Anemia in pregnancy Quiz: Ace Your Exams

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A 29-year-old G1P0 woman at 15 weeks gestation presents to the primary care clinic for evaluation of fatigue for the past three weeks. She has had minimal pregnancy-associated weight gain secondary to daily nausea and vomiting multiple times a day. The nausea and vomiting have improved since she entered the second trimester, and she currently has nausea with vomiting several times each week. Current medications include prenatal vitamins. Vital signs are within normal limits. On physical examination, the patient is comfortable and in no acute distress. There is no tenderness to palpation of the abdomen, and she has a gravid uterus appropriate for gestational age. Laboratory studies are shown below. Which of the following is the most appropriate treatment for this patient?

 Laboratory Test     Serum Value     Reference Range    
 Hemoglobin     10 g/dL     12-16 g/dL    
 MCV     75 fL     80-100 fL    
 Iron     39 mcg/dL     50-170 mcg/dL    
 Ferritin     9 ng/mL     12-150 ng/mL    
 Total Iron Binding Capacity     427 mcg/dL     250-370 mcg/dL    
 Vitamin B12     500 pg/mL     160-950 pg/mL    
 Folate     10.0 ng/mL     2-20 ng/mL    

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