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maternal newborn > Women and Neonatal Health: Reproductive Infections > Flashcards

Women and Neonatal Health: Reproductive Infections Flashcards

1
Q

Why is sulfa not used late in pregnancy?

A

It increases jaundice in newborns.

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2
Q

Types of UTIs

A
  • asymptomatic bacteriuria (ASB)
  • cystitis (lower UTI)
  • acute pyelonephritis
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3
Q

Causative agents of UTIs

A

E. coli
Klebs.
Proteus

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4
Q

Tx of ASB UTI: early in pregnancy

A

oral sulfonamides

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5
Q

Tx of ASB UTI: late in pregnancy

A

ampicillin and nitrofurantoin

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6
Q

Cystitis signs and symptoms

A
  • dysuria
  • urgency and frequency
  • low-grade fever
  • possible hematuria
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7
Q

Why should you still see a physician if taking AZO?

A

It will mask the symptoms of cystitis but is not a cure.

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8
Q

S/S of acute pyelonephritis

A

sudden onset of:

  • chills
  • high fever
  • flank pain
  • N/V/malaise
  • decreased UO
  • dehydration
  • increased systolic BP
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9
Q

Tx of acute pyelonephritis

A

requires hospitalization

  • IV antibiotics
  • carbenicillin, methenamine, cephalosporins
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10
Q

If left untreated, what risk does acute pyelo cause to baby?

A

premature birth and IUGR

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11
Q

vulvovaginal candidiasis

A

aka “yeast infection”

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12
Q

vulvovaginal candidiasis discharge

A

thick, curdy, cottage cheese-like

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13
Q

tx of yeast infection

A

miconazole or fluconazole

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14
Q

What risks do yeast infections present to newborn if present at birth?

A

thrush or diaper dermatitis (spread via in GI tract)

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15
Q

true or false: antifungals are used in the tx of baby and mom with yeast infection/thrush

A

true

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16
Q

bacterial vaginosis/ Gardnerella discharge

A

profuse, grey/yellowish, milky with “fishy odor”

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17
Q

tx for bacterial vaginosis/ Gardnerella

A

metronidazole (Flagyl) or clindamycin

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18
Q

When bacterial vaginosis/ Gardnerella is present during pregnancy, what risks does it pose for mom?

A
  • PROM
  • PTL
  • intra-amniotic (chorioamniocentisis) & postpartum infections
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19
Q

symptoms for trichomoniasis

A
  • greenish, frothy discharge
  • urinary sx
  • strawberry patches on cervix
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20
Q

true or false: “trich” moves on a slide

A

true

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21
Q

diagnostics for trich

A

Trich test or Affirm test

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22
Q

treatment for trich

A

metronidazole 2 grams

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23
Q

Can couples continue to have sex if trich is present?

A

No. Couples should abstain from sex until tx is complete and both are symptom-free.

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24
Q

What class of beverages should be avoided when diagnosed and on tx for trichomoniasis?

A

ETOH

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25
Q

Most common STI in America

A

chlamydia

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26
Q

symptoms of chlamydia

A
  • asymptomatic
  • purulent drainage or discharge
  • dysuria
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27
Q

If left untreated, what can chlamydia turn into?

A
  • PID
  • ectopic PG
  • tubal infertility
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28
Q

Chlamydia: risks to newborn

A

eye infection and lung infection

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29
Q

Prophylactic tx of chlamydia in newborns

A

erythromycin eye ointment

30
Q

tx for chlamydia in adults

A

azithromycin or doxycycline

31
Q

how is chlamydia spread?

A

sexual contact

32
Q

how long is the incubation period for syphylis?

A

10-90 days (multi-partnered people may not know who they got it from)

33
Q

how is syphylis spread?

A

sexual contact
contact with blood
transplacentally during PG

34
Q

at how many weeks gestation can syphylis cross the placenta?

