Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

YR5 Microbiology > Viral Infection in Pregnancy > Flashcards

Viral Infection in Pregnancy Flashcards

You may prefer our related Brainscape-certified flashcards:
Biology 101 flashcards
1
Q

List 6 broad consequences of viral infections during pregnancy

A

Maternal complications
Miscarriage/ stillbirth
Teratogenicity
IUGR/ prematurity
Congenital disease
Persistent infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List 3 viral infections that increase risk of maternal complications

A

Influenza
Varicella Zoster
Hep E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List 3 viral infections that increase risk of miscarriage/ stillbirth

A

Rubella
Measles
Hep E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give 2 viral infections that increase risk of teratogenicity

A

Varicella Zoster
Zika

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Give 2 viral infections that cause IUGR/ prematurity

A

Rubella
CMV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give 2 viral infections that increase the risk of congenital disease

A

CMV
HSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Give 2 viral infections that cause persistent infection in the child

A

HIV
Hep B/C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which 12 viral infections are associated with rashes?

A

VZV (Chickenpox/ shingles)
EBV
HSV
Cytomegalovirus
Parvovirus B19
Enterovirus
Measles
Rubella
Influenza
Hep A-E
HIV
HTLV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

List 3 travel associated viral infections that a pregnant woman may present with

A

Dengue
Zika
Yellow fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List the first 5 human herpes viruses

A

HHV1+2: Herpes Simplex Virus
HHV3: Varicella Zoster virus
HHV4: Epstein Barr Virus (EBV)
HHV5: Cytomegalovirus (CMV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List 3 features of herpes viruses

A

DNA viruses
Once exposed, cause lifelong infection (often latent)
Have capacity to reactivate under stress/ immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the transmission, incubation and latency of HSV 1+2

A

T: close contact
I: Oropharyngeal 2-12d. Genital 4-7d
L: established in dorsal route ganglion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Give 4 presentations of HSV 1+2

A

Asymptomatic
Painful vesicular rash
Lymphadenopathy
Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What investigations should be sent for HSV 1 + 2?

A

Swab lesion - PCR
Serology in immunosuppressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What 3 forms of HSV may occur in pregnancy?

A

Primary: 1st exposure
Non-primary: Previous HSV1, contract HSV2 during pregnancy
Recurrent: Same HSV as previous infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How can a foetus contract HSV from its mother?

A

Ascending infection in PROM (active infection in genital area)
V rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How can neonates contract HSV?

A

Direct contact with infected maternal secretions during delivery
Active infection + kissing baby
Non-familial: other relatives/ hospital staff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When is the risk of maternal to foetus HSV transmission highest? What is advised to reduce risk?

A

Primary genital infection in 3rd trimester
If active HSV in final 6w: C-section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

List 4 complications of primary genital HSV infection

A

Miscarriage
Congenital abnormalities (Ventriculomegaly, CNS abnormalities)
Preterm birth
IUGR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How should a first presentation of genital herpes in pregnancy be managed?

A

Refer to GUM clinic
Aciclovir 5d
HSV antibody testing
Consider C-section if <6w to delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How should recurrent genital herpes in pregnancy be managed?

A

Often self resolving
Consider suppressive therapy from 36w
Maternal antibody offers some protection (though may not prevent transmission)
Avoid prolonged ROM/ invasive foetal monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe the skin, eye and mouth presentation of HSV in a neonate

A

45% of cases
Initially benign, high risk progression to CNS
Must be treated
Usually occurs in first 14d
May last up to 6w

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the CNS involvement (+/- SEM) in neonatal HSV

A

30% of cases
Usually occurs at 2-3w (up to 6)
Seizures
Lethargy
Irritability
Poor feeding
Fevers
Needs CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe disseminated HSV in neonates

A

Presents like Sepsis
Often in 1st week of life
Multi-organ involvement: Liver, Lungs, Heart, CNS, GIT, Renal tract, BM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is this? How should it be treated until results exclude/ confirm diagnosis?

A

Skin, eye, mouth HSV
Treat with Aciclovir
Looks like Staphylococcal eye infection- SWAB!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Describe the transmission, infection rate and incubation period of VZV

A

Transmission: Respiratory
70% infection rate in those susceptible
Incubation: 7-13d
Infectious 24h before rash develops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Describe the presentation of VZV

A

Prodromal fever, malaise, myalgia
Centripetal maculopapular rash
Vesicular rash appears in crops
Pruritic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Describe the susceptibility of pregnant women to varicella zoster

A

10-20% childbearing age suscebtible
10-20% of those contracting VZV develop varicella pneumonia
Varicella encephalitis is rare but mortality 5-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the 3 stages at which a congenital infection can be transmitted?

