American Board of Internal Medicine (ABIM) Certification Practice Exam

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For pregnant individuals exposed to tuberculosis, what is the preferred treatment for latent TB?

Rifampin daily for 4 months
Isoniazid daily for 9 months
Immediate treatment recommended regardless of exposure
Delaying treatment until after delivery is preferred

The correct answer is: Isoniazid daily for 9 months

The preferred treatment for latent tuberculosis (TB) in pregnant individuals is isoniazid taken daily for a duration of nine months. This choice is based on the need to effectively manage latent TB and reduce the risk of progression to active disease, as well as the safety profile of isoniazid during pregnancy. Isoniazid has been shown to be effective in preventing the development of active TB and has a well-established safety record for use in pregnant patients. The other options do not align with established guidelines or safety considerations. For instance, rifampin, while effective for active TB treatment, is not the preferred agent for latent TB, especially in pregnant patients due to concerns regarding potential side effects. Immediate treatment regardless of exposure is not necessary and could expose the mother and fetus to unnecessary risks. Additionally, delaying treatment until after delivery could significantly increase the risk of developing active TB, which poses serious health risks to both the mother and the baby. Hence, the nine-month course of isoniazid is the most appropriate and safest choice for managing latent TB in pregnant individuals.