Our goal is to ensure you have current, accurate information to support your assessment needs.įor more information about taking your United States Medical Licensing Examination (USMLE), make sure to check out the following resources regarding site status, modified test center procedures, safety measures, FAQs, and candidate support (in alphabetical order). Please note that last minute cancellations due to unforeseen circumstances can occur, in which case you will receive a pre-communications letting you know your appointment has been cancelled, with a follow up email letting you know when it has been updated in the system so you can schedule via self-serve. When such a decision occurs in the future, Prometric will process the cancellation and send you a notification that your appointment has been cancelled, so you can schedule a new appointment. We will continue to review our social distancing requirements and make determinations on whether we can preserve future appointments or if they need to be cancelled due to our inability to test at specific locations, based on local and state guidelines.
We will continue to review local & state guidelines to ensure centers are open and operational where permitted to do so. Exercise, if there are no medical or obstetrical contraindications, is also encouraged.Prometric is hopeful that the COVID-19 situation in many markets continues to improve, providing more opportunities to support USMLE test takers. Providing diet education and establishing home blood glucose monitoring (choice E) will be important once the correct diagnosis is established. Obtaining hemoglobin A1c, determining renal function, ruling out proliferative retinopathy and establishing home blood glucose monitoring ( choice C) would be important if the patient was diabetic prior to pregnancy, or if she was diagnosed with overt diabetes based on a fasting blood glucose ≥ 125 mg/dL, in which case the 3-hour OGTT would not have been performed. In patients that are unable or unwilling to comply with insulin therapy, this is a reasonable alternative. Oral antihyperglycemic medications ( choice B), specifically metformin or glyburide, might be considered if home glucose monitoring (4 times daily) reveals persistent hyperglycemia despite diet and exercise changes. Insulin is generally preferred over oral medications in the treatment of gestational diabetes. Insulin therapy ( choice A) might be considered if home glucose monitoring (4 times daily) reveals persistent hyperglycemia despite diet and exercise changes. Diligent efforts to achieve euglycemia for this patient may prevent preeclampsia and gestational hypertension in this pregnancy as well as labor-related morbidity for the fetus and mother due to macrosomia. Other risk factors a personal history of impaired glucose tolerance or gestational diabetes, being a member of an ethnic group with high prevalence of type 2 diabetes, > 30 years of age, family history of diabetes, and previous birth of an infant > 4,000 g. This patient has at least one common risk factor for gestational diabetes: obesity. If ≥ 2 values are abnormal (including fasting glucose), then the diagnosis of gestational diabetes is established. Her fasting blood glucose is 90 mg/dL, but the other values are normal, then she has impaired glucose tolerance. Her one-hour 50-g oral glucose tolerance test (OGTT) was abnormal with a value > 140 mg/dL. This pregnant patient may have gestational diabetes.
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