Which of the following statements about the various forms of hepatitis is accurate?

Choice A reason: This is incorrect. Decreased production of erythrocytes (red blood cells) is a consequence, not a cause, of iron deficiency anemia. Iron is needed to make hemoglobin, the protein that carries oxygen in the red blood cells. Without enough iron, the body cannot produce enough hemoglobin or red blood cells¹.

Choice B reason: This is correct. Inadequate intake of iron is the most common cause of iron deficiency anemia during pregnancy. Pregnant women need more iron than nonpregnant women to support the increased blood volume and the fetal growth. If the dietary intake of iron is not sufficient, the body will use up its iron stores, leading to iron deficiency anemia.

Choice C reason: This is incorrect. Dilution of hemoglobin concentration is a normal physiological change during pregnancy, not a cause of iron deficiency anemia. The blood volume increases by 20% to 30% during pregnancy, while the red blood cell mass increases by only 15% to 20%. This results in a lower concentration of hemoglobin in the blood, but not necessarily a lower amount of hemoglobin or iron³.

Choice D reason: This is incorrect. The fetus establishing iron stores is not a cause of iron deficiency anemia during pregnancy, although it can contribute to it. The fetus needs iron for its own development and growth, and it obtains iron from the mother through the placenta. The fetal iron demand increases in the second and third trimesters, when the fetus accumulates iron in its liver and other tissues. This can deplete the maternal iron stores, especially if the mother does not consume enough iron.

Choice A reason: Insulin is the preferred medication for gestational diabetes mellitus, as it does not cross the placenta and has no adverse effects on the fetus. It can be administered subcutaneously or intravenously, depending on the blood glucose level and the type of insulin.

Choice B reason: Glipizide is an oral antidiabetic agent that belongs to the sulfonylurea class. It stimulates the pancreas to secrete more insulin and lowers the blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cross the placenta and cause hypoglycemia, macrosomia, or teratogenic effects on the fetus.

Choice C reason: Acarbose is an oral antidiabetic agent that belongs to the alpha-glucosidase inhibitor class. It delays the absorption of carbohydrates from the intestine and reduces the postprandial blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cause gastrointestinal side effects, such as flatulence, diarrhea, or abdominal pain, and may interfere with the absorption of other nutrients.

Choice D reason: Repaglinide is an oral antidiabetic agent that belongs to the meglitinide class. It stimulates the pancreas to secrete more insulin and lowers the blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cross the placenta and cause hypoglycemia, macrosomia, or teratogenic effects on the fetus.