MNB FINAL EXAM QUESTIONS AND ANSWERS
Management of Hep B in pregnancy - CORRECT ANSWER✅✅✅-avoid AROM unless needed
-limit vaginal exams after ROM
-avoid FSE and IUPC if possible
-give baby Hep B vaccine and HBIG right away
-bathe neonate quickly
-do not breastfeed if cracked and bleeding nipples
Hep C virus and pregnancy - CORRECT ANSWER✅✅✅-can be cured
-contracted through blood and body fluids
-no direct effect on pregnancy, low vertical transmission
-no intervention to prevent transmission
-same management as Hep B minus vaccine
Trichomonas - CORRECT ANSWER✅✅✅-risk of PPROM, preterm delivery
-treated w/ Metronidazole, TOC
-delay breastfeeding until 12-24 hours post-therapy
-s/s: discomfort, dysuria, dyspareunia, green frothy discharge, strawberry cervix
Bacterial Vaginosis (BV) - CORRECT ANSWER✅✅✅-lactobacilli, clue cells, whiff test/fishy smell
-imbalance of normal bacteria
-increased risk of late miscarriage, preterm birth, PID, post-op infections, low birth weight
-treat with metronidazole
-prevention: pericare and safer sex
Herpes zoster and pregnancy - CORRECT ANSWER✅✅✅-antibody serum screen at first prenatal
-cannot vaccinate during pregnancy, but can breastfeed
,-pregnant patients can receive valtrex for symptoms for shingles
HIV in pregnancy - CORRECT ANSWER✅✅✅-maintain medications (including PrEP/PEP)
-if viral load <1000, vaginal birth can be considered
-avoid FSE and operative vaginal birth
-baby receives Zidovudine PO for 6 weeks
-breastfeeding is discouraged
-standard precautions prior to baby's first bath
Toxoplasmosis - CORRECT ANSWER✅✅✅-lives in cat feces (pregnant women shouldn't change the
litter box!)
-mild flulike symptoms
Listeria and pregnancy - CORRECT ANSWER✅✅✅-deli meats, fruits/vegetables (from soil)
-fever, joint pain, headache, N/V/D
-food safety is KEY for preventing, can do placental cultures
-baby can die
Parvovirus/Fifth disease - CORRECT ANSWER✅✅✅-*very* common childhood virus
-symptoms: fever, arthralgia, fatigue, joint pain, lacy rash
-serum IgG and IgM for higher risk patients
-can lead to hydrops, miscarriage, fetal demise
-typically baby is fine
CMV and pregnancy - CORRECT ANSWER✅✅✅-if baby doesn't pass hearing screening, swab for
CMV (leading cause of deafness)
Zika virus - CORRECT ANSWER✅✅✅-spread through sex and mosquitos
-fever, itchy rash, arthralgia, conjunctivitis (80% are asymptomatic)
, -prevention: mosquito nets
-remains in semen for 6 months
-wait 2 months from possible personal exposure to conception
-watch for IUGR
-can lead to microcephaly
Lyme disease and pregnancy - CORRECT ANSWER✅✅✅-spread by ticks
-bull's eye rash, fever, fatigue, HA; joint pain, fatigue, swelling, facial palsy, short-term memory loss,
nerve pain
-unknown impacts on pregnancy
-breastfeeding is fine unless they are on doxycycline
HSV and pregnancy - CORRECT ANSWER✅✅✅-avoid cerclage/CVS if lesions are present, start
prophylactic valtrex at 36 weeks
-if genital lesion is seen at time of SROM or labor, birth is by C. section
-impact on newborn: skin and eye lesions, CNS disease, meningitis; baby will get IV acyclovir
-breastfeeding is ok if there are no lesions of the breast
TB and pregnancy - CORRECT ANSWER✅✅✅-asymptomatic, fever, cough, weight loss, night sweats,
malaise
-screen with PPD/tuberculin/quantiferon gold
-active TB treat during pregnancy, latent TB wait until after
Group B Strep (GBS) - CORRECT ANSWER✅✅✅-no symptoms
-1/4 carry it normally
-GBS culture of vagina and rectum
at 35-37 weeks
-if positive, give IV antibiotics in labor
-treat if no culture and temp >100.4, PROM >18hrs, GBS + urine, birth <37 weeks, or previous baby with
