A 28-year-old woman, gravida 1 para 0, presents to the family medicine clinic after a positive home pregnancy test. Her last menstrual period was 7 weeks ago and the pregnancy was unplanned; she used condoms inconsistently. She has had type 1 diabetes for 12 years with persistent albuminuria and hypertension. Her medications are ramipril, insulin glargine and insulin aspart, folic acid 1 mg daily, isotretinoin for severe nodular acne (started 4 months ago, last dose this morning), minocycline (for the past 6 months) and benzoyl peroxide gel topically. Urine pregnancy test is positive; creatinine is 78 µmol/L (45-90), HbA1c is 7.4% (4.0-6.0) and urine albumin/creatinine ratio is 6.5 mg/mmol (less than 2.0). Pelvic ultrasound shows a viable intrauterine pregnancy consistent with 7 weeks.
| Heart rate | 82/min |
| Respiratory rate | 14/min |
| Temperature | 36.8 °C |
| O2 saturation | 99%, room air |
| Blood pressure | 146/94 mm Hg |
Question 1 of 30
Which of the following medications should be discontinued at this visit?
Select 3. (0 / 3 selected)
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