Do I need to use the exact same field names of the new Marketo fields required for the sync? For example, we want to name "Score" as "Marketo Score". Is this okay to do or does it need to read exactly the same?
In my experience we just needed the API field name to be the same. You could have a field description that was whatever you wanted in Marketo or conversely in Salesforce as long as the API name was the same.
Kristy is correct - it's the API name of the field that must be exact, not the label.