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An 18-year-old G1P0 woman who is 10 weeks pregnant presents for her first prenatal visit. She reports nausea with occasional vomiting but denies bleeding, urinary symptoms, or abdominal pain. She just graduated high school and works at the local grocery store. She does not take any medications and has no known drug allergies. Physical examination is unremarkable. Initial laboratory studies reveal the following:Serum:Na+: 140 mEq/LCl-: 100 mEq/LK+: 4.0 mEq/LHCO3-: 24 mEq/L BUN: 10 mg/dL Glucose: 100 mg/dLCreatinine: 1.0 mg/dLThyroid-stimulating hormone: 2.5 µU/mLCa2+: 9.5 mg/dLAST: 25 U/LALT: 20 U/LLeukocyte count: 10,000 cells/mm^3 with normal differentialHemoglobin: 14 g/dLHematocrit: 42%Platelet count: 200,000 /mm^3Urine:Epithelial cells: fewGlucose: negative WBC: 20/hpfBacterial: > 100,000 cfu / E. coli pan-sensitiveWhat is the best next step in management?
Observation and treatment if symptoms develop
Nitrofurantoin for seven days
Observation and repeat cultures in one week
Nitrofurantoin for duration of pregnancy
Levofloxacin for three days
Select Answer to see Preferred Response
A 33-year-old G1P0 at 32 weeks gestation presents to her OB/GYN for a prenatal check-up. Her medical history is significant for type II pregestational diabetes mellitus, which has been well-controlled with diet and insulin so far throughout her pregnancy. Which of the following is the recommended future follow-up for this patient?
Ultrasound for fetal growth every week starting now until delivery
Monitor fetal kick counts starting now until 40 weeks gestation
Monthly nonstress test strating at 34 weeks gestation until delivery
Monthly biophysical profile now until delivery
Twice weekly nonstress test now until delivery
A 32-year-old G3P2 at 20 weeks gestation presents to her PCP with complaints of fatigue, chills, and decreased appetite for the past 5 days. Her pregnancy has been uncomplicated to-date, and she has been receiving regular prenatal care. The patient mentions that, in an attempt to increase nutrition for her fetus, she has been consuming increased amounts of dairy products in the past month. At 35 weeks gestation, the patient delivers an ill neonate with sepsis, pneumonia, and disseminated skin findings (Figure A). What is the appropriate action that the PCP should have taken after the patient’s initial presentation?
Supportive care with rest and hydration
Blood and amniotic fluid cultures
Vaginal and stool cultures
Empiric ceftriaxone therapy
Empiric ampicillin therapy
A 27-year-old G0P0 female presents to her OB/GYN for a preconception visit to seek advice before becoming pregnant. A detailed history reveals no prior medical or surgical history, and she appears to be in good health currently. Her vaccination history is up-to-date. She denies tobacco or recreational drug use and admits to drinking 2 glasses of wine per week. She states that she is looking to start trying to become pregnant within the next month, hopefully by the end of January. Which of the following is NOT recommended as a next step for this patient's preconception care?
Begin 400 mcg folic acid supplementation
Recommend inactivated influenza vaccination
Obtain rubella titer
Administer measles, mumps, rubella (MMR) vaccination
Obtain varicella zoster titer