Congenital

Question 1

Early signs of congenital infection

Answer 1

growth retardation, malformations of heart, brain, and limbs, still birth micro/macrocephaly

Question 2

early signs of Perinatal infections

Answer 2

preterm labor, meningitis, pneumonia

Question 3

how do you Dx a congenital infection

Answer 3

PCR sample from neonate

Question 4

TORCH

Answer 4

toxoplasmosis
Other (syphilis, VZV, parvo, Hep B, HIV)
Rubella
Cytomegalo
Herpes simplex

Question 5

Toxoplasma gondii routes of transmission

Answer 5

eating raw meat of domestic animals or through cat feces

Question 6

classic triad of congenital toxoplasmosis

Answer 6

chorioretinitis, hydrocephalus, intracranial calcifications

Question 7

Dx toxoplasmosis

Answer 7

serology on mother and infant, IgM+ is diagnostic

Question 8

Treating congenital toxoplasmosis

Answer 8

pyrimethamine + sulfadiazine + folinic acid for 1 year

Question 9

Common manifestations of early congenital syphilis

Answer 9

appear by 5wks: large, puffy placenta, hepatomegaly, rhinitis, rash, lymphadenopathy, mom with little prenatal care

Question 10

Treatment for congenital syphilis

Answer 10

Penicillin G for 10 days

Question 11

Symptoms of Congenital rubella

Answer 11

Hearing loss, congenital heart defects, ophthalmic problems, IGR, neurologic (mental, psychomotor retardation, microcephaly), bone lesions, purpura, pneumonitis

Question 12

Classic triad of congenital rubella

Answer 12

microcephaly, Patent ductus arteriosis, cataracts

Question 13

Risk factors for congenital CMV

Answer 13

prior infection, pregnancy at young age, first pregnancy, new sex partner during pregnancy, ppl w/ frequent contact w/ babies and toddlers

Question 14

Symptoms of congenital CMV

Answer 14

hearing loss, hepatosplenomegaly, chorioretinitis, microcephaly, jaundice

Question 15

Treatment of congenital CMV

Answer 15

ganciclovir/valganciclovir (teratogen)

Question 16

Spectrums of congenital herpes simplex

• variables in mom
• variables in baby

Answer 16

• type 2 is worse than type 1; primary infection is worse than reactivation; visible lesions worse than subclinical reactivation
• intrauterine is worse than perinatal; disseminated is worse than encephalitis which is worse than skin lesions

Question 17

Prevention of congenital herpes

Answer 17

treat mom with antivirals: acyclovir/valtrex

C-section

Question 18

What is the most severe scenario for congenital herpes

Answer 18

mom has primary HSV-2 infection during pregnancy bc of new sex partner, or newly infected old partner

Question 19

Congenital varicella

Answer 19

very rare (vaccine), limb and brain development impaired, poor outcome

Question 20

Treat congenital varicella

Answer 20

acyclovir

Question 21

Prevention of congenital varicella

Answer 21

vaccination of all seronegative women, advise seronegative women to avoid children w/ pox or shingles

Question 22

Congenital parvovirus

Answer 22

severe anemia in utero that can be treated with inutero transfusion; if not seen it can cause fetal death

Question 23

Antiretroviral treatment for pregnant women w/ HIV

Answer 23

zidovudine regimen: antenatal, intrapartum, and neonatal

Question 24

Group B strep bacteriology

Answer 24

gram + diplococcus, normal flora

Question 25

Early onset Group B strep

Answer 25

0-7 days: sepsis, bone, and brain, pneumonia (grunting, hypoxia, etc)

Question 26

Late onset group b strep

Answer 26

7-89days: sepsis, bone, brain, meningitis (bulging fontanel, neurologic findings)

Question 27

Late, late onset group b strep

Answer 27

> 3mo: sepsis, bone, brain meningitis

Question 28

Why aren’t TORCH panels routine screening?

Answer 28

Because we can’t do a whole lot.