A pregnant patient at 6 months gestation who is 37 years old complains of urinary frequency, thirst, increased appetite, and candida vaginitis that is refractory to treatment. The patient has a history of vaginal delivery of a 10-pound neonate 3 years ago. On physical examination, vital signs are: temperature 98.6°F, pulse 88 beats/min, respirations 18 breaths/min, blood pressure 120/70. Heart has a regular rate and rhythm at 88 beats/min, no S₃, no murmurs. Lungs are clear to auscultation. Abdominal examination is negative. Uterus fundus is above the umbilicus. Ankles: no edema. Dorsalis pedis pulses +2/4 bilaterally. Urine dipstick is negative for protein, + for glucose and + for ketones. The clinician should consider all of the following except:

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The Answer of A pregnant patient at 6 months gestation who is 37 years old complains of urinary frequency, thirst, increased appetite, and candida vaginitis that is refractory to treatment. The patient has a history of vaginal delivery of a 10-pound neonate 3 years ago. On physical examination, vital signs are: temperature 98.6°F, pulse 88 beats/min, respirations 18 breaths/min, blood pressure 120/70. Heart has a regular rate and rhythm at 88 beats/min, no S₃, no murmurs. Lungs are clear to auscultation. Abdominal examination is negative. Uterus fundus is above the umbilicus. Ankles: no edema. Dorsalis pedis pulses +2/4 bilaterally. Urine dipstick is negative for protein, + for glucose and + for ketones. The clinician should consider all of the following except:

A Pregnant Patient at 6 Months Gestation Who Is 37