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CK OB > Perinatal Infections > Flashcards

Perinatal Infections Flashcards

1
Q

______ of women have asymptomatic vaginal colonization with GBS, with the majority having ________carrier status

A

Thirty percent

intermittent or transient

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2
Q

Course of early onset GBS infection

A

This is usually vertical transmission from mother to neonate with a 30% mortality rate at or before
33 weeks but less than 5% at term.

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3
Q

Late onset GBS is characterized as

A

Late-onset infection is less common, occurring after the first week of life, and is characterized by meningitis. This is usually hospital acquired, with a 5% mortality rate

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4
Q

Intrapartum antibiotic prophylaxis of neonatal GBS sepsis is given with _______

A

IV penicillin

G

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5
Q

T or F

All women with a positive GBS urine culture or a previous baby with GBS sepsis will receive intrapartum prophylaxis

A

T

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6
Q

In GBS Infection

Third-trimester vaginal and rectal cultures are
obtained at_______ weeks gestational age, and intrapartum prophylaxis is administered only to those with positive GBS cultures

A

35–37

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7
Q

GBS infection,

Intrapartum prophylaxis is given on the basis of risk factors being present:
1
2
3

A 
preterm  gestation (<37 weeks), 
membranes ruptured >18 h, or maternal fever (>100.4°F) (38°C).
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8
Q

Up to______of pregnant women are toxoplasmosis IgG seropositive

A

40%

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9
Q

Toxoplasmosis

First-trimester infection risk is low (15%), but infections are _____ and _____

A

most serious, even lethal.

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10
Q

Third-trimester infection risk is high (50%), but infections are mostly _______

A

asymptomatic.

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11
Q

Tx of Toxo

_______ are used to treat a known infection.

______is used to prevent vertical transmission from the mother to the fetus.

A

Pyrimethamine and sulfadiazine

Spiramycin

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12
Q

in VZV

The greatest neonatal risk is if maternal rash
appears between ______ and ________

A

5 days antepartum and 2 days postpartum.

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13
Q

__________of patients with varicella will develop varicella pneumonia, which has a high maternal morbidity and mortality

A

10%

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14
Q

________ to a susceptible gravida within 96 h of exposure.

A

Administer VZIG (varicella zoster immune globulin)

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15
Q

T or F

Live-attenuated varicella virus (Varivax III) can be administered to nonpregnant or postpartum to varicella IgG-antibody–negative women.

A

T

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16
Q

_______ is a highly contagious RNA virus that is spread by respiratory droplets.

A

Rubella

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17
Q

Vertical transmission from mother to fetus or neonate can only occur during the _______because the result is residual lifelong immunity

A

viremia of a primary infection

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18
Q

Manifestations may include symmetric IUGR, microcephaly,

or ventriculoseptal defect (VSD

A

fetal infection with rubella

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19
Q

T or F

Rubella infection during pregnancy is generally a mild,
low-morbidity condition

A

T

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20
Q

T or F

All pregnant women should undergo rubella IgG antibody screening

A

T

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21
Q

Because rubella vaccine is made using a live attenuated virus, pregnancy should be avoided for_____

A

1 month after immunization

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22
Q

______is a DNA herpes virus that is spread by infected body secretions

A

CMV

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23
Q

Up to _____ of pregnant women are CMV IgG seropositive.

A

50%

24
Q

Manifestations of Fetal infection of CMV may include:

A

nonimmune hydrops, symmetric IUGR, microcephaly,

and cerebral calcifications in a periventricular distribution

25
Q

______ syndrome is the most common congenital viral syndrome in the United States

A

CMV

26
Q

Neonatal infection of CMV SSx

A

which includes petechiae, mulberry skin spots, meningoencephalitis, periventricular calcifications, hepatosplenomegaly, thrombocytopenia, and jaundice.

27
Q

CMV infection during pregnancy is generally a mild,

low-morbidity condition appearing as a ______

A

mononucleosis-like syndrome with hepatitis.

28
Q

_____ is a DNA herpes virus that is spread by intimate mucocutaneous contact.

A

HSV

29
Q

Up to ___ of pregnant women are HSV IgG seropositiv

A

50%

30
Q

The most common route of fetal infection is contact

with ______ during a recurrent HSV episode

A

maternal genital lesions

31
Q

Definitive Dx of HSV

The definitive diagnosis is a positive HSV culture from fluid obtained from a________, but there is a 20% false-negative rate.

