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Question 1 • Obstetrics & Gynaecology
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A 32-year-old woman who is 28 weeks pregnant presents to the Emergency Department with concerns about chickenpox exposure. She was in close contact with her 4-year-old nephew who developed chickenpox rash 2 days ago. She has is unsure if she had chickenpox as a child, and has not had the vaccine.


Past Medical History:

  • Gestational diabetes (diet-controlled)
  • Mild asthma
  • No known allergies


Medications:

  • Prenatal vitamins
  • Salbutamol inhaler PRN


Vital Signs:

  • Temperature: 37.2°C
  • Blood Pressure: 118/72 mmHg
  • Heart Rate: 82/min
  • Respiratory Rate: 16/min
  • O2 Saturation: 98% on room air


General Examination:

  • Alert and oriented
  • No rash present
  • Chest: Clear breath sounds bilaterally
  • Heart: Regular rhythm, no murmurs
  • Abdomen: Gravid uterus consistent with gestational age, foetal movements felt
  • No lymphadenopathy


What is the most appropriate immediate management for this patient?

A

Oral acyclovir prophylaxis within 24 hours

B

VZIG (Varicella-Zoster Immunoglobulin)

C

Observation only with daily skin checks

D

Immediate hospital admission for IV acyclovir

E

Serological testing of immunity

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