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OB > Infections in Pregnancy > Flashcards

Infections in Pregnancy Flashcards

1
Q

MC bacterial infection in pregnancy

A

UTIs

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2
Q

what are UTIs and bacteriuria

A

with preterm delivery, preeclampsia, maternal anemia, amnionitis, and low birth weight

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3
Q

when should preggers get screened for UTIs

A

at first prenatal visit

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4
Q

MC UTI bug

A

E. coli

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5
Q

what does asymptomatic bacteriuria have increased risk of

A

pyelonephritis

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6
Q

is cystitis multiple or single organsim

A

single

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7
Q

most significant symptoms of cystitis

A

dysuria

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8
Q

what should you NOT use for UTIs in preggers

A

Sulfa (Bactrim or Septra) – inhibits folate (increased NTD)
and raises bilirubin late in pregnancy (kernicterus)
Fluoroquinolones – fetal arthropathy
Tetracyclines – affect fetal bones and teeth

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9
Q

what do you do after treating UTIs

A

test for cure

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10
Q

what meds do you use for UTIs

A

nitrofurantoin
augmentin
fosfomycin

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11
Q

MC urinary tract complication in preggers

A

pyelonephritis

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12
Q

what is pyelo frequently associated with

A

septicemia

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13
Q

when is pyelo MC

A

2nd trimester

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14
Q

pyelo tx

A

ceftriaxone favored

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15
Q

MC cause of neonatal sepsis

A

GBBHS

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16
Q

infant mortality of GBBHS

A

Infant mortality – 25% preterm, 5% term

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17
Q

tx of GBBHS

A

ampicillin or penicillin or clinda for allergies

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18
Q

what does TORCHES stand for

A 
Toxoplasmosis
Other (Hep B, Coxsackie, VZV, West Nile, Measles, HIV, Zika) 
Rubella
Cytomegalovirus
Herpes simplex
Erythema infectiosum
Syphilis
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19
Q

what can happen with untx toxoplasmosis

A

sensorineural hearing loss if untreated (28%)

20
Q

congenital rubella syndrome risk highest risk in wks

A

8-10

21
Q

what is congenital rubella syndrome

A

cataracts, heart defects, hearing defects

22
Q

how long can you shed rubella

A

up to 1yr in stool

23
Q

do maternal antibodies protect fetus against CMV

A

no

24
Q

prognosis of CMV to child and what is the MC sequela

A

Disseminated- Mortality 12% (some statistics up to 30%)

Sensorineural hearing loss is the most common sequela of congenital CMV infection.

25
Q

how is HSV contracted by the baby

A

**through the birth canal

26
Q

when do you consider HSV

A

any septic neonate

27
Q

do you need informed consent for HSV vaginal birth

A

yes

28
Q

how likely is a syphilis mother to have normal baby

A

Mother with primary/secondary syphilis UNLIKELY to have normal infants

29
Q

where can the syphilis rash appear

A

palms and soles!

30
Q

what is pseudoparalysis of parrot and what is it associted with

A

syphilis and pt refuses to weight bear on painful bones

31
Q

what is the only drug that can be used with infected syphilis mother

A

PCN

32
Q

is maternal herpes zoster associated with congenital varicella syndrome?

A

no

33
Q

when is the most critical period for parvovirus to strike

A

13-16wks

34
Q

CHORIOAMNIONITISINTRA-AMNIOTIC INFECTION SYNDROME tx

A

delivery! + abx (ampicllin + gentamycin)

35
Q

what drugs to NOT use in pregnancy (but could be used if its the only choice and the infection is worse than using it)

A

Fluoroquinolones – arthropathy (animal studies)
Streptomycin-ototoxicity
Tetracyclines- Teeth staining, growth stunting

36
Q

what meds do yo avoid in 1st trimester

A

metronidazole

37
Q

what drugs do you avoid in the 3rd trimester

A

Sulfonamides (hyperbilirubinemia-kernicterus)

Nitrofurantoin (hemolysis in G6PD deficiency)

38
Q

postpartum fever after day 1 suspect

A

assume to be pelvic infection until proven otherwise

39
Q

what is the most important RF in endometritis

A

c-section

40
Q

how many organsims are involved in post partum endometritis

A

multiple

41
Q

tx for post vaginal deliver of post partum endometritis

A

Gentamicin & clindamycin

42
Q

tx for postc-section deliver of post partum endometritis

A

Ampicillin/Gentamicin & clindamycin

43
Q

tx for chlamydia

A

Azithromycin (Zithromax) 1 gm po one dose (first-line)

Probs gonnna have terrible stomach SA

44
Q

MC STI

A

chlamydia

45
Q

gonorrhea tx

A

Ceftriaxone (Rocephin) 250 mg IM + azithromycin 1 g po x 1 dose

OB (6 decks)

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