TORCH Infections

Question 1

What are some sx of Toxoplasmosis

Answer 1

Intracerebral calcifications (centre), hydrocephalus, chorioretinitis (TRIAD)
(also microcephaly)

Question 2

What is the exposure that causes toxoplasmosis?

Answer 2

Cat Litter

Question 3

What are the clinical manifestations of CMV exposure in utero

Answer 3

Mental Retardation, cerebral palsy, periventricular calcification, hearing impairment, eye abnormalities (chorioretinitis), hepatosplenomegaly, thrombocytopenia purpura

Question 4

When in gestation do teratogens affect the fetus (Torch etc)

Answer 4

3 - 8 weeks

Question 5

Which anticonvulsant is most toxic to fetus

Answer 5

Valproic acid

Question 6

Where are brain calcifications in CMV

Answer 6

periventricular (unique for CMV)

Question 7

Where are brain calcifications in Toxoplasmosis

Answer 7

intraventricular. therefore obstructing flow of csf therefore hydrocephalus

Question 8

what percent of cmv congenital is asymptomatic at birth

Answer 8

90%

Question 9

Torch infections cause what type of IUGR

Answer 9

symmetrical

Question 10

how do you test for congenital CMV?

Answer 10

CMV antigen in urine

Question 11

what kind of hearing loss is associated with CMV?

Answer 11

sensorineural hearing loss

Question 12

What are infantile symptoms of congenital syphillis

Answer 12

rash, osteochondritis, periostitis, lung & liver fibrosis

Question 13

What are childhood symptoms of congenital syphillis

Answer 13

Hutchinsons teeth

Question 14

What are the early congenital syphillis signs

Answer 14

Early rhinitis (3rd - 8 week OL), rash, IUGR, hepatosplenomegaly

Question 15

How do you prevent syphillis?

Answer 15

prenatal screening

Question 16

What is the drug of choice for syphillis?

Answer 16

Penicillin

Question 17

What is the classic triad of congenital rubella?

Answer 17

cataracts, cardiac abnormalities, deafness

Question 18

how do you prevent congenital rubella?

Answer 18

mom had MMR vaccine

Question 19

How do neonates get HSV ?

Answer 19

Most likely form is peripartum (85%), Postnatal (10%), in utero (5%)

Question 20

how do you recognize HSV?

Answer 20

vesicles

Question 21

When does disseminated HSV happen?

Answer 21

unwell at 5 - 11 DOL

Question 22

What are symptoms of disseminated HSV?

Answer 22

similar to bacterial sepsis, with hyper or hypothermia, irritability, poor feeding, and vomiting

Question 23

How often are skin vesicles seen in disseminated HSV?

Answer 23

75% of cases

Question 24

What are you thinking in a newborn with purulent eye discharge? (neonatal conjunctivitis)

Answer 24

Gonorrhea/ Chlamydia

Question 25

What does gonorrhoea gram stain as?

Answer 25

Gram -ve diplococci

Question 26

Does chalmydia gran stain?

Answer 26

No

Question 27

What is the tx for gonorrhea

Answer 27

ceftriaxone

Question 28

what is the tx for chlamydia

Answer 28

erythromycin (oral)

Question 29

What is dacrocystitis?

Answer 29

requires optho consult, infection of tear duct

Question 30

A 38 week gestation male infant was precipitously delivered vaginally. Weight and head circumference are less than 5th percentile, and length at 10th percentile. He has heptosplenomegaly and petechial rash. Platelets of 22,000 and elevated total and direct bilirubin levels. CT of the head shows bilaterals intracranial calcification with several around the basal ganglia and obstructive hydrocephalus.

Ophthamologic examination reveals chorioretinits. What is the most likely cause of the patient’s findings?

CMV
Rubella 
Toxoplasmosis gondii
Herpes simplex 
Treponema pallidum

Answer 30

Toxoplasmosis