A

14wks - START TX BEFORE 14wks and it won’t affect baby

35
Q

symptoms of syphylis: early

A

chancre (sore) at site of entry (disappears by 4wks)
fever
weight loss
malaise

36
Q

secondary symptoms of syphylis

A

condylomata lata - wart-like plaques

37
Q

Other symptoms for syphylis include

A 
rash
arthritis
chronic sore throat and hoarseness
hepatosplenomegaly
tender lymph nodes
38
Q

true or false: to test for syphylis, blood is drawn and a VDRL and RPR test are performed

A

true

39
Q

If symptoms of syph have been present for <1yr, what is tx?

A

2-4 million u PCN G - IM injection

40
Q

tx for syph if sx are preset for unknown duration or >1yr

A

2.4 million u PCN x3wks

41
Q

if not PG, what two meds are often given for syph?

A

doxycycline or tetracycline

42
Q

if pt is allergic to pcn, what is tx plan?

A

desensitize pt to pcn and admin

43
Q

When are blood “titer” levels done on mom and baby for syph?

A

mom @ 8 months

baby @ 3 months

44
Q

What are the effects syph can have if mom is not treated before 14 weeks gestation?

A

IUGR infant
preterm birth
stillbirth

45
Q

how is gonorrhea spread?

A

sexual contact

46
Q

how do women typically present with gonorrhea?

A

may be asymptomatic

  • yellowish discharge
  • dysuria w/ frequency
  • vulvar irritation
  • erosion of cervix
  • pelvic or back pain
47
Q

dx of gonorrhea

A

swab culture

48
Q

medication for gonorrhea

A

ceftriaxone 250mg “IM”

49
Q

true or false: the partner of an infected person with gonorrhea does not have to be treated

A

false

50
Q

when should pt and partner be retested for gonorrhea after tx?

A

3 months

51
Q

syphylis: risk to newborn

A

eye infection and pneumonia

*prophylactic tx of erythromycin eye ointment at birth

52
Q

symptoms of toxoplasmosis

A

asymp. OR fever with mono symptoms

53
Q

what animal is a definitive host of toxoplasmosis? pt teaching?

A

cats

have PG moms far away from litter box and gardening

54
Q

neonatal conditions caused by toxoplasmosis

A

hydrocephaly
chorioretinitis
cerebral calcifications
enlarged livers, rash, and jaundice after birth

55
Q

tx for toxoplasmosis for mom

A

pyrimethamine, sulfa and folic acid x1yr

56
Q

does toxoplasmosis affect baby different in different trimesters?

A

yes.

1st trimester - more neural defects
3rd - congenital infection

57
Q

Rubella risk to baby

A

hearing loss

58
Q

sx of herpes in newborn

A

CNS, oral, eyes, skin lesion

59
Q

can a baby die of herpes

A

yes

60
Q

what two stds lead to PID

A

chlamydia and gonorrhea

61
Q

sx of pid

A

pelvic pain, malaise, fever, chills, N/V, bleeding

62
Q

tx of PID

A

tx of pt and partner: antibiotics ie. Rocephin

63
Q

GBS+ increases risk of what to mom

A

PROM, PTL, UTI, preterm birth

64
Q

GBS+ increases risk of what to baby

A 
neonatal sepsis (sx in 1wk)
neonatal meningitis (sx within 1wk-3months)
65
Q

Which infection is the women given antibiotics before and duing labor

A

GBS+

66
Q

Stages of HIV sx

A

acute: mono sx
asymptomatic (5-10yrs): most PG women are here
symptomatic HIV
AIDS (end-stage): wasting syndrome, tumors, infections

67
Q

How is HIV passed to baby?

A

labor or breastmilk

68
Q

how to prevent HIV transmission to baby

A 
start ART meds 14weeks gestation (zdv)
avoid amnios
can do vag delivery (low viral loads - CS = high viral loads)
wash baby immediately
no breastfeeding
69
Q

important med to give to HIV+ mom in labor/ aCS

A

ARV

70
Q

why have HIV passage to baby declined

A

moms taking ART in PG
delivering by CS before SROM
no internal FHR monitoring during labor

71
Q

are babies usually asymp. at birth for HIV

A

yes

72
Q

initial med given to babies with HIV moms

A

AZT/ZDV

*will take ART like mom if positive later

maternal newborn (6 decks)

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