Congenital Infections

Question 1

What are the TORCHES infections?

Answer 1

Toxoplasmosis
Rubella
CMV
Herpes/Hepatitis 
Syphilis

Question 2

What is the common presentation for most TORCHES infections?

Answer 2

SGA or IUGR
Thrombocytopenia
Hepatosplenomegaly
Jaundice
Microcephaly

Question 3

How can Toxoplasma gondii be acquired?

Answer 3

Cat Feces
Undercooked meat
Undercooked eggs
Unpasteurized milk

Question 4

What is the most common clinical finding in Congenital Toxoplasmosis?

Answer 4

Chorioretinitis
Intracranial Calcification
Hydocephalus

Question 5

What is chorioretinitis?

Answer 5

Inflammationof the posterior portion of the uvea tract and retina
Manifest later as Blurry vision, retinal detachment, glaucoma

Question 6

Where are intracranial Calcifications?

Answer 6

Caudate nucleus
Choroid Plexus
Meninges
Subpendyma

PeriVentricular most classic for cmV

Question 7

How is Toxoplasmosis diagnosed?

Answer 7

Serum IgM titers or persistent IgG
Optho exam
Neuro Exam
Head CT
LP (Toxo PCR)

Question 8

What are the most common outcomes in Toxoplasmosis Infections?

Answer 8

Mental Retardation

Seizures

Question 9

How is rubella transmitted?

Answer 9

Vertical Transmission or respiratory droplets

German Measles

Question 10

What are the most common presentations of Congenital Rubella Syndrome?

Answer 10

Patent Ductus Arteriosus
Deafness
Cataracts

Question 11

How is Rubella Treated?

Answer 11

Reverse Transcriptase PCR
Serum IgM
Rise in IgG titer over 2-3 weeks
Culture

Question 12

What is the most common congenital infection in developed countries?

Answer 12

Cytomegalovirus

Question 13

How is CMV transmitted?

Answer 13

Infected secretions
Vertically
Transfusion

Question 14

Infection with CMV in which semester leads to the worst sequelae?

Answer 14

1st trimester.

Question 15

What are the most common findings in CMV?

Answer 15

Petechia/Ecchymosis
Jaundice at birth or within a few hours
Hepatosplenomegaly

Question 16

What causes the charicteristic Bluberry muffin rash in CMV?

Answer 16

Erythropoesis occurring in the skin, not the BM.

Question 17

Where are Intracranial Clcifications seen in cmV?

Answer 17

PeriVentricular

Question 18

How is CMV diagnosed?

Answer 18

Urine CMV culture
Serum IgM titers
Head CT

Question 19

What is the Treatment for CMV?

Answer 19

Gancyclovir possibly

Question 20

What are the non-congenital manifestations of HSV?

Answer 20

Genital Herpes
Gingivostomatitis
Conjunctivitis
Encephalitis
Eczema Herpeticum

Question 21

What are the physical Findings in HSV?

Answer 21

SEM (Skin, Eye, mouth)
Irritability
Lethargy
poor feeding
tremulousness 
seizures

Question 22

How is HSV Diagnosed?

Answer 22

Culture
CBC, LFT
PCR

Question 23

How is Congenital HSV transmitted?

Answer 23

Ask preggo women about history of herpes and active lesions
C-Section if they have active lesions
Cultures on newborns
Tx with Acyclovir

Question 24

What is the Tx for Congenital Syphilis?

Answer 24

Penicillin?

Question 25

What are the Stages of Syphilis?

Answer 25

1^: Painless, genital ulcer
2^: Rash
Fever, malaise, LAD, Condyloma lata
Latent
3^: Gumma, bone/skin/visceral changes
Neurosyphilis at any stage