Microbiology 9s - Neonatal and childhood infections

Question 1

Infections currently screened for in pregnancy

Answer 1

HIV, Hep B, syphilis

Rubella status screened for but NOT the infection itself

Question 2

what is the most common cause of congenital deafness in UK?

Answer 2

CMV

Question 3

what can early acquisition of toxoplasmosis in pregnancy lead to?

Answer 3

miscarriage

Question 4

long-term sequelae of congenital toxoplasmosis

Answer 4

low iQ
microcephaly
deafness

Question 5

4C’s of toxoplasmosis seen in babies at birth

Answer 5

Chorioretinitis
Intracranial calcifications
MicroCephaly/HydroCephalus
Convulsions

(+hepatosplenomegaly/jaundice)

Question 6

when in the pregnancy is it worst to get rubella?

Answer 6

worst in first trimester, after 20 weeks the risk is negligible

Question 7

classic triad seen in congenital rubella syndrome

Answer 7

cataracts, congenital heart disease (PDA; ASD/VSD) + deafness (SNHL)

Question 8

chlamydia trachomatosis in neonate sx

Answer 8

neonatal conjunctivitis or pneumonia

Question 9

main causes of early onset neonatal infection

Answer 9

GBS E.coli ListeriA

Question 10

INVESTIGATIONS if early onset sepsis suspected

Answer 10

FBC, CRP, Blood cultures, Urine dip/MSU, Urine MC&S, LP, CXR

Question 11

antibiotics for early onset sepsis

Answer 11

Benpen + gent +/- amoxicillin

Question 12

causes of late onset sepsis in neonate

Answer 12

CoNS, S.aureus, E.coli, Candida, gram -ves e.g. Klebsiella, pseudomonas, GBS

Question 13

antibiotics used for late onset neonatal sepsis (1st line and community acquired)

Answer 13

1st line = cefotaxime + vancomycin

community acquired: cefotxime + amoxicillin +/- gentamicin

Question 14

contraindications to LP

Answer 14

Meningococcal disease, raised ICP, bleeding disorder, overlying infection at site, spina bifida

Question 15

streptococcus pneumonia bacterial staining

Answer 15

gram +ve, alpha haemolytic, optochin sensitive

Question 16

current vaccine for strep pneumonia

Answer 16

Prevenar 13 (conjugate vaccine)

Question 17

haemophilus gram stain and pattern

Answer 17

gram -ve coccobaccillus

Question 18

in what age group does haemophilus tend to cause meningitis?

Answer 18

<5 years

Question 19

biggdst causes of mortality in neonatal period

Answer 19

prematurity and intra-partum related complications

Question 20

biggest cause of mortality post-neonatal

Answer 20

pneumonia and congenital anomalies

Question 21

cold agglutinins - which respiratory infection?

Answer 21

Mycoplasma pneumonia

Question 22

treatment of mycoplasma pneumoniae

Answer 22

Macroldies e.g. azithromycin

Question 23

children >4, epidemics every 3-4 years

Answer 23

Mycoplasma pneumonia

Question 24

Classic presentation of mycoplasma pneumonia

Answer 24

Headache, fever, myalgia, dry cough

Question 25

extra pulmonary manifestations of M.pneumoniae

Answer 25

Haemolysis (IgM antibodies to erythrocytes + cold agglutinins)
Neuro - encephalitis, meningitis, cerebellar ataxia
polyarthralgia
otitis media
bullous myringitis

Question 26

what is pyuria

Answer 26

pus cells on urine microscopy