6 Perinatal Infections

Question 1

Early onset vs Late onset GBS infection

Answer 1

• fulminant pneumonia, sepsis

* meningitis

Question 2

Candidate for Pen G prophylaxis

Answer 2

All women with positive GBS urine culture, prev baby with GBS sepsis

Positive 3rd tri V/R culture at 35-37w aog

Intrapartun risk fx: preterm gestation, ROM >18h, maternal fever 38C

Question 3

Chorioretinitis
IC calcifications
Symmetrical IUGR

Answer 3

Congenital Toxoplasmosis

Question 4

Toxoplasmosis exposures

Answer 4

Cat feces
Raw goat milk
Undercooked infected meat

Question 5

Treatment for Toxoplasmosis

Answer 5

Pyrimethamine and sulfadiazine

Question 6

Prophylaxis (vertical transmission)

Answer 6

Spiramycin

Question 7

Triad of zigzag skin lesions, microphthalmia, limb hypoplasia

Answer 7

Congenital Varicella

Question 8

VZIG is given to susceptible gravida within ____ of exposure

Answer 8

96hours

Question 9

Congenital Deafness, Cataracts and Heart Defects

Answer 9

Congenital Rubella

Question 10

Most common congenital viral syndrome

MCC of deafness in chilsren

Neonatal thrombocytopenia and petechiae, PV calcifications

No lifelong immunity, fetal infection can occur w reactivation

Answer 10

CMV infection

Question 11

HIV: The major route of vertical transmission is through transplacental.

Answer 11

False

Question 12

The greatest benefit to the fetus of CS delivery is women with low CD4 counts and high RNA viral load.

Answer 12

TRUE

Question 13

Pregnancy enhances progression of HIV infection to AIDS

Answer 13

False

Question 14

Nonimmune hydrops
Macerated skin
Hematologic abN
Large, edematous placenta

Answer 14

Congenital Syphilis (early onset)

Question 15

Presents at 2yr

Hutchinson teeth
“Mulberry molars” 
Saber shins
Saddle nose
CN8 deafness

Answer 15

Congenital Syphilis (late onset)

Question 16

Localized painless chancres
Positive tests : Darkfield, specific tests
60% fetal infection rate

Answer 16

1 syphilis

Question 17

“Money spots”

Systemic spirochetemia

Nonspecific tests become positive

Answer 17

2 Syphilis

Question 18

Classic necrotic, ulcerative nodules

CVS, CNS, Bones

CSF will be (+)

Answer 18

4 Syphilis

Question 19

Absent of symptoms and PE findings

Positive nonspecific and FTA test

Answer 19

Latent Syphilis

Question 20

Alternative to Benzathine Penillin (2.4M units IM x 1) in the presence of allergy

Answer 20

Same (add desensitization regimen)

Question 21

Syphilis serologic titers decreased 4x by 6 months and should be negative in _______

Answer 21

12-24mos

Question 22

Iatrogenic (50% of gravida)
Acute fever, headache, myalgias, hypotension, uterine contractions
Onset 1-2h, Peaks 8h, Resolution 24-48h

Answer 22

Jarisch-Herxheimer Rxn

Supportive Mngt