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Reproductive > Congenital and Perinatal Infections > Flashcards

Congenital and Perinatal Infections Flashcards

1
Q

according to the timing baby infections can be classified as

A

Prenatal
Perinatal
Postnatal

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2
Q

what are the main type of modes for congenital infections?

A

Vertical (transplacental, breast milk)
Horizontal
Ascending

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3
Q

Varicella is caused by

A

Varicella Zoster Virus

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4
Q

some characteristics of VZV?

A

herpes virus
dsDNA linear
capsule and envelope

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5
Q

what is the difference between exanthems and enanthems?

A

Exanthems are rashes outside of the body

Enanthems are lesions inside the body in the mucosal surfaces

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6
Q

what are the main findings after 14 days of a person with VZV infection?

A

Fever, lethargy, pruritic vesicular rash

(rash clear fluid first then becomes turbid and explodes) rash develops ~48 hours after symptoms onset

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7
Q

what is the most common complication of VZV infection?

A

secondary bacteremia (strep pyogenes [GAS] and staph aureus)

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8
Q

congenital varicella syndrome consists in? when is the foetus most at risk for severe consequences?

A 
limb hypoplasia
cicatricial scarring 
mycrocephally, cataracts
mental retardation
GIT and GUrinary tract abnormalities
First Trimester PRIMARY INFECTION
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9
Q

if the mom gets varicella during the last 2 trimester of pregnancy it is most likely that?

A

the child will develop shingles without having had varicella in the first year of life

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10
Q

what happens if the mom develops primary varicella during the -7,+2 days of delivery?

A

the mom would lack the specific antibodies for the protection of the foetus and the baby in (30% of cases) will develop varicella as the virus will be present in higher [] in the mother fluids

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11
Q

if the baby gets infected in uterus previous to delivery or during delivery

A

Hemorrhagic Varicella

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12
Q

what is the main way of avoiding perinatal infection after the mother develops primary varicella?

A

Prophylactic VZIG

Varicella Zoster Immunoglobulin

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13
Q

prophylactic antibodies for varicella should be given 96 hours post-exposure T/F

A

T

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14
Q

treatment for acute varicella is?

A

Oral acyclovir if rash but no systemic symptoms

IV if pneumonitis, neurological symptoms, organ involvement and hemorrhagic rash

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15
Q

vaccine against varicella gives?

A

100% protection against severe disease

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16
Q

what type of vaccine is Varicella vaccine?

A

Live attenuated virus (also rubella)
given at 18 months of life
if never given 2 doses for >12yo

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17
Q

Cytomegalovirus is what type of virus

A

Herpes Like Virus

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18
Q

where does cytomegalovirus remains silent?

A

lymphocytes

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19
Q

transmission of cytomegalovirus happens via?

A

all bodily fluids

10% of adults shedding virus at any one time

20
Q

congenital CMV is more prevalent in

A

developed countries

people encounter the virus later on in life

21
Q

most commonly CMV is given to the baby by

A

breastmilk

22
Q

of the infected population of babies (1%) how many are symptomatic

A

10% [deafness]

23
Q

What is the most common cause of CMV infection in babies?

A

primary infections (20-50% of foetal infections)

24
Q

of the symptomatic infections how many develop long term sequelae

A

90%

Asymptotic (only 15%)

25
Q

what is the main form of diagnosis for CMV?

A

IgG avidity
IgM detection
Nucleic Acid Detection
PCR of amniotic fluid

26
Q

if the baby is infected it will also be affected?

A

F

ultrasound required to determine if abnormalities present

27
Q

if the baby is symptomatic at birth what is required?

A

multidisciplinary approach to management, Ganciclovir

28
Q

how many people will have asymptomatic infections with rubella virus?

A

25-50%

virus shed in nasopharyngeal secretions

29
Q

the clinical presentation of rubella infection include

A

lymphoadenopathy (posterior cervical)
Exanthem
Polyarthralgia

30
Q

congenital rubella syndrome causes the most amount of damage in

A

first trimester of pregnancy (first month specially)

31
Q

what is the outcome of congenital rubella syndrome

A

1/3 normal life
1/3 live with parents
1/3 institutionalised

32
Q

what is the classic triad of congenital rubella syndrome

A

Ophthalmological (catarcts, glaucoma, retinopathy)
Cardiac (pulmonary artery stenosis, patent ductus arteriosum)
Auditory

33
Q

what is the main way of testing for rubella?

A

serovonversion
amniotic fluid, cord blood
foetal IgM

34
Q

one of the main characteristics of infection by parvovirus B19(erythrovirus) in children

A

Slapped Cheek

35
Q

in adults erythrovirus can cause anaemia?

A

not because of the long live of normal RBCs (120 days)

36
Q

why does erythrovirus causes hydrops fetalis

A

because of the rapid death of RBCs there is water retention anaemia

37
Q

what is the risk of foetal loss in infection by erythroparvovirus?

A

10% in the first 10 weeks

38
Q

diagnosis of parvovirus?

A

rising titre of IgG
IgM
nucleic acid detection
if infected weekly ultrasound is recommended and blood transfusion according to findings

39
Q

if there is a first infection during pregancy with herpes virus what is recommended?

A

acyclovir and suppression of viral load until delivery

40
Q

if there recurrent infections during pregancy with herpes virus what is recommended?

A

acyclovir and suppression
careful examination at time of delivery
investigation of the baby

41
Q

some of the problems HSV can cause are?

A

preterm labour, IUGR

near delivery –> ulcers, encephalitis

42
Q

what are some of the problems with syphilis infection?

A

30-40% still born

snuffles (clear, copious secretions from the nose)

43
Q

congenital syphilis has a high risk of foetal transmission?

A

T

44
Q

prenatal testing for infections MUST be done for the following

A 
Varicella Zooster
Rubella
Syphilis
HBV
HCV
HIV
GBS
45
Q

prenatal testing for infections should be done for the following

A

Cytomegalovirus

Toxoplasma gondii

Reproductive (7 decks)

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