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Path Week 2 > Mi - Viral Infections in Pregnancy > Flashcards

Mi - Viral Infections in Pregnancy Flashcards

1
Q

causes of a rash in pregnant women

A

VZV
EBV
HSV
CMV
parvovrius b19
enterovrius
measles
rubella

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2
Q

who gets CMV

A

chemo / AI pts

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3
Q

name some herpes viruses

A

HSV, VZV, CMV, EBV

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4
Q

what type of virus is herpes

A

DNA

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5
Q

can herpes viruses be cleared

A

no - cause lifelong latent infection reactivated under stress

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6
Q

how is HSV transmitted

A

close contact

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7
Q

sx of herpes

A

asymptomatic
painful vesicualr rash
lymphadenopathy
fever

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8
Q

Dx for herpes

A

viral detection - lesion swab for PCR
serology

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9
Q

how can foetus be infected with HSV

A

active rash in mothers genitals then PROM

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10
Q

how can neonates get HSV

A

kissing baby with oral herpes
direct contact with mothers infected secretions in delivery

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11
Q

3 types of HSV infection

A

primary - 1st time infected
non primary - prev infection with a type of HSV then ifnected with another
recurrent - latent reactivation

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12
Q

2 risks of HSV in pregnancy

A

vertical transmission - greatest if active infection in 3rd trimester
in utero infection - primary infection causing miscarriage / congenital abnormalities

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13
Q

Tx of HSV in preg

A

acyclovir suppression 6 weeks pre birth

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14
Q

Ix for HSV in preg

A

GUM referral to look for other STIs
HSV AB testing
acyclovir
C section if within 6 weeks pre birth

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15
Q

3 types of neonatal HSV

A

skin eye mouth (SEM)
CNS involvement
dissemninated

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16
Q

Sx, time frame of occurence and prognosis of SEM HSV in neonates

A

benign
first 14 days or up to 6 weeks
high risk of progression to CNS

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17
Q

Sx, time frame of occurence and Ix of CNS HSV in neonates

A

seizures, lethargy, irritability, poor feeding
2-3 weeks of life, up to 6
LP

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18
Q

Sx, time frame of occurence and prognosis of disseminated HSV in neonates

A

like sepsis - multi organ involvement
1st week of life
death, too late to treat here

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19
Q

Tx of neonatal HSV

A

acyclovir

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20
Q

incubation of VZV

A

7 to 13 days

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21
Q

timeline of VZV course

A

get infection
24hrs later, rash starts
lesions crusted over 5-7 days after

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22
Q

complications of maternal varicella

A

10% varicella pneumonia
encephalitis (rare)

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23
Q

3 types of congenital varicella syndrome

A

in utero
perinatal
postnatal

24
Q

Sx of congenital varicella syndrome

A

neuro abnormalities
occular abnormalities
low birth weight
GI abnormalities
limb abnormalities & skin scarring

25
Q

when would you Ix a pregnant woman with VZV for ?Tx

A

if no previous chicken pox or vaccination

26
Q

when would you offer Tx to VZV pregnant woman

A

if VZV IGG <100

27
Q

Tx for VZV pregnant woman

A

oral acyclovir 800mg or oral valaciclovir 1000mg

28
Q

what % of people have CMV by 16 years old

29
Q

transmission and incubation of CMV

A

saliva / resp secretions / urine
4-8 weeks

30
Q

Sx of CMV

A

mostly none
maculopapular rash, sore throat, temp, glands

31
Q

Ix of CMV

A

PCR of urine / saliva
serology +/- bronchoscopy

32
Q

when is the biggest risk to baby with CMV infection

A

3rd trimester

33
Q

Sx of CMV for foetus

A

encephalitis
microcephaly
ventriculomegaly
–> poor development
jaundice
thrombocytopenia
hepatosplenomegaly
chroioretinitis

34
Q

when is CMV tested for in baby

A

Guthrie card in 1st week of life

35
Q

Ix for CMV for mother

A

check serology & compare to 8 week booking scan
USS +/- amniocentesis

36
Q

Tx for CMV

37
Q

conjunctivitis, rash, cough, fever, koplik spots. Dx?

38
Q

headache, low fever, sore throat, spots on soft palate. lymphadenopathy. Dx?

39
Q

contrast the rashes of measles and rubella

A

measles = rash starts at hair line / behind ears and goes to chest over 3 days
rubella = rash starts on face then spreads to chest within hours

40
Q

Ix of rubella

A

buccal swab for PCR and serology

41
Q

when is rubella most a problem for foetus & what happens

A

1st trimester - pre 8 weeks = miscarriage, pre 10 weeks = 90% have foetal defects

42
Q

rubella after 20 weeks gestation. prognosis?

43
Q

congenital rubella syndrome Sx in neonate?

A

microcephaly
cataracts
retinopathy
bone lesions
purpura
hepatosplenomegaly
PDA heart

44
Q

congenital rubella syndrome Sx developing in older child?

A

panencephalitis
hearing loss
DM
intelectual disability
thyroid dysfunction

45
Q

complications for mother of measles in preg

A

secondary bacterial infections
otitis media / pneumonia / GI
encephalitis

46
Q

measles Sx for foetus

A

foetal loss *** main one
preterm delivery
no congenital abnormalities
subacute sclerosing panencephalitis

47
Q

Sx of SSPE & onset

A

progressive neuro Sx and neuro degeneration
7-10 years post infection

48
Q

in whom in parvovirus b19 a particular worry and why

A

sickle cell pts - causes aplastic crisis

49
Q

Sx of parvovirus in pregnancy

A

mostly none
erythema infectiosum / slapped cheek
polyarthropathy

50
Q

when are you infectious in parvovirus

A

6 days post exposure to 1 week

51
Q

parvovirus Sx in foetus before 20 weeks

A

hydrops fetalis 3% - accumulation of fluid in soft tissue, leads rapidly to death
foetal anomalies 1%
foetal loss 7%

52
Q

parvovirus Sx in foetus after 20 weeks

53
Q

enterovirus / hand, foot, mouth prognosis in preg women

A

usually fine, no severe outcomes

54
Q

enterovirus / hand, foot, mouth prognosis/complications in neonates

A

myocarditis, hepatitis, encephalitis, bleeding, multi organ failure

55
Q

complications for neonate from zika

A

microcephaly !!!
brain damage
seizures
limb movement issues

Path Week 2 (18 decks)

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