GBS
Management of Hep B in pregnancy - CORRECT ANSWER✅✅✅-avoid AROM unless needed
-limit vaginal exams after ROM
-avoid FSE and IUPC if possible
-give baby Hep B vaccine and HBIG right away
-bathe neonate quickly
-do not breastfeed if cracked and bleeding nipples
Hep C virus and pregnancy - CORRECT ANSWER✅✅✅-can be cured
-contracted through blood and body fluids
-no direct effect on pregnancy, low vertical transmission
-no intervention to prevent transmission
-same management as Hep B minus vaccine
Trichomonas - CORRECT ANSWER✅✅✅-risk of PPROM, preterm delivery
-treated w/ Metronidazole, TOC
-delay breastfeeding until 12-24 hours post-therapy
-s/s: discomfort, dysuria, dyspareunia, green frothy discharge, strawberry cervix
Bacterial Vaginosis (BV) - CORRECT ANSWER✅✅✅-lactobacilli, clue cells, whiff test/fishy smell
-imbalance of normal bacteria
-increased risk of late miscarriage, preterm birth, PID, post-op infections, low birth weight
-treat with metronidazole
-prevention: pericare and safer sex
Herpes zoster and pregnancy - CORRECT ANSWER✅✅✅-antibody serum screen at first prenatal
-cannot vaccinate during pregnancy, but can breastfeed
,-pregnant patients can receive valtrex for symptoms for shingles
HIV in pregnancy - CORRECT ANSWER✅✅✅-maintain medications (including PrEP/PEP)
-if viral load <1000, vaginal birth can be considered
-avoid FSE and operative vaginal birth
-baby receives Zidovudine PO for 6 weeks
-breastfeeding is discouraged
-standard precautions prior to baby's first bath
Toxoplasmosis - CORRECT ANSWER✅✅✅-lives in cat feces (pregnant women shouldn't change the
litter box!)
-mild flulike symptoms
Listeria and pregnancy - CORRECT ANSWER✅✅✅-deli meats, fruits/vegetables (from soil)
-fever, joint pain, headache, N/V/D
-food safety is KEY for preventing, can do placental cultures
-baby can die
Parvovirus/Fifth disease - CORRECT ANSWER✅✅✅-*very* common childhood virus
-symptoms: fever, arthralgia, fatigue, joint pain, lacy rash
-serum IgG and IgM for higher risk patients
-can lead to hydrops, miscarriage, fetal demise
-typically baby is fine
CMV and pregnancy - CORRECT ANSWER✅✅✅-if baby doesn't pass hearing screening, swab for
CMV (leading cause of deafness)
Zika virus - CORRECT ANSWER✅✅✅-spread through sex and mosquitos
-fever, itchy rash, arthralgia, conjunctivitis (80% are asymptomatic)
, -prevention: mosquito nets
-remains in semen for 6 months
-wait 2 months from possible personal exposure to conception
-watch for IUGR
-can lead to microcephaly
Lyme disease and pregnancy - CORRECT ANSWER✅✅✅-spread by ticks
-bull's eye rash, fever, fatigue, HA; joint pain, fatigue, swelling, facial palsy, short-term memory loss,
nerve pain
-unknown impacts on pregnancy
-breastfeeding is fine unless they are on doxycycline
HSV and pregnancy - CORRECT ANSWER✅✅✅-avoid cerclage/CVS if lesions are present, start
prophylactic valtrex at 36 weeks
-if genital lesion is seen at time of SROM or labor, birth is by C. section
-impact on newborn: skin and eye lesions, CNS disease, meningitis; baby will get IV acyclovir
-breastfeeding is ok if there are no lesions of the breast
TB and pregnancy - CORRECT ANSWER✅✅✅-asymptomatic, fever, cough, weight loss, night sweats,
malaise
-screen with PPD/tuberculin/quantiferon gold
-active TB treat during pregnancy, latent TB wait until after
Group B Strep (GBS) - CORRECT ANSWER✅✅✅-no symptoms
-1/4 carry it normally
-GBS culture of vagina and rectum
at 35-37 weeks
-if positive, give IV antibiotics in labor
-treat if no culture and temp >100.4, PROM >18hrs, GBS + urine, birth <37 weeks, or previous baby with
GBS
