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Questions
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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?
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D. Women with poorly controlled diabetes (A1C > 9.5%) have a significantly increased risk of fetal congenital malformation, which occur at approximately 22%.
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A, B, and C are incorrect. The baseline malformation rate in the general population is approximately 3%.
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Which of the following statements best describes the potential risks and benefits of inhaled corticosteroid use for asthma management during pregnancy?
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A. Inhaled corticosteroids were associated with an increased incidence of cleft palate in animal studies
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B. Pregnant women using an inhaled corticosteroid should be converted to budesonide, the preferred agent in pregnancy
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C. The risk of poor maternal and fetal health outcomes is greater with uncontrolled asthma than with exposure to most asthma medications during pregnancy
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D. Uncontrolled asthma impacts maternal health, but does not impact fetal health
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C. Most therapies are well tolerated, and are safer for mother and fetus than uncontrolled asthma.
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A. Cleft palate in animal studies was associated with zileuton, not inhaled corticosteroids
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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.
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D. Uncontrolled asthma impacts fetal health, and may lead to babies who are small for their gestational age.
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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?
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A. Change from lamotrigine to valproic acid
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B. Add topirimate as a second adjunctive agent
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C. Empirically increase lamotrigine
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D. Check a baseline lamotrigine serum trough concentration, recheck each trimester
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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
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A. Valproic acid has the highest rate of congenital malformations among the AED medications
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B. Medication monotherapy, at the lowest ...