Infection

Question 1

What does TORCH stand for?

Answer 1

Toxoplasmosis
Other eg. Syphilis
Rubella
CMV
HSV

Question 2

When can TORCH infections occur?

Answer 2

8 weeks - 24 wks in utero

Question 3

What is the MC TORCH infection?

Answer 3

CMV

Question 4

How are all TORCH cases treat and where?

Answer 4

Treat aggressively in hospital

Question 5

What 2 Sx may TORCH also cause?

Answer 5

Neonatal jaundice
Polyhydromnias

Question 6

What type of species is toxoplasmosis?

Answer 6

Protozoal

Question 7

Toxoplasmosis
Sx?
Acronym?

Answer 7

IUGR + neuro (enceph + hydroceph)
3Cs
Chorioretinitis, hydrocephalus, IC calcifications

Question 8

Toxoplasmosis
Dx?

Answer 8

MRI = Diffuse Intracerebral calcification (+ high IgG)

Question 9

Toxoplasmosis
Tx?

Answer 9

Pyrimethamine + Sulfadiazine
(mum = spiramycin)

Question 10

what organism causes syphillis?

Answer 10

treponema pallidum

Question 11

Neonatal Syphillis
Sx?
Acronym?

Answer 11

Hutchinson Triad:
-Peg shaped incisors - TEETH
- Interstitial Keratitis - EYES
- CN8 Deafness - EARS

Syphilitic Snuffles/rhinitis
Muscotaneous rash
Frontal boss

Snuffles
Yellow skin (desquamating rash)
Pul hypoplasis
Hutchinson teeth
Impaired hearing (SN)
L
Screening (VDRL)

Question 12

Neonatal Syphillis
Screening?

Answer 12

ELISA
Venereal disease research lab (VDRL)

Question 13

Neonatal Syphillis
Dx?

Answer 13

EIA (detect Ab to syphilis)
VDRL
TPPA
Microscopy of snuffles

Dark light microscopy = -ve spirochele

Question 14

Neonatal Syphillis
Tx?

Answer 14

IM benzathine penicillin

Question 15

what organism causes rubella?

Answer 15

Togavirus

Question 16

Rubella
Sx?

Answer 16

-Blueberry muffin rash
-Sensorineural hearing loss (SNHL)
-Congenital cataracts
-Patent ductus arterioles (Cardiac abnormality)
in 1/3

Question 17

Rubella
Dx and Tx?

Answer 17

Ig M

supportive Tx

Question 18

CMV
Sx?

Answer 18

Vague
BM rash
Neuro Sx

Question 19

CMV
Dx?

Answer 19

MRI = Periventricular intracortical calcification (+ high IgG)

Question 20

CMV
Tx?

Answer 20

IV Ganciclovir

Question 21

HSV
Sx?
Acronym

Answer 21

Encephalitic

Head (meningoencephalitis - temporal)
Sacral ganglion
Vesicular rash
2 mum to baby

Question 22

HSV
Tx?

Answer 22

IV Aciclovir

Question 23

HSV Tx:
If had HSV2 in past, prophylaxis 36wk onward =
If HSV after 36wks =

Answer 23

PO Aciclovir 400mg TDS

Consider C section

Question 24

VZV - what is it when:
<20 weeks?
>20 weeks?

Answer 24

<20 weeks - neonatal congenital varicella syndrome - limb hypoplasia, pneumonia ….

> 20 weeks - neonatal chicken pox

Question 25

For VZV, what is tested and what Tx is given determined on what’s found?

Answer 25

Test mum’s Antibodies first

+ve = nothing (already have antibodies)

-ve =
<20 weeks - VZ Ig
>20 weeks - IV Aciclovir

Question 26

Can you breastfeed if mother has Hep B?
what is given to the baby and when?

Answer 26

Can breastfeed
give baby Hep B vaccine within 12 hrs of birth

Question 27

What is given to baby is mum has HIV and when?

Answer 27

Zidovudine to baby for 6+ weeks post birth (+ mum from 14 weeks gestation onwards)

Also give ARV (Antiretroviral drugs) for 6+ weeks to baby

Question 28

Can mums with HIV breastfeed?

Answer 28

CI to breastfeed unless HIV <100 copies/ml

Question 29

Neonatal sepsis:
Cause?
what it can progress onwards to cause?
manifests as?

Answer 29

Group B strep (GBS) causes meningitis - septicaemia in <3m neonate
Manifests as Respiratory distress

Question 30

Rf for neonatal sepsis?

Answer 30

Prematurity
Low birth weight
Black ethnicity
M:F 1:1

Question 31

Sx of neonatal sepsis?

Answer 31

Resp Distress!!!!!
Poor feed
High fever
Low urine output
Floppy
Low GCS

Question 32

Dx of neonatal sepsis?

Answer 32

LP
FBC (high neutrophils)
Blood MC+S
VBG (Metabolic acidosis - fetal hypoxia)

Question 33

Tx of neonatal sepsis?

Answer 33

IV cefotaxime

Question 34

why would we not use Ceftriaxone in treating neonatal sepsis?

Answer 34

High risk of kerniecterus and neonatal jaundice