ToRCHes infections

Question 1

infection that passes from mother to infant during pregnancy or delivery
many cause congenital malformations: growth retardation, intellectual disability, hepatosplenomegaly, miscarriage, stillbirth

Answer 1

ToRCHes

Question 2

ToRCHeS

Answer 2

Toxoplasma gondii
Other: parvovirus B19
Rubella
CMV
HIV, HSV-2
e
Syphilis

Question 3

maternal infections that can cause neonatal meningitis

Answer 3

GBS
E.coli
Listeria monocytogenes

Question 4

infections are more severe if:

Answer 4

primary infection during pregnancy

Question 5

transmission: cat feces or undercooked meat

Answer 5

toxoplasmosis: toxoplasma gondii (protozoa)

Question 6

congenital infection has this triad:
chorioretinitis
hydrocephalus
intracranial calcifications

Answer 6

toxoplasmosis: toxoplasma gondii (protozoa)

Question 7

congenital infection:
infection of RBC precursors → severe fetal anemia, CV failure → hydrops fetalis (fluid accumulating in different parts of body: ascites, pleural effusions)

Answer 7

parvovirus B19

Question 8

childhood infection:

“slapped cheek rash” →lacy reticular rash on chest and shoulders

Answer 8

erythema infectiosum (fifth disease): parvovirus B19

Question 9

adult infection:

arthritis

Answer 9

parvovirus B19

Question 10

children: mild fever + rash

Answer 10

rubella

Question 11

congenital infection has this triad:
cataracts
PDA
sensorineural deafness
blueberry muffin" rash: areas of extramedullary hematopoiesis

Answer 11

rubella

Question 12

adult: mononucleosis-like syndrome

Answer 12

CMV (most common)

Question 13

congenital infection:
jaundice
hepatosplenomegaly
sensorineural hearing loss (witha mom who has mononucelosis-like syndrome)

Answer 13

CMV

Question 14

concern of transmission during L&D (not pregnancy)

Answer 14

HIV and HSV

Question 15

prevention of HIV transmission

Answer 15

HAART during pregnancy
if high viral load: 
intrapartum zidovudine during delivery
C-section
after delivery: zidovudine prophylaxis to infant
AVOID breastfeeding

Question 16

vesicular skin rash
conjunctivitis
pneumonia
CNS: meningoencephalitis
disseminated disease: sepsis

Answer 16

HSV

Question 17

prevention of HSV transmission

Answer 17

suppression with acyclovir starting at 36 wks

if active genital infection at time of labor or prodromal sx: C-section

Question 18

congenital infection:
early sx (onset during first 2 years of life)
hepatomegaly, elevated LFTs
rash followed by desquamation of hands and feet
snuffles: blood-tinged nasal secretions
skeletal abnormalities
late sx due to scarring/inflammation: (onset after first 2 years of life)
frontal bossing
interstitial keratitis (corneal scarring → blindness)
saddle nose deformity
hutchinson teeth (nothing of upper incisors)
perforation of hard palate
saber shins (anterior bowing of tibia)

Answer 18

syphliis

Question 19

treatment of syphlis in pregnant patient with pen allergy?

Answer 19

#1 desensitize patient
#2 penicllin G (best treatment)