Chapter 10 Infectious Diseases in Pregnancy

Question 1

asymptomatic bacteriuria is >___ colonies on culture

Answer 1

100,000

Question 2

in early pregnancy, 20-30 fold increased risk of developing

Answer 2

acute pyelonephritis

Question 3

ASB in pregnancy further associated with ___, and ___

Answer 3

preterm birth

low birth weight infants

Question 4

during pregnancy, _____ effects of ____ decrease bladder tone and cause ureteral and renal pelvic dilation, as well as decreased ureteral peristalsis resulting in physiologic hydronephrosis of pregnancy

Answer 4

smooth muscle relaxation,

progesterone

Question 5

UA may be positive for

Answer 5

leukocyte esterase, nitrates, or hematuria. urine sediment will have elevated WBCs and bacteria.

Question 6

treatment of asymptomatic bacteriuria

Answer 6

amoxicillin,
nitrofurantoin (macrobid)
trimethoprim/sulfamethoxazole (Bactrim)
cephalexin

Question 7

ASB may persist a test of cure should be obtained how long?

Answer 7

1-2 weeks.

Question 8

in addition to treating infection, patients with dysuria / bladder pain may find __ beneficial, acts as a local anesthetic to reduce the pain.

Answer 8

pyridium.

will cause urine to turn bright orange.

Question 9

diagnosis of acute pyelonephritis characterized by

Answer 9

fever, chills, flank pain, dysuria, urgency, frequency. CVA tenderness. Lab abnormalities: pyuria, bacteriuria, elevated WB count. WBC CASTS are highly associated with pyelonephritis and diagnosis can be confirmed on urine culture.

Question 10

Approximately 50-80% of PTs have serologic evidence of past cmv infection. However, presence of antibodies is not perfectly protective against either reinfecion or vertical transmission of infection from mother to fetus.

Answer 10

True

Question 11

Diagnosis of cmv usually confirmed by serologic testing serum samples collected 3-4 wks apart tested in parallel for anti cmv igG essential for Dx.

Answer 11

From neg to pos or a significant increase greater than 4 fold ex 1:4 to 1:16 in anti cmv igG is evidence o infection.

Presence of cmv igM useful but not completely reliable indication of primary infection

Question 12

Principal sono findings suggestive of fetal injury are

Answer 12

Microcephaly, ventriculomegaly, intervertebral calcification, fetal hydrops, growth restriction, oligohydramnios

Question 13

Treatment or prophylaxis for cmv

Answer 13

None.

Question 14

Rubella widely disseminated nonpuritic, erythematous maculopapular rash, arthritis, arthralgias, lymphadenopathy, lasts 3-5 days

Answer 14

True

Question 15

4 most common anomalies associated with congenital rubella syndrome (crs)

Answer 15

Deafness, eye defects such as cataracts or retinopathy, Cns defects, cardiac malformations

Question 16

PTs advised to avoid pregnancy for —- after mmr

Answer 16

1 month

Question 17

Gonococcal infections associated with

Answer 17

Pid preterm delivery pprom chorioamnionitis, neonatal sepsis, maternal postpartum sepsis

Question 18

Treatment of gonorrhoeae

Answer 18

Im ceftriaxone, oral cefixime, or im spec tinomycim

Question 19

Untreated chlamydial infections can cause

Answer 19

Neonatal conjunctivitis or pneumonia

Question 20

Treatment of chlamydia durin pregnancy

Answer 20

Azithromycin, amoxicillin, or erythromycin. 1 gram dose azithromycin . Test of cure in 3 weeks

Question 21

All PTs screened for hepatitis b surface antigen (hbsag). Those + are likely to have chronic disease and at risk for transmission to fetus. How to confirm active hep b infection?

Answer 21

Hepatitis b core antibody and hepatitis b surface antibody igM and igG should also be checked.

Question 22

PTs with acute hepatitis b are pos for

Answer 22

Hbsag and igM antibody to the core antigen.

Question 23

PTs with chronic hepatitis b are pos for .

Answer 23

surface antigen and pos for igG antibody to the core antigen

Question 24

Syphillis can cross placenta (treponema pallidum) as early as 6 weeks

Answer 24

True

Question 25

All regnant wen should be tested usin nonspecific antibody tests including either

Answer 25

Veneral disease research laboratory vdrl

Or rapid plasma reagin rpr

Question 26

All positive rpr or vdrl must be confirmed with fta-abs fluorescent treponemal antibody test and the t pallidum particle agglutination. Once reactive, specific treponemal tests usually remain positive for life.

Answer 26

True

Question 27

Treatment for treating maternal infection preventing maternal syphillis transmission to fetus and for treating fetal infection

Answer 27

Penicillin

Question 28

If pt has primary syphillis trtment

Answer 28

One dose of penicillin 2.4 million units benzathene penicillin g

Question 29

If pt has secondary or

Tertiary syphillis will need

Answer 29

Weekly treatments of 2.4 million units of

Benzathene penicillin g for 3 weeks

Question 30

Toxoplasma Gondi is a common protozoan. Organism is dependent on

Answer 30

Wild and domestic cats which are the only known host for the oocyst

Question 31

Bv treatment in pregnancy

Answer 31

Metronidazole 7d

Question 32

Gbs has been leading cause of

Answer 32

Neonatal sepsis

Question 33

Diagnosis of parovirus

Answer 33

IgM igG parovirus

Question 34

Most common fetal/neonatal complication of this infection during pregnancy

Answer 34

Fetal anemia and hydrops

Question 35

What is the

Mechanism by which parovirus interaction causes fetal anemia

Answer 35

Parovirus b19 causes fetal anemia by bone marrow suppression. Virus is cytotoxic to rbc precursors leading to decreased production.