A

In utero: Crossing placenta
Perinatal: during childbirth
Postnatally: after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the risks of congenital varicella syndrome depending on timing?

A

0-12w: 0.4%
12-20w: 2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

List 6 complications of congenital varicella syndrome

A

Neurological abnormalities
Occular abnormalities
Skin scarring
Limb abnormalities
GI abnormalities
LBW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

In which cases post exposure is a women considered to have sufficient evidence of immunity against VZV?

A

Hx of previous chickenpox or shingles
2 doses of varicella vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What treatment is required if a pregnant woman is exposed to VZV with no previous infection or immunisation?

A

Urgent antibody testing on recent blood sample
If VZV IgG <100, offer PEP

33
Q

What treatment is required if a pregnant woman is exposed to VZV with no previous infection or immunisation?

A

Urgent antibody testing on recent blood sample
If VZV IgG <100, offer PEP

34
Q

What PEP is required for women presenting within 7d exposure of VZV?

A

Oral aciclovir 800mg
or
Oral Valaciclovir 1000mg TDS
from day 7-14 after exposire

35
Q

What PEP is required for women presenting after 7d from exposure of VZV?

A

Oral aciclovir 800mg QDS
or
Oral valaciclovir 1000mg TDS
up until 14d post exposure

36
Q

What drug should be used in active infection with VZV in pregnancy?

A

Aciclovir

37
Q

Describe the epidemiology, transmission and incubation of cytomegalovirus

A

Common early childhood infection: 2-6% infants by 6m, 40% by16y
T: Saliva, Resp. secretions, Urine
I: 4-8w

38
Q

Give 2 presentations of CMV

A

Mostly asymptomatic
Maculopapular rash, infectious-mononucleosis like illness

39
Q

What investigations are used for CMV?

A

PCR urine/ saliva, amniotic fluid
Serology

40
Q

When is the biggest risk of CMV transmission during pregnancy?

A

3rd trimester

41
Q

List 7 complications of maternal CMV for the infant

A

Encephalitis
Microcephaly
Ventriculomegaly
Chorioretinitis
Jaundice
Thrombocytopenia
Hepatosplenomegaly

42
Q

How do most congenitally infected newborns with CMV present?

A

Initially asymptomatic
15-25% go on to develop neurodevelopmental abnormalities- sensorineural hearing loss within 3y

43
Q

What happens if maternal CMV infection is suspected?

A

Test booking bloods for CMV IgG
If had no IgG, but has IgM now= primary infection

44
Q

What testing is performed on the baby if maternal CMV is suspected?

A

USS +/- amniocentesis
At birth: Guthrie card
Urine + saliva PCR within 21d

45
Q

The child of a 35w pregnant woman develops a vesicular rash. What should you do first?

A

Ask if she has had chickenpox before

46
Q

What is this rash?

A

Most likely Measles or Rubella
Flat, Maculopapular

(not vesicular/ blistering like chickenpox)

47
Q

Describe the spread of the rash in rubeola

A

Appears at HAIRLINE/ behind ears
Spreads cephaocaudally over 3d

48
Q

Give 5 signs/ symptoms of rubeola

A

Conjunctivitis
Cough
Coryza
Fever
Koplik spots on buccal mucosa

49
Q

What are the alternative names for rubeola and rubella?

A

Rubeola: Common Measles
Rubella: German measles

50
Q

Describe the spread and nature of the rash in rubella

A

Begins on the FACE
Spreads cephalocaudally within hours
Fine, macular rash
Mildly pruritic

51
Q

Give 6 signs/ symptoms of rubella

A

Headache
Low grade fever
Sore throat
Coryza
FORCHHEIMER spots on soft palate
Lymphadenopathy- tender

52
Q

Describe the spread of the rash in roseola infantum

A

After fever subsides, rash develops
Starts on NECK + TRUNK
Spreads to the face + extremities

53
Q

Give 3 features of roseola infantum

A

Affects 3-36m
Caused by HHV6
Abrupt high fever

54
Q

Describe the nature, transmission and incubation period of rubella

A

RNA virus
T: Respiratory
I: 12-21d

55
Q

What investigations are used when suspecting rubella?

A

Buccal swab for PCR
Serology

56
Q

In which population is congenital rubella syndrome more prevalent?

