lamotrigine serum trough concentration, recheck each trimester

D. check a baseline serum concentration when the patient is well controlled, and then recheck serum trough concentrations each trimester and adjust medication doses accordingly

A. Valproic acid has the highest rate of congenital malformations among the AED medications

B. Medication monotherapy, at the lowest ...

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