OBS: Antenatal Care -- Infection Screening

Question 1

Interpretation of EIA +ve, VDRL -ve

Answer 1

EIA +ve indicates past infection
VDRL -ve indicates adequately treated syphilis / late latent syphilis

Question 2

2 Treatment regime for late latent syphilis

Answer 2

1. IM Pen G 2.5 MU Q1w for 3w
2. IM Procaine Penicillin 1.2 MU daily + Probenecid 500mg QID for 15 days

Question 3

Other investigations required at the same time of syphilis treatment

Answer 3

STD screening: Triple swab
1. HVS for trichomonas
2. Endocervical swab for gonorrhoea, chlamydia
+ Contact tracing

Question 4

How to confirm the complete eradication of syphilis?

Answer 4

Serial monitoring of VDRL titre

Question 5

2 Treatment regime for primary / early latent syphilis

Answer 5

1. IM Pen G (single dose)
2. IM Procaine penicillin 1.2 MU daily for 10 days

Question 6

USG signs for neonatal syphilis infection

Answer 6

no obvious USG features as the bacteria does not cause structural malformation

Question 7

Management if Rubella IgG is -ve

Answer 7

Rubella vaccine post-partum

Question 8

Management if HBsAg is +ve

Answer 8

order LFT & HBV DNA load to determine if antenatal antiviral is indicated