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HD 2 > Pregnancy and infection > Flashcards

Pregnancy and infection Flashcards

1
Q

Is hepatitis dangerous for mother, baby or both

A

Both

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2
Q

Is hepatitis dangerous for mother baby or both

A

MOther

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3
Q

Is syphilis more harmful to foetus or mother

A

Foetus

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4
Q

What 3 diseases are harmful to mother and foetus

A

Hepatitis
VZV
HIV

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5
Q

What diseases are more harmful to foetus than mother

A 
HSV
Syphilis
CMV
Toxoplasmosis
rubella
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6
Q

What does the ToRCHeS anagram tell us?

A 
Toxoplasmosis
Other
Rubella
Cytomegalovvirus
Herpes
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7
Q

3 categories that infections of foetus/ mother can be divided into

A

Parasite
Virus
Bacteria

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8
Q

What 2 things are immune systems responses based on

A
  • Early IgM rise

- IgG rise

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9
Q

What does the early IgM rise represent

A

Early recognition of new pathogen in immune system

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10
Q

What does IgG signify

A

Past infection

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11
Q

What does PCR enable

A

Detection of the viral DNA or RNA

Can give diagnosis earlier than serology

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12
Q

What does CMV stand for

A

Cytomegalovirus

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13
Q

How can CMV be transmitted

A

Saliva, blood/ blood products, sexual intercourse, organ transplantation or via mother

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14
Q

Is primary or secondary CMV infection more likely to cause congenital CMV

A

Primary

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15
Q

In which trimester is congenital CMV more likely

A

first

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16
Q

What is the prevalence of CMV

A

7 per 1000 live births

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17
Q

What % of babies with CMV are systomatic

A

13

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18
Q

How do you diagnose congenital CMV

A
  • Maternal serology (CMV IgG and IgM)

- Neonatal urine/ saliva for CMV DNA (PCR)

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19
Q

What are the severe symptoms of congenital CMV

A

Intrauterine growth retardation
Hepatosplenomegaly
Microcephaly

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20
Q

What is the commonest congenital cause of sensorineural hearing loss

A

CMV

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21
Q

What does VZV stand for

A

Varicella Zoster Virus

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22
Q

What % of UK adults are immune to VZV

A

80-90

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23
Q

How many people can 1 person infect with VZV

A

10-12 susceptible individuals

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24
Q

How does timing of infection affect risk of VZV

A

Mother: the later the infection the worse and the greater foetal complications

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25
What CNS complications are associated with VZV
VZV ecephalitis and meningitis
26
What is Ro?
Number of people that one sick person will infection on average
27
How is VZV diagnosed
Swab of vesicle fluid | Maternal serology
28
What preventative mangement is available for VZV?
Varicellar Zoster ImmunoGlobulin (post exposure) | Vaccination (controversial)
29
Why should VZV vaccination not be offered during pregnancy
Because it is a live attenuated vaccine
30
What diseases does VZV lead to
Chicken pox | Shingles
31
Typical sign of shingles
Reactivation of chicken pox in one nerve root so NEVER crosses the midline
32
Affect on the skin of congenital varicellar syndrome
Skin lesions leading to limb hypoplesia
33
Affect on CNS of congenital varicella syndrome
Microcephaly Hydrocephaly Neurodevelopmental delay
34
Is HSV1 or HSV2 related to sexual activity
HSV2
35
What % of adults have HSV1 by age 40
90
36
What disease is herpes simple virus associated with
Cold sore Genital lesion CNS infection
37
How is the majority of HSV transmitted to neonate
Perinatally (as child passes through vaginal canal)
38
How is neonatal HSV infection diagnosed
Clinical HSV DNA PCR neonate blood vesicle swab Maternal vesicle swab
39
What is the treatment for neonatal HSV infection
Aciclovir treatment
40
Is rubella common or rare in UK
Rare- been removed from UK antinatal screening
41
Why is rubella unworrying outside of pregnancy
Self limiting disease
42
How is rubella diagnosed
Serology Oral fluid Upon clinical suspicion (rash)
43
When is the risk greatest for congenital rubella
Early on in pregnancy (sometimes before she knew was pregnant)
44
MMR vaccinates against..
Measles, mumps and rubella
45
What is parvovirus B19 nicknamed
Slapped cheek disease due to ruddy appearance of cheek
46
What it the cellular target of parvovirus B19
Erythryocytes
47
How do you diagnose parvovirus B19
Maternal serology/ PCR | Foetal ultrasound
48
What is the biggest risk of parvovirus B19 contracted in 9-20 weeks gestation
Hydrops fetalis (heart failure)
49
What parasite causes toxoplasmosis
Toxoplasma gondii
50
How do humans contract toxoplasmosis
Cat is natural host | Humans are intermediate host with ingestion of oocysts via faeces or infected meat
51
What is the risk to the mother and baby of contracting toxoplasmosis in first trimester
Risk to mother lowest | Risk to foetus greatest
52
Clinical features of congenital toxoplasmosis
``` IUGR Hydrocephalis Cerebral calcification Microcephaly Hepatosplenomegaly ```
53
Diagnosis of congenital syphilis
``` Clinical syndrome (non painful genital ulcer) Serology ```
54
When is there highest risk of syphilis transmission
First trimester
55
Treatment of syphilis?
Penecilin
56
How does secondary syphilis present
Rash of palms of feet and hands
57
Signs of late congenital syphilis
``` Hutchinsons teeth Cluttons joints High arched palate Deafness Saddle nose deformity ```
58
What is tested for in antenatal screening
Hep B HIV Syphilis CMV
59
In what way are UTI different in pregnancy
Higher risk to outflow obsutrction
60
What is the risk of group B strep in pregnant women
Neonatal sepsis
61
What ethical issues are involved in infection
Antenatal screening Serology difficult to interpret May lead to amniocentis Often no treatment

HD 2 (26 decks)

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