Pregnant infections

Question 1

T
O
R
C
H

Answer 1

toxo
other- syph/varicella/parvo
rubella
CMV
HSV

Question 2

suspect w __ and __ and __

nonspecific include __ and __ and __

Answer 2

HSM/IUGR/thrombocytopenia

fever/rash/exposure

Question 3

Toxo caused by ___

__/__ cause rapid prolif
__ shed by cat, viable for 18m
__ are slow, metabolic form to establish __ (think HIV)

Answer 3

toxoplasma gondii

sporozoite/tachyzoite
oocysts
tissue cysts, latency

Question 4

toxo pathogenesis

__ ingested
__ released, invade ___

__ converted to __, necrosis surrounded by ___

__ controls infection, induces __ formation

Answer 4

oocysts
sporozoites, host cells

sporozoites, tachyzoites, inflam

IS, tissue cyst

Question 5

Toxo CM

Mother is __, may have __

Fetal triad C/H/I

nonspecific __/__/__ leading to petechia/purpura

even if asx, at risk for ___

greatest risk of transmission in __
worse fetal abnorms from acute infection in ___

Answer 5

asx, regional LAD

chorioretinits/hydrocephalus, intracranial calcifications

fever/HSM/thromboyctopenia

chorioretinitis

3rd trimester
1st trimester

Question 6

Toxo dx

mother- measure __ for acute

child __ of amniotic fluid
CSF fluid, look for __

serology: anti-toxo __ or __

Answer 6

IgM

PCR
eosinophilia

IgM/IgG

Question 7

Syphillus- T pallidum is ___
transmitted via ___

primary shows __/__ chancre

2nd is widespread, nonprutic rash esp on __ and __, w F/M/H

test w __/__

Answer 7

spirochete
sexual contact

painless/indurated

palms/soles
fever, malaise, HA

RPR/VPRL

Question 8

congenital syph CM

majority are __ at birth

can ahve fetal, __ or __ manifestations

Fetal such as S/N/H

early <2: __ on palms/soles, H, A, R, P of long bones

Late >2: hutchison triad of __ and __ and __
as wells as __ and short __

Answer 8

asx

early/late

stillbirth, neonatal death, hydrops fetalis

lesions
HSM, anemia, rhinitis, periostits

interstitial keratitis, notched teeth, deafness
saddle nose/short maxila

Question 9

Rubella is __ virus
__ +, __ togavirus

High __ but low __, self limiting

transmission is ___

CM: low grade __, __ sx, L, A
maculopapular rsh on __ and __ and __

Answer 9

rubivirus
ssRNA, enveloped

infectivity, virulence

resp

fever, URI, LAD, arthralgia
head/neck/trunk

Question 10

Rubella pathophys
enters __ and spreads to LN
viremia seed virus in __ such as placenta
__ in placenta seeds __

earlier results in __ of affected infant

Answer 10

nasopharynx
organs
viremia, fetal organs

higher likelihood

Question 11

Congenital Rubella Syndrome

infection worst during \_\_\_
classic triad
C/G
S of CN8
P/P

can cause __ lesion
I/H/T

Answer 11

1st trimester
cataracts/glaucoma
sensorineural hearing loss
PDA/PA hypoplasia

blueberry muffin
IUGR/thrombocytopenia/HSM

Question 12

CMV
__ virus, __

vertical trans: __ __ delivery, __

horizontal via __, __ __ transplant

infection can be __ or __

CM In mom: usually __
minimal __, __ sx, __

reinfection of CMV in mom can occur w ___

Answer 12

dsDNA, enveloped

in utero, vaginal, breast milk

saliva, genitl, organ

primary/reinfection

asx
pharyngitis, mono, LAD

differnt strain

Question 13

congenital CMV
most __ at birth, develop sx later

CM- esp __
__ and ___

can have C
__ calcifications
HSM/H/__ disablity

Answer 13

asx

sensorineural hearing loss
seizures, petechial rash

chorioretinitis
periventricular
hydrocephalus, intellectual

Question 14

Dx Congential CMV

__ is gold standard, takes long

__ from urine/saliva in 1st 2 wks

__ measured w PCR

Answer 14

culture

viral isolation

viral load

Question 15

HSV
__ virus, __
transmitted via __

__ recommended for mom w outbreak
give __/__

in utero/placental infection is __
mostly occurs in __ as result of __ w virus shed from V/V/C/P

Dx- __ maternal lesion
culture from __
__ PCR

Answer 15

dsDNA, enveloped
contact

C section
acyclovir/valacyclovir

rare
direct contact
vulva/vagina/cervix/perianal

culture
infant
CSF

Question 16

HSV perinatal CM
presents __ after birth

skin/eye/mouth: __/__, no _
dx w __

CNS: L/poor __, R, may have __/__
dx w ___

disseminated can lead to __w multiple organs
concern w __/__/___

Answer 16

2-3w

lesion/vesicle, organ involved
tzank smear

lethargy, feeding, RDS, vesicles/encephalitis
CSF

sepsis
DIC/vesicles/encephalitis

Question 17

Parvo B19
linear __, __

Cm in mom: acute onset __, __ anemia
no __, resolves in __

CM in young
___ w fever/malaise/myalgia
__ on cheeks (slapped)
rash spreads to __/__ and appears M/R

transmitted via ___

Answer 17

ssDNA, naked

arthralgia, asx
joint dxn, wks

erythema infectiosum
indurated rash
arms/legs
macular/reticular

respitory drops

Question 18

Pathophys of Parvo B19

infects fetal __, stie of __
leads to __
obsrved as nonimmune __ on US w __/__edema

__ and __

infection in 1st trimester leads to ___
during 2nd trimester poses greatest risk of ___

Answer 18

liver, RBC production
fetal aplastic anemia
hydrops
scalp/skin

death/hydrops fetalis

spontaneous abortion
hydropic infant

Question 19

Hydrops fetalis 2+ of follwing

A
P
P
S
P

Answer 19

ascites
pleural effusion
percardial effusion
skin edema
polyhydramnios

Question 20

Varicella virus
__ virus, enveloped
transmission __ after mom infected primarily (not __)

infected b4 2ow
Congenital varicella syndrome
\_\_ skin lesion/vesicle
\_\_ hypoplasia
\_\_ defects
M/S

dx via __/__/__

Answer 20

dsDNA
transplacentally, zoster

circatrial
limb
ocular
microcephaly/seizure

culture/DFA/PCR

Question 21

Bacterial infections in preg
___ GBS which is gram __

__ gram neg rod

L mono which is gram ___

mothers screened for asx carrier at __
if positive, give __ prior to delivery

Answer 21

strep agalactiae, positive cocci

e coli

positive rod

34-36 wks
ab

Question 22

CM of neonatal meningitis

F/L
G
H
B

Answer 22

fever/lethargy
gaze deviations
hemiparesis
bulging fontanelle