Mehl + UW BGstrep prophylaxis 12-13 (1)

Question 1

Mehl. what is adequate prophylaxis? abs + time of injection.

Answer 1

Adequate prophylaxis is considered to be IV penicillin or ampicillin administered within 4 hours of completion of Stage 2 (delivery of fetus; stages of delivery discussed later).

Question 2

Mehl. what is wrong answer in 2CK?

Answer 2

Oral amoxicillin + clavulanate (Augmentin) is wrong. This is listed as wrong answer choice on 2CK form.

Question 3

Mehl. we do not automatically give GBS prophylaxis in the current pregnancy just because the woman had a (+) culture in the prior pregnancy.

Answer 3

When discussing indications for giving GBS prophylaxis, the first step is mentioning when you do not give it, which is when there is Hx of mere colonization with GBS in prior pregnancy.

Question 4

Mehl. Knowing not to give it in this scenario is actually the highest yield point.

Answer 4

.

Question 5

Mehl. Indications for giving GBS prophylaxis. what positive? when?

Answer 5

(+) Rectovaginal swab at 36 weeks.

Question 6

Mehl. Indications for giving GBS prophylaxis. urine?

Answer 6

GBS bacteriuria at any point during the pregnancy, even if it was successfully treated.

if they say woman had 1st trimester GBS asymptomatic bacteriuria + she received ampicillin or penicillin + cultures are currently negative, we still give intrapartum prophylaxis.

Question 7

Mehl. Indications for giving GBS prophylaxis. Hx of what?

Answer 7

Hx of early-onset GBS disease in prior pregnancy (i.e., meningitis, pneumonia, or sepsis) in NEONATE.

This is different from mere colonization in the mom while pregnant. In this scenario, the neonate actually went on to get a GBS infection.

Question 8

Mehl. Indications for giving GBS prophylaxis.
- If mother’s GBS status is unknown or equivocal, we give it if any one of the following is present:? 3

Answer 8

1) Rupture of membranes (ROM) > 18 hours.
2) Maternal fever >38 C.
3) Preterm delivery (<37 weeks).

Question 9

Mehl. 2CK Obgyn form, for instance, says that a pregnant woman is in labor at 40 weeks, her temperature is 37
C, and her GBS status is unknown. They ask which of the following is the best indication for prophylaxis in this patient –> answer = ROM > 18 hours.

Answer 9

.

Question 10

Mehl. Another 2CK Obgyn Q asks for the Tx of GBS sepsis in the neonate –> answer = ampicillin + gentamicin;
vancomycin + ceftriaxone is wrong on the form.

Answer 10

.

Question 11

Mehl. Not GBS table.

Three most common bacteria causing infections in neonates are?

Answer 11

GBS, Ecoli, listeria

Question 12

Mehl. Not GBS table.
If they say there is neonatal infection caused by gram-positive cocci, answer?

Answer 12

GBS

Question 13

If they say there is neonatal infection caused by gram-negative rod, answer?

Answer 13

E coli

Question 14

If they say there is neonatal infection caused by gram-positive rod, answer?

Answer 14

Listeria

Question 15

Mehl. Not GBS table. listeria spread?

Answer 15

Listeria can be contracted by the pregnant female via soft cheeses and deli meats.

Question 16

UW table. antenatal screenin, weeks?

Answer 16

new table tipo sako 36-38 weeks.

Question 17

UW table. indications. urinary?

Answer 17

GBS bacteriuria or GBS urinary infection in current or prior pregnancy (regardless or treatment)

Question 18

UW table. indications. culture?

Answer 18

GBS positive rectovaginal culture (mehl. said 36 weeks) in current pregnancy

Question 19

UW table. indications. Unknown GBS status PLUS any of the following?3

Answer 19

<37 weeks gestation
Intrapartum fever
Rupture of membrane >= 18 hours

Question 20

UW table. indications. Prior what disease?

Answer 20

Prior infant with early-onset neonatal GBS infection

Question 21

UW table. intrapartum prophylaxis. What abs? what is allergy?

Answer 21

Iv penicillin or ampicillin
IF allergy –> give cefazolin