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ENRP Exam 1 > Gynecologic Infection Part 4 > Flashcards

Gynecologic Infection Part 4 Flashcards

1
Q

TORCH?

A
  • toxoplasmosis
  • other (syphilis,varicella, parvo)
  • rubella
  • CMV
  • HSV
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2
Q

Of the TORCH infections which are bacteria, parasite, and what type virus>

A
  • Toxoplasma gondii is a parasite
  • Other:
    • syphilis: spirochete bacteria
    • varicella zoster: DNA virus, herpes
    • Parvovirus B19: DNA virus
  • Rubella: RNA
  • CMV: DNA, herpes
  • HSV: DNA, herpes
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3
Q

How does one get toxoplasmosis what causes it and how does it spread?

A
  • Cats are the host and it is spread through cat feces (oocyte) and raw meat (cyst)
    • both give rise to motile tachyzoite
  • tachyzoites can spread transplacentally to cause congenital infection
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4
Q

Immune competent presentation of toxoplasmosis?

A
  • non specific febrile illness with lymphadenopathy
  • maternal infection usually asx
    • can result in still birth or severe neuro deficiency
  • can cause chorioretinints and intracranial calcifications
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5
Q

Toxoplasmosis screening/diagnosis in pregnancy? Tretment?

A
  • Serology with IgG and IgM
  • Spiramycin or pyrimethamine-sulfadiazine to protect fetus
    • not available in US
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6
Q

Early congeintal syphilis?

A
  • mucous membrane involvement within life → snuffles
  • rash on palms and soles, condyloma lata (seen in secondary syphilis in adults)
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7
Q

Late congenital syphilis presentation?

A
  • Neurosyphlis: sensorineural hearing loss, intellectural disablity
  • Gumma formation
  • Saber shins, saddle nose, frontal bossing
  • interstital keratits of eye
  • Hutchinson’s teeth
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8
Q

VZV spread? How does it present?

A
  • Respiratory droplets or contact with active vesicles
  • Fever malaise, diffuse vesicular rash of various stages of healing
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9
Q

How does VZV infection in mother during 8-20 weeks impact the baby?

A
  • limb hypoplasia, cicatrical skin lesions
  • this is rare and not caused by herpes zoster
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10
Q

Neonatal varicella treatment?

A
  • if knowon peripartum maternal VZV or herpes exposure treat the infant with immune globin
  • If severe/disseminated infection use acyclovir
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11
Q

When doe you give a pregnany mom VZV vaccine?

A

Should be vaccinated post partum because it is a live attenuated vaccine and not safe for pregancy

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12
Q

Parvovirus B19 what does it cause in kids and what does it do to a pregnancy?

A
  • Self limiting febrile illness causing “slapped cheek rash” cytotoxic to erythroid progenitor cells
  • In pregnancy it can lead to fetal loss, fetal anemia, and hydrops fetalis
    • previous infection can lead to fetal protection
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13
Q

Describe Rubella.

A
  • Mild self limiting febrile illness
  • head to toe rash
  • fever lymphadenopathy URI
    • soft palate petechiae
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14
Q

Congenital Rubella Syndrome?

A
  • Sensorineural hearing loss
  • Congenital heart disease
  • cataracts
  • “blueberry muffin baby” extramedullary hematopoiesis
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15
Q

what is the leading cause of nonhereditary sensorineural hearing loss?

A

CMV

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16
Q

Congenital CMV?

A

If symptomatic (~10%)

  • sensorineural hearing loss
  • intellectural disablity
  • chorioretinitis
  • HSM, jaundice, petechia

Asx: (~90%)

  • can dev SNHL
17
Q

Management of a pregnant patient with HSV?

A
  • acyclovir for active infection
  • suppress with acyclovir after 36 weeks
  • C-section if genital lesions are present at delivery
18
Q

Neonatal HSV management?

A

Acyclovir

19
Q

When is group B strep vaginal/rectal swabbing done

A

35-37 weeks

20
Q

Risks to newborn if group b strep infection?

A

Sepsis, meningitis, pneumonia

21
Q

Group B strep microbiology?

A
  • Gram + cocci in chains
  • Beta hemolytic
    • complete hemolysis
  • Lancefield group B
    • no bacitracin sensitivity
  • Virulence factors are anti phagocytic carb capsule
22
Q

Treatment for GBS?

A

Penicillin G or Ampicillin

23
Q

Post partum Endometritis risk factors?

A
  • Colonization with GBS
  • C-section (increases risk 10-30x)
  • prolonged labor
  • PROM
  • chorioamnionitis
24
Q

What are common organisms causing post partum endometritis? What is the treatment?

A
  • Group A streptococcus
    • can lead to streptococcal TSS
  • Group B streptococcus
  • Gentamicin plus Clindamycin or Ampicillin/Sulbactam
25
Q

How does Actinomyces IUD infection present? Describe Actinomyces.

A
  • with vaginal discharge after long term implantation
    • it can ascend to involve ovarie and fallopian tubes with PID like sx
  • Actinomyces: anaerobic filamentous gram positive bacteria
26
Q

How to manage lactational mastitis?

A
  • continue breast feeding and empty breast
  • Abx geared to S. aureus:
    • MSSA: use Amoxicillin/clauvulanate
    • MRSA: use Trimethoprim/Sulfamethoxazole
      • dont use if infant <1mo or premature
27
Q

What is penicillinase? What are organisms expressing this sensitive to?

A
  • sub type of beta lactamase enzyme
  • expreseed by bacteria that are sensitive to oxacilllin
28
Q

How does Augmentin (amoxicillin + Clavulanate) work?

A

Clavulanate inhibitis penicillinases allowing the amoxicilin to work

29
Q

Sulfamethoxazole and Trimethoprim MOA’s? What are the AE’s in infants?

A
  • Sulfamethoxazole: folic acid synthesis inhibitors
  • Trimethoprim: DHFR inhibitors
  • Together this is called Bactrim
  • Kernicterus in neonates bc it displaces bilirubin from albumin

ENRP Exam 1 (7 decks)

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