A 40yo G10P9 at 36wks states that she requires her albuterol inhaler four times per week. Her PEFR is 90% of her personal best. She reports some mild interference with daily activity. Choose the most appropriate intervention to manage her symptoms and reduce the risk of complications during pregnancy.

A 35yo G1P0 at 12wks has frequent asthma exacerbations. Her PEFR is 50% of her personal best, and she reports that her asthma wakes her up four to seven times per week. Choose the most appropriate intervention to manage her symptoms and reduce the risk of complications during pregnancy.

A 24yo G2P1 at 14wks presents for her routine prenatal visit. Her medical history is significant for asthma. During her appointment, the patient states that she uses an inhaled corticosteroid daily. She also has been using her albuterol multiple times a day for shortness of breath and wheezing. You note expiratory wheezing and shallow breathing on examination. Assessment of her PEFR is 70% of predicted. The most appropriate next step is to:

A 34yo woman is referred for pre pregnancy counseling. She is heterozygous for the deltaF508 cystic fibrosis mutation. There is no family history of cystic fibrosis on either side o the family. Her husband of Asian descent has not yet been screened. The couple states that they would potentially be interested in preimplantation genetic diagnosis or prenatal diagnosis if the husband is found to be a carrier. The test that most accurately determines his carrier status for cystic fibrosis is:

A 37yo G2P1 at 34wks calls your office for advice. She has no medical concerns and has had routine prenatal care. Her son was sent home from school yesterday with a fever and has tested positive for influenza A. The patient continues to care for her sick son. She denies any fever, cough, shortness of breath, chest pain and nausea. She denies contractions and reports fetal movement. The most appropriate management for her exposure is:

A 27yo patient G2P1 at 10wks presents to your office for a routine prenatal visit. Two months ago she traveled throughout Southeast Asia, volunteering in medically underserved areas where Mycobacterium tuberculosis is endemic. Since her return to the US 6 wks ago, the patient reports increased cough, dyspnea, malaise, night sweats, and fever. You suspect that she has acquired M. tuberculosis during her recent travels. The best next diagnostic study for this patient is:

A 26yo G3P3, with no prenatal care delivered a term infant. She received epidural anesthesia and required manual extraction of her placenta because of umbilical cord avulsion. The patient's medical history is noncontributory. Less than 24hrs after the delivery, she has a temperature of 102F, RR 28, and HR 115. She reports moderate loch and cramps abdominal pain. On examination, she has decreased breath sounds and crackles on the left side. Breasts are non-ntender, and her uterine fundus is near the umbilicus and non-tender. She does not have CVA tenderness. She has grade 2+ edema of bilateral lower extremities with no calf tenderness. The most likely cause of her fever is:

A 25yo G1P0 at 17wks, who has HIV presents for prenatal care. She is currently being treated with combination antiretroviral therapy. Her viral load is undetectable and her CD4 count is greater than 200. She is rubella non-immune. Although she received the hepatitis B vaccination series many years ago, she has not received any vaccination since her HIV diagnosis. The patient had confirmed chickenpox in childhood. During her initial prenatal visit, you explain that the influenza vaccine and Tdap vaccine are recommended. The other vaccine that you recommend for this patient during the antenatal period is:

A 25yo G1P0 at 28wks presents to the clinic with fever, myalgias, and malaise for the past 24hrs. Her husband has recently recovered from influenza. She has not received the flu vaccine. On exam, she appears flushed and ill. Temp 103.1F, RR 26, HR 115 and her lungs are clear bilaterally. The most appropriate next step in her management is administration of:

What happens to vital capacity in pregnancy?

Which of the following is used for treating asthma

acutely?

Which of the following is not a criterion for severe

community-acquired pneumonia?

What is the most common complication of

influenza?

Which of the following is not a characteristic of mild

persistent asthma?

A 25-year-old G4P3 at 19 weeks' gestation and in good health is brought to the emergency room for altered mental status. She is somnolent with complaints of headache and dizziness. She vomited in the ambulance. The patient's spouse reports that she was sleeping alone in the back of the house when he found her like this. The emergency medical technicians report chat she had two space heaters in the room with her and no ventilation. You are concerned that she is suffering from carbon monoxide poisoning. Which of the following is your initial treatment?

Which of the following statements about cystic

fibrosis (CF) and pregnancy is true?

In which group of pregnant patients can treatment

of latent tuberculosis be postponed to the postpartum

period?

Which of the following is the best choice for treatment of pneumocystis pneumonia?

What effect does progesterone have on tidal volume?

What happens to carbon dioxide production in

pregnancy?

Which of the following is not a hallmark of asthma?

The fetal response to maternal hypoxemia includes which of the following?

A pregnant woman in the late second trimester is being evaluated in the emergency room for an asthma exacerbation. An arterial blood gas is sent. Her PCO2 is 42 mm Hg, and her pH is 7.29. This is consistent with:

Which of the following is the best measure of asthma severity?

Which asthmatic patients should receive stress-dose corticosteroids in labor?

Which of the following medications is contraindicated in pregnant patients with asthma?

How long does the cough associated with acute bronchitis last?

Which of the following is the most common organism to cause chronic inflammation in the lungs of patients with cystic fibrosis?

A 25yo G3P2 at 20wks presents to the ER for an asthma exacerbation. Her FEV1 is 40%. She receives inhaled corticosteroids and 3 doses of an inhaled beta agonist. Her FEV1 is now 50%. She has an oxygen saturation of 95%. What is the next best step in management of this patient?