Antenatal care: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Antenatal care

Sample item

A pregnant woman at her booking visit has a positive VDRL and confirmatory treponemal test, and no history of penicillin allergy. What is the appropriate treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Benzathine penicillin G

Syphilis in pregnancy can cross the placenta and cause stillbirth, hydrops and congenital syphilis. Penicillin is the only drug that reliably treats the fetus. Women who are allergic should be desensitised and then given penicillin, because doxycycline is contraindicated in pregnancy.

Option by option

  • A. Oral doxycycline

    Doxycycline is contraindicated in pregnancy because of effects on fetal teeth and bones.

  • B. No treatment until after delivery

    Delaying treatment risks fetal infection.

  • C. Oral azithromycin alone

    Azithromycin does not reliably cross the placenta to cure the fetus and has treatment failures.

  • D. Benzathine penicillin G (correct)

    Correct. Benzathine penicillin prevents congenital infection and treats the mother.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Benzathine penicillin G. Syphilis in pregnancy can cross the placenta and cause stillbirth, hydrops and congenital syphilis.

Why is "Oral doxycycline" not the answer?

Doxycycline is contraindicated in pregnancy because of effects on fetal teeth and bones.

Why is "No treatment until after delivery" not the answer?

Delaying treatment risks fetal infection.

Why is "Oral azithromycin alone" not the answer?

Azithromycin does not reliably cross the placenta to cure the fetus and has treatment failures.

What concept does this question test?

It tests Antenatal care in OBG. Penicillin is the only drug that reliably treats the fetus. Women who are allergic should be desensitised and then given penicillin, because doxycycline is contraindicated in pregnancy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antenatal care?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.