ID II Flashcards
at what time in gestation does toxo have
1) greatest transmission
2) more severe disease to fetus if acquired
1) later in pregnancy (less Ab)
2) earlier (embryopathy)
at what time in gestation does syphillis have
1) greatest transmission
2) more severe disease to fetus if acquired
1) anytime in pregnancy (like CCcmv)
2) later (mom doesn’t get treated, titers are still high - unusual)
at what time in gestation does rubella have
1) greatest transmission
2) more severe disease to fetus if acquired
1) U shaped (U for rubella), early and late
2) earlier (embryopathy)
at what time in gestation does CMV have
1) greatest transmission
2) more severe disease to fetus if acquired
1) anytime in pregnancy (like ssssyphillis)
2) earlier (embryopathy)
what is treatment for toxo
pyremathamine and sulfadiazene for on year
sulfadiazene can cause BM suppression and neutropenia so supplement with folinic acid
what are risk factors for CMV transmission in BM?
higher in PT babies.
decreases with both freezing and thawing of BM
when is SNHL detected in CMV
usually not until one year
when does fetal IgG vs placental transfer begin?
starts production around 10 weeks, pinocytosis and active transport from placenta around 20 weeks and accelerates during 3rd trimester. Levels exceed maternal levels by term.
when should breastfeeding be discouraged in regards to TB?
only during active, untreated TB. If being treated, okay to bf.
when should pregnant women be treated in regards to TB?
if asymptomatic with no additional risk factors - wait until postpartum b/c isoniazid can cause liver failure in fetus
if higher risk (ie exposure), then do INH after first trimester.
always give B6
how do you manage an infant in these situations:
1) mother has latent TB ((+) PPD, neg CXR, asymptomatic OR (+) CXR but asymptomatic)
2) mother has active TB (((+) PPD, (+) CXR, symptoms))
1) treat mother with INH (either after 1st tri or post partum), baby needs nothing additional, allow breastfeeding
2) treat mother with full regimen, baby needs testing, if (+) treat with INH until 3-4m –> give TB test. If (-) TB test, continue INH for 9m total. allow breastfeeding after mother treated for >2w
consider BCG vaccine to infant if mom has multidrug resistant Tb
what is the most common source of VAP organisms?
oropharynx
what are examples of antigen presenting cells?
macrophages, dendritic cells and B lymphocytes
where do T cells mature and into what
originate in BM and mature and differentiate in thymus to CD4 or CD8 CD4: Mostly helper, receptors for MHC class II, secrete cytokines and signal to CD8 T cells and B cells CD8: Mostly cytotoxic killer, receptors for MHC class I, destruct virally infected cells
What are the 4 classes of CD4 T helper cells?
(4 types: Th1 (activate NK cells, macrophage and CD8 T cells, inflammatory), Th2 (influence B cells and eosinophil activation), T17 (secrete potent inflammatory iL-17) and T reg (downregulate immune response))
