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NBME p2ck_form7 Answers

step2ck_form7/Block 2/Question#29 (9.2 difficulty score)
A 25-year-old primigravid woman at 27 weeks' ...
Intramuscular administration of betamethasone๐Ÿ”,๐Ÿ“บ
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 +3 
submitted by yotsubato(1088),

Note: Oral Amoxicillin is not given. It has to be IV pennicillin.




 +2 
submitted by step_prep5(196),
  • Patient presenting with preterm labor < 32 weeks: (1) Betamethasone (for fetal lung development) (2) IV penicillin (if GBS positive or unknown) (3) Magnesium (neuroprotective for baby) (4) Tocolytic (to stop contractions)
  • Active labor: Contractions AND cervical changes
  • C-section would only be indicated if there were signs of intramniotic infection, fetal instability or maternal instability
  • Note: Patients should receive intravenous antibiotics rather than oral antibiotics in a patient who is GBS positive or GBS unknown

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 +0 
submitted by embeemee(1),

i get the answer, but would a VB even be possible given her GBS+ status?

usmile1  Yes, being GBS+ is very common and is not a contrainidcation for vaginal delivery. just give intrapartum IV PCN to prevent infection in the newborn +