Infections SMFM questions

Question 1

Mortality/Morbility for neonatal HSV

Answer 1

Mortality 4% for central nervous system
30% for disseminated

20% of survivors have long term neurologic sequelae

Question 2

Risk of transmission for HSV

• primary
• recurrance

Answer 2

Primary - 30-60%
Recurrance- 3%
No lesions 1:5000

Question 3

Symptoms of LIsteria Monocytogenes

Answer 3

fever and flu-like illness
sometimes preceeding diarrhea
rarely: cranial nerve deficits, endocarditis, brain abscess ( mainly in immunocompromised)

Question 4

OB complications of listeria

Answer 4

higher rate than the non-pregnant population

miscarriage, stillbirth, preterm labor, and low birth weight

Question 5

management of listeria during pregnancy

Answer 5

symptomatic- IV ampicillin and targeted blood cultures

Asymptomatic or gastroenteritis without a fever- no treatment

Question 6

Poor indicators in septic shock

Answer 6

depressed cardiac output, high serum lactate ( >4), reduced oxygen extraction

Question 7

CMV transmission rates

Answer 7

most common infection up to 2% of newborns
Primary - 30-70%
Recurrent 0.15%-2%
Transmission is highest in the 3rd trimester (40-70%)
1st trimester- 30%
2nd trimester 35%

Question 8

CMV incubation period

Answer 8

28-60 days

Question 9

CMV avidity

Answer 9

low- 2-4 months

high >4 months

Question 10

parvovirus exposure- testing

Answer 10

IgG+ IgM neg- immune
IgG+ and IgM+- monitor for fetal infection (u/s every 1-2 weeks for 8-12 weeks)
IgG- and IgM– recheck in 4 weeks

Question 11

Parvovirus transmission rate

Answer 11

17-33%

Question 12

CMV ultrasound findings

Answer 12

echo bowel, ventriculomegaly, intracranial calcifications, abdominal calcifications, hepatosplenomegaly, echo kidney, ascites, microcephaly, hydrops, growth restriction