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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
Q

What CNS complications are associated with VZV

A

VZV ecephalitis and meningitis

26
Q

What is Ro?

A

Number of people that one sick person will infection on average

27
Q

How is VZV diagnosed

A

Swab of vesicle fluid

Maternal serology

28
Q

What preventative mangement is available for VZV?

A

Varicellar Zoster ImmunoGlobulin (post exposure)

Vaccination (controversial)

29
Q

Why should VZV vaccination not be offered during pregnancy

A

Because it is a live attenuated vaccine

30
Q

What diseases does VZV lead to

A

Chicken pox

Shingles

31
Q

Typical sign of shingles

A

Reactivation of chicken pox in one nerve root so NEVER crosses the midline

32
Q

Affect on the skin of congenital varicellar syndrome

A

Skin lesions leading to limb hypoplesia

33
Q

Affect on CNS of congenital varicella syndrome

A

Microcephaly
Hydrocephaly
Neurodevelopmental delay

34
Q

Is HSV1 or HSV2 related to sexual activity

A

HSV2

35
Q

What % of adults have HSV1 by age 40

A

90

36
Q

What disease is herpes simple virus associated with

A

Cold sore
Genital lesion
CNS infection

37
Q

How is the majority of HSV transmitted to neonate

A

Perinatally (as child passes through vaginal canal)

38
Q

How is neonatal HSV infection diagnosed

A

Clinical
HSV DNA PCR neonate blood
vesicle swab
Maternal vesicle swab

39
Q

What is the treatment for neonatal HSV infection

A

Aciclovir treatment

40
Q

Is rubella common or rare in UK

A

Rare- been removed from UK antinatal screening

41
Q

Why is rubella unworrying outside of pregnancy

A

Self limiting disease

42
Q

How is rubella diagnosed

A

Serology
Oral fluid
Upon clinical suspicion (rash)

43
Q

When is the risk greatest for congenital rubella

A

Early on in pregnancy (sometimes before she knew was pregnant)

44
Q

MMR vaccinates against..

A

Measles, mumps and rubella

45
Q

What is parvovirus B19 nicknamed

A

Slapped cheek disease due to ruddy appearance of cheek

46
Q

What it the cellular target of parvovirus B19

A

Erythryocytes

47
Q

How do you diagnose parvovirus B19

A

Maternal serology/ PCR

Foetal ultrasound

48
Q

What is the biggest risk of parvovirus B19 contracted in 9-20 weeks gestation

A

Hydrops fetalis (heart failure)

49
Q

What parasite causes toxoplasmosis

A

Toxoplasma gondii

50
Q

How do humans contract toxoplasmosis

A

Cat is natural host

Humans are intermediate host with ingestion of oocysts via faeces or infected meat

51
Q

What is the risk to the mother and baby of contracting toxoplasmosis in first trimester

A

Risk to mother lowest

Risk to foetus greatest

52
Q

Clinical features of congenital toxoplasmosis

A 
IUGR
Hydrocephalis
Cerebral calcification
Microcephaly
Hepatosplenomegaly
53
Q

Diagnosis of congenital syphilis

A 
Clinical syndrome (non painful genital ulcer)
Serology
54
Q

When is there highest risk of syphilis transmission

A

First trimester

55
Q

Treatment of syphilis?

A

Penecilin

56
Q

How does secondary syphilis present

A

Rash of palms of feet and hands

57
Q

Signs of late congenital syphilis

A 
Hutchinsons teeth
Cluttons joints
High arched palate
Deafness
Saddle nose deformity
58
Q

What is tested for in antenatal screening

A

Hep B
HIV
Syphilis
CMV

59
Q

In what way are UTI different in pregnancy

A

Higher risk to outflow obsutrction

60
Q

What is the risk of group B strep in pregnant women

A

Neonatal sepsis

61
Q

What ethical issues are involved in infection

A

Antenatal screening
Serology difficult to interpret
May lead to amniocentis
Often no treatment

HD 2 (26 decks)

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