Infection - Obstetric and perinatal infection Flashcards
immune tolerance
adaptation of normal immune system in pregnancy
foetus acts as non self allograft
what does a foetus act as in pregnancy
non self allograft
different immune system
what does the placenta act as
immunological barrier
certain components eg IgG antibodies can get through
pathogens/immune cells cannot
cloaking effect
which type of antibody can go through the placenta
a.igA
b.igM
c.igG
c.igG
how do placental cells differ to normal cells
reduced depression of class 1 MHC antigens
syncytium blocks immune cells
T cells inhibited
which cells are inhibited by the placenta
a.B cells
b. D cells
c.F cells
d.T cells
d.T cells
which antigens have decreased expression in the placenta
a.class 1 MHC
b.class 2 MHC
c.class 3 MHC
c.class 3 MHC
what happens to systemic immunity in pregnancy
a.surpression
b.increase
a.surpression
down regulation of T cells
pregnant worm are at ……… risk of infection
a.lower
b.higher
b.higher
eg hep A
also rheumatoid arthritis decreases
what happens in some inflammatory disease in pregnancy eg rheumatoid arthritis and IBD
a.worsens
b.imrpoved
b.imrpoved
what happens if the maternal immune system is fully functional
a.graft rejection
b.foetal abnormalities
c.graft vs host reaction
a.graft rejection
synthesis of which antibody is entirely lacking in pregnancy
a.igG
b.igM
c.IgA
a.igG
which fetal antibodies are not produced in significant amounts until the second half of pregnancy
a.IgM AND IGg
B.IGM and IgA
c.IgA and IgG
B.IGM and IgA
which infections are more severe in pregnancy
malaria
UTI -> presses on uterus limitation of flow
influenza -> mechanical issues (lungs inflating H1M)
candidiasis
listeriosis
varicella
which transmission occurs during pregnancy
a.intrauterine
b.perinatal
a.intrauterine
which transmission occurs during birth
a.intrauterine
b.perinatal
b.perinatal
rubella, parvovirus, cmv, syphillis are all spread via which transmission
a.intrauterine
b.congenital
c.perinatal
a.intrauterine
during pregnancy via placenta
they are known as congenital infections - present at time of birth
TORCH infections
toxoplasma , rubella , cmv , herpes
HIV, HBV, group b streptococci. listeria , chlamydia and neisseria gonorrhoea are spread via which transmision
a.intrauterine
b.congenital
c.perinatal
c.perinatal
(blood mixing, organisms present in GU tract of mother)
which of these is an example of post natal transmission
a.via placenta
bb.via blood mixing in birth
c.via GU tract in birth
d.via breastmilk
d.via breastmilk
how is HTLV spread
a.intrauterine
b.perinatal
c.postnatal
c.postnatal
via breast milk
what is the incubation period of rubella
a.7-14 days
b..14-21 days
c.21-30 days
b..14-21 days
fever, malaise(joint pain) ,nodes behind the ear,athralgia and irregular maculopapular rash (non specific)lasting 3 days indicates which disease
a.rubella
b.erythrovirus b19
c.cmv
d.syphillis
a.rubella
often unoticed in adults/healthy
what type of rash is present for 3 days in rubella
a.irregular maculopapular rash
b.regular maculopapular rash
a.irregular maculopapular rash
redness non specific (could be flat or slightly raised)
congenital rubella syndrome
mother contracts rubella in first 16 weeks of pregnancy
moves across placenta
how is congenital rubella syndrome spread
a.intrauterine
b.perinatal
c.post natal
a.intrauterine
sensorineural deafness, insulin dependent diabetes and type1 diabetes , cataracts, brain and heart problems occur in which situation
a.rubella
b.congenital rubella syndrome
c. cmv
d.syphillis
e.eryhtorvirus
b.congenital rubella syndrome
febrile illness in children and maculopapular rash on the face (slapped cheek syndrome) are present in which infection
a.rubella
b.congenital rubella syndrome
c. cmv
d.syphillis
e.erythrorvirus
e.erythrorvirus b19
what has caused the decrease in congenital rubella syndrome since the 1970s
a.MMR vaccine ]
b.HPV vaccine
a.MMR vaccine
when is maternal infection with eryhrovirus b19 dangerous
a.first 16 weeks
b.10-20 weeks
c.20-30 weeks
b.10-20 weeks
asymptomatic in adults
w
erythrovirus 19 is ………. in adults
a.symptomatic
b.symptomatic
a.symptomatic
in which perinatal infection is there destruction of foetal red cells (anaemia) and fetal heart failure (hydros fatales) leading to a swollen pale foetus and fatality for the foetus
a.rubella
b.erythrovirus 19
c.cmv
d.syphillis
e.congenital ribella syndrome
b.erythrovirus 19
if mother in contact with person with macropapular rash which antibodies are looked for in serology when looking for erthrovirus 19
a.igG and IgM
b.igG and iGA
a.igG and IgM
igg = previous infection
iGm = current infection
repeat after 4 weeks if none found
if present then infection occurred
treated with intrauterine blood transfusion
what is done if rubella is detected in pregnancy
a.intrauterine blood transfusion
b.termination options
c.further tests to define risk
c.further tests to define risk
and termination options
presece of which antibody indicates current infection with E19/ rubella
a.igG
b.igM
b.igM
what is the best sample to take for cmv in newborns
a.blood
b.urine
c.swab
b.urine
what family is cmv
a.herpes
b.strep
c.staph
a.herpes
n cmv which infection is higher risk in pregnancy
a. reactivation
b.primary infection
b.primary infection
more likely severe infection and more likely transmission
reactivation - less risk of mother and transmission
CMV inclusion disease refers to….
