Which one of the following vaccines is safe to give during pregnancy?
Correct Answer B:
Influenza vaccine should be given to all pregnant women who will be in the second or third trimester during the influenza season. High-risk patients should be vaccinated regardless of the trimester. The vaccine is a killed virus preparation and its safety in pregnancy is well-established. Rubella and varicella vaccines contain live attenuated virus and are associated with adverse effects on the fetus. The safety of the pneumococcal vaccine in pregnancy has not been evaluated.
Which one of the following vaccinations is contraindicated in pregnancy?
Correct Answer E: The varicella vaccine contains live attenuated varicella-zoster virus. Immunization during pregnancy is contraindicated because the effects on the fetus are unknown. Diphtheria, hepatitis B, influenza, and tetanus vaccines are not contraindicated during pregnancy.
At a routine visit in October, a 17-year-old primigravida at 10 weeks gestation asks whether she should get influenza vaccine. Her mother recommended it, but she is concerned about the needle stick and potential harm to the fetus.
Which one of the following would you do?
Correct Answer A:
Women who will be pregnant during the influenza season should receive the inactivated vaccine. The live nasal vaccine is not approved for use in pregnancy. The vaccine can be given in any trimester. Coexistent illness is not required for this indication. There appears to be some protective effect for the infant up to the age of 6 months. Immunization of family members is sometimes recommended for immunocompromised patients. In the absence of other indications, however, it has not been recommended for family members of pregnant patients.
Which one of the following single-dose regimens is effective for treatment of uncomplicated urethral or cervical infection caused by Chlamydia trachomatis?
Azithromycin, 1 g orally once, is effective for treatment of uncomplicated urethral or cervical infection caused by Chlamydial trachomatis. Doxycycline and amoxicillin are effective for this condition, but must be taken for 7-10 days. Cefixime and metronidazole are effective as single doses for uncomplicated gonorrhea and vaginal trichomoniasis respectively, but neither is indicated for the treatment of Chlamydia.
Which one of the following is indicated for treatment of Chlamydial urethritis during pregnancy?
Correct Answer C:
Erythromycin is safe and effective for treatment of chlamydial infection during pregnancy. Ciprofloxacin is not consistently effective and is contraindicated during pregnancy. Ofloxacin and doxycycline are effective, but are contraindicated in pregnancy.
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