48. A 48-year-old diabetic patient diagnosed as first degree uterine prolapsed, was admitted for an elective surgery. She has complaints of urinary frequency , urgency and incontinence . Physical examinatior result shows that she has skin rash at the area of perineum and upper part of her thigh. What is the priority intervention for the woman? A. Catheterization B. Kegel exercises C. Restriction of fluid intake D. Use skin protection product 49. You see a 20-year-old G1PO with a diagnosis of genital herpes in pregnancy . What is the gestational age at which a primary infection occurs that the risk of transmission to the baby is greatest? A. First trimester (8-13) weeks) B. Second trimester (14 -22 weeks) C.Third trimester (29-34 weeks) D.Third trimester (34-40 weeks) 50. You admit a woman at 40 weeks of gestation in labour with confirmed genital herpes. This is thought to be a primary infection . She is offered an emergency CS that she refuses. How will you manage this patient? A. Administer herpes immunoglobulin to the mother and baby after birth B. Administer herpes immunoglobulin to the baby after birth C. Allow vaginal delivery and offer baby prophylactic aciclovir D. Commence her on intravenous aciclovir and also offer the neonate intravenous aciclovir 51. An elective caesarean section is being performed on a 30-year-old Rhesus D negative pregnant woman at 37 weeks of gestation for placenta praevia (major). Arrangements were made and she is receiving intraoperative cell salvage (ICS) transfusion. What would be the plan with regard to Rhesus D prophylaxis in this woman assuming the baby's blood group is unknown? A. Administer 500 IU anti-D Ig and then take a sample of maternal blood 30-45 min after (ICC) infusion

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48. A 48-year-old diabetic patient diagnosed as first degree uterine prolapsed, was admitted for an elective surgery. She has complaints of urinary frequency , urgency and incontinence . Physical examinatior result shows that she has skin rash at the area of perineum and upper part of her thigh. What is the priority intervention for the woman? A. Catheterization B. Kegel exercises C. Restriction of fluid intake D. Use skin protection product 49. You see a 20-year-old G1PO with a diagnosis of genital herpes in pregnancy . What is the gestational age at which a primary infection occurs that the risk of transmission to the baby is greatest? A. First trimester (8-13) weeks) B. Second trimester (14 -22 weeks) C.Third trimester (29-34 weeks) D.Third trimester (34-40 weeks) 50. You admit a woman at 40 weeks of gestation in labour with confirmed genital herpes. This is thought to be a primary infection . She is offered an emergency CS that she refuses. How will you manage this patient? A. Administer herpes immunoglobulin to the mother and baby after birth B. Administer herpes immunoglobulin to the baby after birth C. Allow vaginal delivery and offer baby prophylactic aciclovir D. Commence her on intravenous aciclovir and also offer the neonate intravenous aciclovir 51. An elective caesarean section is being performed on a 30-year-old Rhesus D negative pregnant woman at 37 weeks of gestation for placenta praevia (major). Arrangements were made and she is receiving intraoperative cell salvage (ICS) transfusion. What would be the plan with regard to Rhesus D prophylaxis in this woman assuming the baby's blood group is unknown? A. Administer 500 IU anti-D Ig and then take a sample of maternal blood 30-45 min after (ICC) infusion

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48. D. Use skin protection productExplanation: The patient has a skin rash at the area of the perineum and upper part of her thigh, which suggests she may have contact dermatitis or another skin condition. Using a skin protection product can help alleviate the symptoms and prevent further irritation.49. D. Third trimester (34-40 weeks)Explanation: The risk of transmission of genital herpes to the baby is greatest during the third trimester (34-40 weeks) of pregnancy. This is when the virus is most likely to be active and potentially transmitted to the baby during delivery.50. D. Commence her on intravenous aciclovir and also offer the neonate intravenous aciclovirExplanation: In the case of a primary infection of genital herpes during labor, it is important to manage the infection aggressively. Administering intravenous aciclovir to the mother can help reduce the risk of transmission to the baby. Offering the neonate intravenous aciclovir can also help reduce the risk of transmission and potential complications.51. A. Administer 500 IU anti-D Ig and then take a sample of maternal blood 30-45 min after (ICS) infusionExplanation: In the case of a Rhesus D negative pregnant woman with unknown blood group of the baby, it is important to administer 500 IU anti-D Ig to the mother to prevent the development of antibodies against the baby's blood. Taking a sample of maternal blood 30-45 minutes after the intraoperative cell salvage (ICS) infusion can help determine the baby's blood group and ensure appropriate management.

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