A

Immigrants from countries with high burden of CRS
Lots circulating
Sparse vaccination programes/ avoidance

57
Q

When is risk of CRS highest? What consequences correlate with the time of infection?

A

Greatest risk: 1st trimester
<8w: 20% spontaneous abortion
<10w: 90% fetal defects
>18w: hearing defects + retinopathy
>20w: risk much lower

58
Q

List 8 complications of congenital rubella syndrome for the infant at time of birth

A

Microcephaly
Meningioencephalitis
Cataracts
Retinopathy
Bone lesions
Cardiac defects in 50%: PDA, PS
Purpura
Hepatosplenomegaly

59
Q

List 5 late manifestations of CRS

A

Pancephalitis
Hearing loss: bilateral SNHL
Intellectual disability
DM
Thyroid dysfunction

60
Q

What is seen here? What condition is this associated with?

A

Severe cataracts at birth
Congenital Rubella Syndrome

61
Q

Describe the nature, transmission and incubation period of measles (rubeola)

A

RNA virus
T: Respiratory, Conjunctiva
I: 7-18d

62
Q

Describe the prodrome in rubella and rubeola

A

Rubella: 1-5d pre-rash
Rubeola: 2-4d

63
Q

What complication for the mother may arise if they contract measles in pregnancy?

A

Secondary bacterial infection
Otitis media/ pneumonia/ GI/ Encephalitis

64
Q

List 3 complications for the baby from measles during pregnancy

A

Foetal loss
Preterm delivery
Subacute sclerosis panencephalitis (SSPE)

65
Q

What is SSPE?

A

Occurs 7-10y after natural infection
Fatal, progressive degenerative disease of CNS

66
Q

What is this rash?

A

Parvovirus B19
“Slap cheek syndrome”

67
Q

Describe the nature, transmission, incubation and infectious period of parvovirus B19

A

DNA virus
T: Respiratory, blood products
I: 6-8d
Infectious 6d post exposure- 1w after Sx onset

68
Q

Give 4 symptoms/ presentations of parvovirus B19

A

Mostly asymptomatic
Erythema infectiosum/ slapped cheek/ 5ths disease
Polyarthropathy
Transient aplastic crisis (vulnerable pop. e.g. sickle cell)

69
Q

What investigations are used for parvovirus B19?

A

Virus detection PCR
Serology

70
Q

What are the statistics of complications from parvovirus in pregnancy?

A

Transmission in 33%
9% of which get infected
Of those infected 3% develop Hydrops fetalis
1% foetal abnormalities
7% foetal loss

71
Q

How does parvovirus B19 cause hydrops fetalis?

A

Cytotoxic to foetal red blood precursor cells
Severe anaemia
Accumulation of fluid in soft tissues + serous cavities: ascites, pleural effusion, pericardial effusion, cardiomegaly

72
Q

What should be done if parvovirus B19 is suspected in pregnancy?

A

Refer to foetal med for monitoring
If develops Hydrops: Intrauterine transfusion
Test booking + current bloods for IgG + IgM to parvovirus

73
Q

What is this rash?

A

Hand foot and mouth disease
(HFM)
Cocksackie enterovirus

74
Q

Describe the transmission and incubation of enterovirus

A

T: Respiratory +/- faecal
I: 2-40d

75
Q

List 4 symptoms/ presentations of enterovirus

A

Hand, foot + mouth disease
Rash
Encephalitis
Myocarditis

76
Q

Of all enteroviruses, which poses the main risk during pregnancy?

A

Cocksackie virus
Perinatal newborn infection can occur in last week of pregnancy

77
Q

List 5 complications of neonatal cocksackie infection

A

Myocarditis
Fulminant hepatitis
Encephalitis
Bleeding
Multi-organ failure

78
Q

List 7 important topics to cover in a pregnant woman presenting with a rash

A

Gestation: date of LMP, due date by scan
Date of onset, clinical features, type + distribution of rash, associated features
Past hx infection
Past hx of antibody testing
Past immunisation hx
Known contacts with rash
Travel hx

79
Q

What should be investigated for a pregnant woman presenting with rash?

A

Antenatal booking bloods: antibody test to determine immunity/ susceptibility
Swab/ scrape rash if vesicular
Blood sample: antibody +/- PCR

80
Q

List 3 ways in which Zika virus can spread

A

Mosquito bite
STI
Blood transfusion

81
Q

List 4 complications of Zika for the baby

A

Microcephaly
Severe cranial abnormalities
Seizures
Problems with feeding, limb movement, vision + hearing

YR5 Microbiology (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions