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Infectious Disease (OSI type) > OBGYN - Infectious diseases > Flashcards

OBGYN - Infectious diseases Flashcards

1
Q

What is the most common cause of CAP in pregnancy

A

S. pneumoniae

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2
Q

What is the most common cause of influenza pneumonia?

A

Influenza A and B

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3
Q

What is the most frequent complication of pneumonia?

A

premature rupture of membranes

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4
Q

What is the DOC for initial therapy in pneumonia in pregnancy?

A

Macrolide

If sever, Fluoroquinolones

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5
Q

What is the vaginal pH in patients suspected with Bacterial Vaginosis?

A

pH >4.7

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6
Q

What is the Amsel’s criteria for vaginal vaginosis?

A
  1. pH >4.7
  2. Clue cells
  3. Milky white discharge
  4. Fishy ordor when KOH is added

BacVag is 3 out 4

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7
Q

What is the DOC for BacVag?

A

Metronidazole 500mg/tab BID x 7 days

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8
Q

[Diagnosis]

Green-yellow frothy vaginal discharge
offensive odor
strawberry cervix
dyspareunia
vulvovaginal soreness, itching
A

Trichomoniasis

Gold standard: culture

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9
Q

What is the vaginal pH in patients with trichomoniasis?

A

pH >4.5

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10
Q

What is the treatment for Trichomoniasis?

A

Metronidazole 2grams single dose

treat partner

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11
Q

In breastfeeding woman with trichomoniasis,what will you advise the mother?

A

Stop breastfeeding for 12 to 24 hours AFTER the last dose

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12
Q

Pregnant patient on her 1st trimester had trichomoniasis, what will you advise?

A

Withold metronidazole until after first trimester

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13
Q

What is the most common clinical presentation of vulvovaginal candidiasis?

A

Vulval pruritus

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14
Q

what will you see under the microscope in patients with vulvovaginal candidiasis?

A

Pseudohyphae (mycelia) and or budding yeast (coinidia)

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15
Q

What is the vaginal pH in patients with vulvovaginal candidiasis?

A

Normal 4.0 to 4.5

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16
Q

What topical azole is contraindicated in pregnant patients with VVC?

A

Fluconazole

The rest, give for 7 days as cream, suppository or tablet

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17
Q

What is the DOC for C. trachomatis in pregnancy

A

Azithromycin 1g PO SD

alternative: amoxicillin 500mg PO TID x 7 duas

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18
Q

How will you treat the partner of a pregnant patient infected with C. trachomatis?

A

Treat sexual partners during the 60 days preceding the onset of symptoms

Give Azithromycin 1g PO SD

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19
Q

What is the culture medium used to culture N. gonorrheae?

A

Thayer-Martin

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20
Q

What are the perinatal complications of gonorrhea?

A
  1. Ophthalmia neonatorum
  2. Pharyngeal and respiratory tract infection
  3. Anal canal infection
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21
Q

What is the DOC for gonorrhea in pregnant patients?

A
  1. Ceftriaxone 250mg IM SD OR
  2. Cefixime 400mg/tab SD
  3. Cephalosporin Injectible PLUS Azithromycin 1g PO single dose PLUS treatment for chlamydia
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22
Q

What are the ocular prophylaxis for gonorrhea in infants

A
  1. 1% silver nitrate solution
  2. 1% tetracycline ointment or solution
  3. 0.5% erythromycin ointment within one hour after borth
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23
Q

What antibiotic can you give for patients allergic to penicillin

A

Azithromycin

Cephalosporin is not tolerated for patients allergic to penicillin

NEVER GIVE QUINOLONES OR TETRACYCLINE

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24
Q

Most common method of transmission of syphilis to infants

A

Transplacental

Neonatal - contact with genital lesions and emmbranse

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25
Q

What is the screening test for syphilis

A

Non-treponemal tests

VDRL or RPR

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26
Q

What are the confirmatory test for syphilis during pregnancy?

A
  1. FTA-ABS
  2. TP-PA
  3. MHA-TP, TP PA
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27
Q

What is the recommended treatment for early syphilis during pregnancy?

A

Benzathine penicillinG as single IM dose

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28
Q

What is the recommended treatment for early syphilis during pregnancy?

A
  1. Aqueous crystalline penicillin G OR

2. Aqueous procaine penicillin

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29
Q

___ reaction

often appears after penicillin treatment of women with primary and secondary syphilis characterized by uterine contractions accompanied by late fetal heart decelerations

A

Jarish-Herxheimer reaction

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30
Q

What is the DOC for herpes simplex in pregnancy?

A

Acyclovir for >/36 weeks AOG

They can breastfeed as long as there are no active breast lesions

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31
Q

What is the fetal immunoglobulin which responds to infection?

A

IgM

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32
Q

When does fetal cell mediated and humoral immunity begin to develop?

A

9 to 15 weeks

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33
Q

[Diagnosi]

pruritic vesicles over the trunk and extremities some with crusting

A

Varicella = chickenpox

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34
Q

How many doses of varicella vaccine do you need to give?

A

2 doses

35
Q

How will you manage a pregnant woman with significant exposure to a person with varicella

A

Get a VZV serology

if seropositive, patient is immune

if seronegative, give VZIg within 96 hours up to 10 days of exposure

36
Q

What are the components of Congenital Varicella Syndrome?

A
  1. Chorioretinitis
  2. Micropthalmia
  3. Cerebral Cortical atrophy
  4. Growth restriction
  5. Hydronephrosis
  6. Limb hypoplasia
  7. Cicatricial skin lesion
37
Q

In mothers with clinical evidence of varicella 5 days before and up to 2 days after delivery, what will be your management to the infant

A

give VZIg to neonate

38
Q

[Rubella]

What immunoglobulin will you check if patient had rubella 4-5 days after onset of clinical disease up to 6 weeks after appearance of rash?

A

Serum IgM

39
Q

[Rubella]

Immunoglobulin that peaks 1-2 weeks after appearance of rash

A

Serum igG

40
Q

A woman should not get pregnant after receiving MMR vaccine within ____ month

A

1 month

41
Q

What are the components of congenital rubella syndrome?

A
  1. Sensorineural deafness
  2. Cataracts
  3. congenital glaucoma
  4. Central nervous system degect
42
Q

What is the most common perinatal infection?

A

CMV

Present in body fluids including breastmilk

43
Q

___ can cause tetanus neonatorum

A

C. tetani

44
Q

Clostririum species know to cause septic abortion

A

C. perfringes

45
Q

[Diagnosis]

fever
tachycardia out of proportion of the fever; uterin discharge, marked leukocytosis; intravascular hemolysis, jaundice, hemogloninuria

hypotension, renal shutdown, DIC

A

C. perfringes

46
Q

Symotoms of infant tetanus can appear from ___ to ___ days

A

1 day to 30 days

47
Q

What is the schedule in giving Td/Tdap in pregnancy?

A

0,1,6-12 months

then every 10 years

48
Q

Universal vaginal and rectal GBS screening and culture should be done at ___

A

35 to 37 weeks

49
Q

Intrapartum prophylaxis for tetanus is indicated in the following

A
  1. Previous infant with GBS disease
  2. GBS bacteriuria during current pregnancy
  3. Positive GBS screening culture
  4. Unknown GBS status
50
Q

What are the recommended Intrapartum prophylaxis for C. tetany?

A
  1. Penicillin G (IV)

Alternative: Ampicillin (IV)

Alternative to penicillin: Cefaz, Clinda

51
Q

Unkown GBS status and the following requires intrapartum tetanus prophylaxis

A
  1. Delivery <37 weeks
  2. Amniotic membrane rupture >18 hours
  3. Intrapartum temperature >38 degC
  4. Intrapartum NAAT positive for GBS
52
Q

[Diagnosis]

Stillborn preterm delivered at 30weeks AOG;

amniotic fluid is brownish during delivery

A

Listeriosis

53
Q

What is the characteristic placental finding associated with listeriosis?

A

pale placenta

54
Q

Stage of toxoplasma that can cross the placenta and affect the fetus

A

Tachyzoites

Toxoplasmosis has no vaccine

55
Q

What are the characteristic ultrasound findings of toxoplasmosis in the fetus?

A
  1. Intracranial calcifications
  2. Hydrocephay
  3. Liver calcifications
  4. Hyperechoic bowel
  5. ascites
  6. Placental thickening
  7. Growth restriction
56
Q

What are the triad of toxoplasmosis in the fetus?

A
  1. Chorioretinitis
  2. Intracranial calcifications
  3. hydrocephalus (convulsions)
57
Q

What drug can reduce congenital infection of toxoplasmosis?

A

Spiramycin

58
Q

Drugs that can be given to eradicate toxoplasmosis parasites in the placenta and fetus

A
  1. Pyrimethamine
  2. Sulfonamides
  3. Folinic acid

only after 18 weeks or suspected fetal infection

59
Q

In pregnant women with malaria, what accumulates in the palcenta?

A

infected erythrocytes

A. flavoristris

60
Q

What is the gold standard for the diagnosis of malaria?

A

Blood smear

61
Q

What antimalarial drug can you give to pregnant patients during the 2nd and 3rd trimester

A

Sulfadoxine-pyrimethamine

62
Q

What drug decreases the placental infection of malaria?

A

Chlorquine and hydroxychlorquine

63
Q

What drugs used for malaria are contraindicated during pregnancy

A

Primaquine

Doxycycline

64
Q

What drugs used for malaria are contraindicated during pregnancy

A

Primaquine

Doxycycline

65
Q

[Prevention of Zika]

What will you advise to women planning to conceive?

A

Delay conception at least 8 weeks after symptom onsent

66
Q

[Prevention of Zika]

What will you advise men planning to conceive?

A

Delay conception at least 6 months

67
Q

What is the criteria for asymptomatic bacteriuria?

A

> 100,000 organisms/mL

68
Q

What is the treatment for asymptomatic bacteriuria?

A
  1. Amoxicillin 3g SD
  2. Ampicilin 2g SD
  3. Nitrofurantoin 200mg SD
69
Q

What is the most common GI cause of surgery during pregnancy?

A

appendicitis

70
Q

What are the complications of hyperemesis gravidarum?

A
  1. Weight loss
  2. Dehydration
  3. Ketosis
  4. Alkalosis - (loss of HCl, Low K)
  5. Transient hepatic dysfunction
71
Q

What causes crab louse?

A

Phthirus pubis

pepper grain feces in hair shafts

72
Q

What is the most contagious of all STIs

A

Phthirus pubis

73
Q

What is the most common viral STD?

A

HPV 6, 11

Tx: Podofilox 0.5% solution or gel; Imiquimod 5% cream (contraindicated to pregnant patients)

74
Q

What is the most accurate and sensitive test to diagnose HSV?

A

PCR

75
Q

What test determines antibodies to HSV for its definitive diagnosis?

A

Western blot

76
Q

“school of fish” in microscopy

A

Chancroid

H. ducreyi
Tx: azithromycin 1g orally

77
Q

[Phase of LGV]

shallow painless ulcer

A

primary infection

78
Q

[Phase of LGV]

painful adenopathy or bubo

A

secondary infection

79
Q

[Phase of LGV]

multiple draining sinuses

A

tertiary infection

80
Q

Bipolar safety pin appearance

A

Donovanosis

K. granulomatis

Tx: Doxycycline 100mg twice daily

81
Q

[Diagnose]

Yellow, frothy, increased odor, cervical erythema

pH >4.5

A

Trichomoniasis

82
Q

What is the gold standard for diagnosis of Bacterial Vaginosis

A

Gram Stain

83
Q

[Diagnosis]

white cheesy discharge, pruritus, vulval burning, external dysuria, dypareunia

A

candidiasis

Tx: Butoconazole

84
Q

What is the gold standard in diagnosng N. gonorrheae

A

NAAT

Tx: Ceftriaxine 250mg IM or Cefixime 400mg PO + Chlamydia therapy

Infectious Disease (OSI type) (24 decks)

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