what happens inside cells
marked multisystem cells
symptoms of cmv are…
a.a spectrum
b.set
a.a spectrum
asymptomatic - CMV inclusion disease
how is cMV diagnosed in babies
a.PCR urine
b.blood
c.serology
a.PCR urine
how is cMV diagnosed in mothers
a.PCR urine
b.blood
c.serology
c.serology
syphylis is……….
a.acute
b.chronic
b.chronic
tested for antenatally
if detected maternal infection can be detected
which infection causes hepatosplenomegaly, jaundice , anaemia affects teeth brain and ears and can lead to miscarriage
a.rubella
b.erythrovirus 19
c.cmv
d.syphillis
e.congenital ribella syndrome
d.syphillis
what is syphillis in mothers treated with
a.penicillin
b. clarithrmycin
c, doxycycline
a.penicillin
which infection prior to 20 weeks causes limb deformities, brain and eye abnormalities and maternal pneumonitis
a.rubella
b.erythrovirus 19
c.cmv
d.syphillis
e.congenital ribella syndrome
d.varicella
d.varicella
chickenpox
what is tested for to test for immunity when mother in contact with chicken pox
a.urine PCR
b.VZV IgG
c.IgM
b.VZV IgG
if mother has a VZV gig negative result and has been in contact with chickenpox what is given
a.VZIG given
b.penicillin given
a.VZIG given
what is screened for in pregnancy
HBV
HIV
syphyllis
rubella
When screening for HBV what is screened for
a.current infection
b.past or present infection
c.immunity
a.current infection
screen for HBsAg
When screening for HIV what is screened for
a.current infection
b.past or present infection
c.immunity
a.current infection
If hep B is present what is given
a.penicillin to mother
b.VZIG given
c.antiretrovirals
d.HBV vaccine for baby
d.HBV vaccine for baby
if HIV present what is given
a.penicillin to mother
b.VZIG given
c.antiretrovirals
d.HBV vaccine for baby
c.antiretrovirals
elective c section
NO breast feeding
need to follow up baby until after 18 months
what week is booking blood taken at
a.10
b.12
c.13
d.16
c.13
infections around time of birth
choriamniotis - 2nd half of pregnancy, bacterial infection from GU tract
bacterial meningitis
neonatal varicella
HSV
which part of pregnancy does Chorioamnionitis normally occur
a.1st half
b.2nd half
c,1st trimester
b.2nd half
neonatal conjunctivitis are associated with which bacteria
a.neisseria gonorrhoea
b.strep pnneumoniae
c.staph aureus
d.e coli
a.neisseria gonorrhoea
and chlamydia (STIs in GU tract)
c trachomitis can lead to pneumonia
which neonatal infections can present as sepsis / meningitis
group B strep
listeria monocytogenes
e coli
specific sepsis and meningitis to first 3 months
listeria monocytogenes is..
a.gram neg
b.gram pos
c.gram pos rod
d, gram pos cocci
c.gram pos rod
risk in food stuffs and unpasterized milk
pregnant women are advised to avoid unpasteurised milk etc to avoid which bacteria
a.group B strep
b. listeria monocytogenes
e coli
b. listeria monocytogenes
early onset neonatal meningitis
what is listeria treated with
a.penicillin
b.ZGIG
c.amoxicillin
d.doxycycline
c.amoxicillin
may need to give gentamicin too
group B strep is ………. for neonate
a.mild
b.serious
b.serious
if problems with group b strep previously when is it screened for in mother
a.16 weeks
b.13 weeks
c.36 weeks
c.36 weeks
given prophylactic penicillins during birth
what is given for group b strep in pregnancy
a.penicillin
b.ZGIG
c.amoxicillin
d.doxycycline
e.prophylactic penicillin
e.prophylactic penicillin
puerperal sepsis
sepsis of uterus and genital tract post partum
how is puerperal sepsis diagnosed
a.bloods
b.serology
c,vaginal swab
c,vaginal swab
what is the main cause of puerperal sepsis
a.neisseria gonorrhoea
b.strep pnneumoniae
c.staph aureus
d.e coli
e.group a strep
e.group a strep
