perinatally acquired infxns

Question 1

toxo infxn in neonate occurs secondary to____

Answer 1

maternal primary infxn

Question 2

what happens to risk of toxo transmission as gestational age incr?

Answer 2

risk of transmission icnreases

Question 3

severity of disease____as gestational age increases

Answer 3

decreases

Question 4

vertical transmission of toxo is most likely to occur in ___trimester

Answer 4

2nd-3rd

Question 5

what signs do most newborns infected with toxo display?

Answer 5

most are asympt early

Question 6

classic triad of toxo in infants

Answer 6

1. hydrocephalus
2. chorioretinitis
3. intracranial calficcations

Question 7

inflammation of the posterior portion of the uveal tract and retina

Answer 7

chorioretinitis

Question 8

what is the uveal tract?

Answer 8

iris + ciliary body + choroid

Question 9

periventricular calcifications in brain

Answer 9

CMV

Question 10

diffuse calcifications in brain

Answer 10

toxo

Question 11

dx of toxo (6)

Answer 11

1. serum IgM titers
2. persistent IgG titers
3. opth exam
4. neuro exam
5. head CT
6. toxo PCR on CSF

Question 12

how to tx congenital toxo in an infant (4)

Answer 12

1. pyrimethamine
2. sulfadiazine
3. leucovorin
4. corticosteroids

Question 13

what is the only known source of rubella infxn

Answer 13

rubella

Question 14

transmission of rubella (2)

Answer 14

1. vertical transmission

2. respiratory droplets

Question 15

another name for rubella

Answer 15

german measles

Question 16

what is the most common vaccine preventable cause of birth anomalies in the world?

Answer 16

congenital rubella syndrome

Question 17

when can mother transmit rubella to fetus

Answer 17

1 month before conception thru 2nd trimester

Question 18

cellular damage & necrosis in eyes, heart, brain, ears

Answer 18

congenital rubella syndrome

Question 19

classic triad in CRS

Answer 19

deafness
cataracts
congenital heart disease

Question 20

most common isolated sequela in CRS is?

Answer 20

hearing loss

Question 21

dx of rubella (4)

Answer 21

1. culture
2. serum IgM
3. rise in IgG over 2-3 wks
4. PCR

Question 22

tx of rubella

Answer 22

none, must prevent with vaccine!

Question 23

if you see a jaundiced baby, what virus should you think of?

Answer 23

CMV

Question 24

what is the most common congenital infxn in developed countries?

Answer 24

CMV

Question 25

transmission of CMV (3)

Answer 25

1. secretions
2. vertically
3. transfusions

Question 26

what is the leading cause of childhood sensorineural hearing loss in developed countries?

Answer 26

CMV

Question 27

initial sx of HSV can appear when?

Answer 27

before 4 weeks of age

Question 28

initial sx of HSV are most common when?

Answer 28

3 days of age

Question 29

dx of HSV

Answer 29

CSF for culture and PCR

Question 30

tx of HSV

Answer 30

IV acyclovir for 14-21 days

Question 31

congenital sx infxns of hep B are most commonly _____

Answer 31

chronic

Question 32

if mother is HepB+, how to tx infant

Answer 32

hep B vaccine + hep B immunoglobulin

Question 33

mucocutaneous lesions, osteochondritis, hemorrhagic rhinitis, metaphyseal dystrophy, periostitis

Answer 33

early sx of congenital syphilis

Question 34

tx of syphilis in infants?

Answer 34

PCN for 10 days if mom not adequately tx’d

Question 35

risk of infxn for infant born to untx’d seropos HIV mother is _____%

Answer 35

25-30%

Question 36

time increments to test babies born to HIV+ mothers

Answer 36

2 days, 14 days, 1-2 months, 3-6 months