A

ruptured vesicle or debrided ulcer

32
Q

Fetal infection with HSV

A

Manifestations may include spontaneous abortions, symmetric IUGR, microcephaly, and cerebral calcifications.

33
Q

With passage through an HSV-infected birth canal, the neonatal attack rate is ____ with a primary infection, but ______ with a recurrent infection

A

50%

<5%

34
Q

HSV Neonatal infection SSx

A

meningoencephalitis, mental retardation, pneumonia, hepatosplenomegaly, jaundice, and petechiae.

35
Q

A cesarean section should be performed in the presence of genital HSV lesions at the time of labor. If membranes have been ruptured______ the virus may already have
infected the fetus and cesarean delivery would be of no value

A

> 8–12 h,

36
Q

______is an RNA retrovirus that is spread by infected body secretions.

A

HIV

37
Q

HIV Transplacental infection occurs, but the major route of vertical transmission is _________

A

contact with infected genital secretions at the time of vaginal delivery

38
Q

Without maternal azidothymidine (AZT) prophylaxis, the vertical transmission rate is ____, but with AZT the infection rate is lowered to _____ with vaginal delivery

A

30%

10%

39
Q

In HIV,

With elective cesarean section without labor and before membrane rupture, the perinatal infection rate may be ________

A

<5%.

40
Q

The greatest benefit to the fetus of cesarean delivery is

probably in women with ______ and ____, making infection through a vaginal delivery much more likely.

A

low CD4 counts and high RNA viral loads

41
Q

At birth neonates of HIV-positive women will have positive HIV tests from_______

A

transplacental passive IgG passage

42
Q

T or F

HIV-infected breast milk can potentially transmit the disease to the newborn

A

T

43
Q

T or F

Progression from HIV to AIDS in infants is more
rapid than in adults

A

T

44
Q

T or F

Pregnancy in an HIV-positive woman enhances progression to AIDS.

A

F

Pregnancy in an HIV-positive woman does not enhance progression to AIDS.

45
Q

HIV Infected pregnant women should take________as part of their drug regimen, starting at 14 weeks and continuing throughout pregnancy, intrapartum, and after delivery

A

triple-drug therapy including the drug zidovudine

ZDV

46
Q

Example of triple therapy in HIV

A

This includes 2 nucelotide reverse transcriptase inhibitors (NRTIs) with either an NNRTI or a protease inhibitor. An example would be zidovudine, lamivudine, or ritonavir

47
Q

_____ is caused by Treponema pallidum, a motile anaerobic spirochete that cannot be cultured

A

Syphilis

48
Q

Transplacental infection is common with vertical transmission rates of ____ in primary and secondary
syphilis

A

60%

49
Q

What Syphilis stage

Papules become painless ulcers with rolled edges (chancres) which appear 2–3 weeks after contact at the site of infection, most commonly the vulva, vagina, or cervix

A

Primary

50
Q

What Syphilis stage?

Two to three months after contact, fever, malaise, general adenopathy, and a maculopapular skin rash (“money spots”) are seen.

Broad exophytic excrescences (condyloma lata) appear on
the vulva.

A

Secondary

51
Q

What stage?

Darkfield microscopy of lesion exudate is positive for the spirochete, but the nonspecific serologic tests
VDRL or rapid plasma reagin [RPR] test) are not yet positive

A

Primary

52
Q

______is characterized by absence of symptoms or physical findings. One third of cases proceed to tertiary disease. The nonspecific and treponema-specific
tests remain positive

A

Latent syphilis

53
Q

______ is a symptomatic stage with symptoms dependent on which organ system is affected by the classic necrotic, ulcerative nodules (gummas

A

Tertiary syphilis

54
Q

Tx of Syphilis

A

Benzathine penicillin 2.4 million units IM × 1 is given in pregnancy to ensure adequate antibiotic
levels in the fetus.

55
Q

How to ff-up serology in pts with syphilis

A

Follow serology titers at 1, 3, 6, 12, and 24 months. Titers should be decreased fourfold by 6
months, and should be negative in 12-24 months

56
Q

In Syphilis Tx,

The _______ is associated with treatment and occurs in half of pregnant women. It starts in 1-2 hours, peaks in 8 hours, and resolves in 24-48 hours

A

Jarisch-Herxheimer reaction

CK OB (15 decks)

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