Mixed 19

Question 1

How woulda fetus present if infected with Parvovirus B19?

Answer 1

Fetal infection leads to interrupted erythropoiesis, causing profound anemia and CHF. The fetal CHF can cause ascites, pericardial effusions, and pleural effusion with secondary pulmo hypoplasia, as seen in hydrops fetalis.
*Mothers (adults) who are also infected may present with arthralgia and arthritis of the extremities, with or without rash.

Question 2

What would you give to a premature infant to prevent RDS?

Answer 2

Corticosteroids (dexamethasone, betamethasone) increase surfactant production by accelerating maturation of type 2 pneumocytes.

Question 3

What drug do you give as an alternative to heparin in the event that a patient presents with heparin-induced thrombocytopenia?

Answer 3

Bivalirudin, lepirudin, and argatroban are direct thrombin inhibitors and don’t need antithrombin III for their action.
All forms of heparin should be avoided in this patient.