Ob: congenital infections

Question 1

hydrocephalus
intracranial calcifications
chorioretinitis
ring-enhancing lesions on MRI

Answer 1

toxoplasmosis

Question 2

toxoplasmosis

• transmission
• dx
• tx
• prevention

Answer 2

transmission: transplacental, primary infection via consumption of raw meat or contact with cat feces
dx: serologic testing
tx: pyrimethamine + sulfadiazine
prevention: can give spiramycin prophylaxis for the third trimester

Question 3

purpuric "blueberry muffin" rash
cataracts
mental retardation
hearing loss
PDA

Answer 3

rubella

Question 4

rubella

• transmision
• dx
• tx
• prevention

Answer 4

transmission: transplacental in the first trimester
dx: serologic testing
tx: symptomatic
prevent: immunize before pregnancy; vaccinate mother after delivery if serologic titers still remain (-)

Question 5

petechial rash

periventricular calcifications

Answer 5

CMV

Question 6

CMV
-transmission
-dx
-tx
no prevention

Answer 6

transmision: primarily transplacental
dx: urine; culture; PCR of amniotic fluid
tx: postpartum ganciclovir

Question 7

skin, eye and mouth infections

life-threatening CNS/ systemic infection

Answer 7

HSV

Question 8

HSV

• transmission
• dx
• tx
• prevention

Answer 8

intrapartum transmission if the mother has active lesions; transplacental transmission is rare

dx: serologic testing
tx: acyclovir
prevention: perform a C-section if lesions are present at delivery

Question 9

often asymptomatic
failure to thrive
bacterial infections
increased incidence of URT and LRT disease

Answer 9

HIV

Question 10

HIV

• transmision
• dx
• tx
• prevention

Answer 10

transmission: in utero, at delivery or via breast milk
dx: screen with ELISA then confirm with a Western blot
tx: highly active antiretroviral therapy (HAART)

prevention: AZT or neviraprine in pregnant women with HIV; perform elective C-section if viral load is > 1000.
treat infants with prophylactic AZT; avoid breastfeeding

Question 11

maculopapular skin rash
lymphadenopathy
hepatomegaly
"snuffles": mucopurulent rhinitis
osteitis

Answer 11

syphilis

Question 12

saber shins
saddle nose
CNS involvement

hutchinson’s triad

• peg-shaped central incisors
• deafness
• interstitial keratitis

Answer 12

late congenital syphilis

Question 13

syphilis

• transmission
• dx
• tx
• prevention

Answer 13

transmission: intrapartum; transplacental transmission is possible
dx: dark-field microscopy; VDRL/RPR, FTA-ABS
tx: penicillin
prevention: penicillin in pregnant women who test (+)