NBME Step 2 CK Form 7 Amniotomy and vaginal delivery (NBME Answers)

Retired NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 1/Question#18 (reveal difficulty score)
An 18-year-old primigravid woman at 37 weeks' ...
Amniotomy and vaginal delivery 🔍 / 📺 / 🌳 / 📖
tags: repro inc

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submitted by ∗charcot_bouchard(574)

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Only two things you need to know about HSV and Delivery -

Once had HSV anytime in life or during pregnancy (except Labor) >> Give acyclovir from 36 weeks onwards. Everything else expectant.

Have prodrome or lesion during labor - CS.

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submitted by ∗step_prep5(246)

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Woman at 37 weeks’ gestation presenting in labor who has history of genital herpes but currently does not have lesions or prodromal symptoms and therefore can undergo vaginal delivery
Key idea: Women with history of HSV should begin acyclovir prophylaxis at 36 weeks gestation and women with active HSV lesions or prodromal symptoms during labor should have a Cesarean delivery performed

https://step-prep.org/tutoring/

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submitted by ∗krewfoo99(115)

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u world: QID 4806.

Begin antiviral supression at 36 weeks. If there are lesions/prodromal symptoms during the time of delivery then do C section. If no lesions of prodormal symptoms during time of delivery, then Vaginal delivery.

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submitted by dreamyyn(10)

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the question did not mention if the patient has been receiving acyclovir since 36 week. So I think she needs to receive acyclovir? and UW also mentioned that the amniotomy is no longer performed. ID:15691

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lindasmith462 UW 4806 “Initiating antiviral tx at delivery is unlikely to have an immediate effect on viral replication ∴ it is not indicated as it does not decrease the risk of neonatal HSV infxn” As far as the amniotomy I think stopping elective amniotomy for progression of labor was relatively recent change and these exams are old - honestly IDK why they put that in there other than to make the Q harder cause they're dicks +5

alimd lindasmith462 Thery don't fucking care about their assesments. It's just a piece of shit with shitty interface for which we pay $60 +

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submitted by ∗russnels(20)

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Current herpes infection unlikely due to no recurrent s/sx for 6 weeks. Get that baby out of there

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