Neonatal and Tanner Stages Flashcards
Congenital Rubella Syndrome (3)
- Transplacental passage of rubella virus
- Dx: + viral culture, PCR, IgM antibodies
- Tx: isolate infant from pregnant woman; early intervention; refer to specialist
Congenital Rubella Syndrome, Early and Delayed S/S
Early S/S: cataracts, retinopathy, micropthalmost, glaucoma, retardation, congenital heart disease, deafness, FTT, blueberry muffin lesions, rash
Delayed S/S: 2-4 year delay –> diabetes, encephalopathy
Hepatitis B in Newborn (5)
- Transplacental passage of HepB virus
- Incubation: 60-150 days
- Dx: Serology, +surface antigen
- Tx: HepB vaccine in first 12 hours along with HepB gamma globulin to avoid perinatal experience
- Interferon used to treat chronic HepB
Newborn HepB S/S (8)
- Malaise
- Anorexia
- N/V and RUQ pain
- Fever
- HA
- Dark urine
- Rash
- Causes chronic carrier- later leads to hepatomegaly, jaundice, rash, arthralgia/arthritis
Neonatal HSV: Skin/Eyes/Mouth Type (2)
- Presentation in 1st 2 weeks of life
2. Cutaneous lesions where infant contacted mother’s genitals
Neonatal HSV: CNS Type (4)
- 2nd-3rd week presentation
- Seizures
- Apnea
- Neuro instability
Neonatal HSV: Disseminated Type (4)
- Presents in 1st week
- Acutely ill –> very sick
- Shock
- DIC
Neonatal HSV: Dx and Tx
Dx: + culture
Tx: Acyclovir 20mg/kg IV q8 for 21 days (CNS and Disseminated), 14 days for Skin, Eye, Mouth
Neonatal HSV in the context of an STI (4)
- Type 1 (Oral), or Type 2 (Genital) - sexually transmitted from asymptomatic carrier
- S/S: Painful vesicles/blisters with burning and irritation,, dysuria, systemic symptoms, extra-genital lesions, LAD
- Dx: + viral culture
- Tx: Acyclovir
Chlamydia Trachomatis in Newborn: Neonatal Conjunctivitis (3)
- Occurs 5-14 days after birth
- Conjunctival edema/injection, eye discharge, and pseudomembrane
- Tx: oral erythromycin for 10-14 days (also for pneumonia)
Chlamydia Trachomatis in Newborn: Neonatal Pneumonia (4)
- Occurs 2-19 weeks after birth
- Rhinorrhea, congestion, tachypnea with staccato cough, rales, wheezing rare
- Dx: culture, hyperinflation on chest x-ray with eosinophilia
- Tx: oral erythromycin for 10-14 days
Chlamydia as STI (4)
- Often asymptomatic
- S/S: spotting, vaginal discharge, dysuria, pyuria, mild abd pain, FB sensation in the eyes, cervicitis, conjunctivitis
- Dx: +culture
- Tx: one gram of Azithromycin PO for one dose (alternative: doxy/erythromycin or levofloxacin)
Newborn Gonococcal infection (5)
- Transmitted from vaginal secretions during delivery
- Conjunctivitis – injected/swollen conjunctiva, eye discharge that becomes thick, lid edema, can lead to blindness, corneal ulceration
- Other s/s - scalp abscess, sepsis, meningitis with fever, tachypnea, tachycardia
- Dx: culture
- Tx: silver nitrate/erytrhomycin opthalmic ointment, ceftriaxone/cefotaxime (if hyperbilirubinemia) for disseminated disease
Clinical course of HIV in newborn period (4)
- Transmitted via placenta during birth
- Can be asymptomatic for years
- Possible s/s: premature, LBW, recurrent infections, FTT, diarrhea, developmental delay, LAD, hepatosplenomegaly, CNS, parotitis
- Tx: ARV prophylaxis, ARV tx if positive culture and <12 months; consult ID specialist
Clinical Course of HPV (5)
- Viral infection
- Usually asymptomatic/subclinical but can cause pain
- S/S: warts which are cauliflower-like, appear 4-6 weeks after exposure, friable
- Dx: PAP test
- Tx: cryotherapy, podofilox solution