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Clinical Pathology > 49 Infections of pregnancy, puerperium and neonate > Flashcards

49 Infections of pregnancy, puerperium and neonate Flashcards

1
Q

Define puerperium:

A

The weeks following delivery in which the mothers tissues return to a non-pregnant state. 6-8 weeks.

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2
Q

Define neonate.

A

An infant less than 4 weeks old.

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3
Q

Which infections can be transmitted from mother to baby during pregnancy? (6).

A 
Cytomegalovirus.
Parvovirus B19.
Toxoplasmosis.
Syphilis.
Varicella Zoster.
Zika.
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4
Q

Which infections can be transmitted form mother to baby during delivery? (6).

A 
Group B streptococcus.
Herpes simplex virus.
Gonorrhoea.
Chlamydia.
HIV.
Hepatitis B.
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5
Q

How do serum levels of antimicrobials change during pregnancy?

A

Increased glomerular filtration rate increase renal excretion.
Serum levels lower.

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6
Q

Which antimicrobials cross the placenta?

A

All to some extent.

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7
Q

Which antimicrobials are safe in pregnancy? (2).

A

Penicillins.

Cephalosporins.

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8
Q

Which antibiotics aren’t safe in pregnancy? (4).

A

Chloramphenicol.
Tetracycline.
Fluoroquinolone (ciprofloxacin).
Co-trimoxazole.

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9
Q

How are viral infections diagnosed during pregnancy?

A

Serology/PCR of blood, vesicle fluid, amniotic fluid.

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10
Q

What is bacteriuria associated with in pregnancy? (2).

A

Premature delivery.

Increased peri-natal mortality.

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11
Q

How are UTI’s treated in pregnancy?

A

7 days non-toxic antibiotic:

Amoxicillin or trimethoprim.

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12
Q

How should trimethoprim be used in pregnancy? (2).

A

Not in first trimester.

Given with folate.

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13
Q

What are intra-amniotic infections associated with in pregnancy? (3).

A

Pre-term labour.

Peri-natal morbidity and mortality.

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14
Q

Define chorioamnionitis:

A

Inflammation of umbilical cord, amniotic membranes and placenta.

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15
Q

What are the clinical features of intra-amniotic infection? (5).

A 
Sustained maternal fever >38o.
Uterine tenderness.
Malodorous amniotic fluid.
Increased white cell count.
Maternal/foetal tachycardia.
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16
Q

What are the risk factors for intra-amniotic infection? (5).

A 
Prolonged rupture of the membrane.
Amniocentesis.
Chordocentesis.
Cervical cerclage.
Multiple vaginal examinations.
17
Q

What is the pathogenesis of intra-amniotic infection? (2).

A

Spread up cervix.

Rarely haematogenous: listeria monocytogenes.

18
Q

What are the organisms that commonly cause intra-amniotic infections?

A

Group B Streptococcus.
Enterococci.
Escherichia coli.

19
Q

What is puerperal endometritis?

A

Infection of the womb in puerperium.

20
Q

What are the risk factors for puerperal endometritis? (4).

A

C sections.
Prolonged labour.
Prolonged rupture of membranes.
Multiple vaginal examinations.

21
Q

What are the features of puerperal endometritis? (6).

A 
Fever (38.5 in 1st 24hr or 38 >4hrs after 24hr).
Uterine tenderness.
Purulent, foul smelling lochia.
Increased white cell count.
General malaise.
Abdominal pain.
22
Q

What are the causes of puerperal endometritis? (3)

A

Escherichia coli.
Beta-Haemolytic streptococci.
Anaerobes.

23
Q

How is puerperal endometritis treated?

A

Broad spectrum IV antimicrobials until 48 hours apyrexial.

24
Q

What are the clinical features of puerperal mastitis? (6).

Mean onset?

A

Abrupt onset chills, fever and soreness.
Red, warm and tender breast.
5.5 weeks post delivery.

25
Q

What is the most common form of puerperal mastitis?

How is it treated? (3).

A

Staphylococcus aureus.

Optimising nursing techniques and breast care, flucloxacilllin, incision + drainage if abscess.

26
Q

What are the clinical features of neonatal sepsis/meningitis?

A 
Abnormal temperature.
Dyspnoea, apnoea, cyanosis.
Tacky/bradycardia, hypotension.
Hepatomegaly + jaundice.
Anorexia, D+V, abdominal distension.
Bleeding disorders.
Lethargy, irritability, seizures.
27
Q

What are the common causes of neonatal meningitis/sepsis?

A

Group B streptococcus.
Escherichia coli.
Listeria monocytogenes.

28
Q

What is the common antibiotic combination for neonatal sepsis/meningitis?

A

Amoxicillin and gentamicin.

Clinical Pathology (66 decks)

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