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Infectious Disease > EXAM #2: PERINATALLY ACQUIRED INFECTIONS > Flashcards

EXAM #2: PERINATALLY ACQUIRED INFECTIONS Flashcards

1
Q

What are the TORCHES infections?

A

1) Toxoplasmosis
2) Other
3) Rubella
4) CMV
5) Herpes/Hepatitis
6) Syphilis

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2
Q

How is Toxoplasmosis acquired?

A

CATS via cat feces AND:

  • Undercooked meat
  • Uncooked eggs
  • Unpasteurized milk
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3
Q

What should pregnant mothers be told not to do?

A

Change the litter box

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4
Q

How does the risk of Toxoplasmosis change with gestational age? How does the severity of Toxoplasmosis change with gestational age?

A
  • Increased RISK with gestational age

- Decreased SEVERITY with gestational age

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5
Q

What is the classic triad of CNS findings in perinatal Toxoplasmosis?

A

1) Hydrocephalus
2) Chorioretinitis
3) Intracranial calcifications (diffuse or speckled)

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6
Q

What is chorioretinitis?

A

Inflammation of the posterior portion of the uveal tract and retina

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7
Q

What two TORHCES infections have intracranial calcifications? What is the mnemonic to remember the difference?

A

CMV and Toxoplasmosis

  • CMV= periVentricular
  • ToXoplasmosis= diffuse
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8
Q

How is the diagnosis of Toxoplasmosis made?

A

1) Head CT
2) Ophthamology exam
3) IgM or persistent IgG titers

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9
Q

How is Toxoplasmosis treated post-natally?

A

1) Pyrimethamine
2) Sulfadiazine
3) Leucovorin
4) Corticosteroids

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10
Q

What are the major clinical outcomes of Toxoplasmosis?

A

1) Mental Retardation
2) Seizures
3) Cerebral Palsy
4) Deafness

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11
Q

What type of virus is Rubella?

A

Togaviridae

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12
Q

What are the only known source of Rubella infection?

A

Humans

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13
Q

What is the alternate name for Rubella?

A

German Measles (in adults)

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14
Q

What is the most common vaccine preventable disease in the world?

A

Congenital Rubella Syndrome (CRS)

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15
Q

What are the classic symptoms of CRS?

A

1) Deafness
2) Cataracts
3) Congenital heart disease

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16
Q

What is the most common isolated sequelae of CRS?

A

Deafness

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17
Q

What are the two most common heart defects associated with CRS?

A

1) PDA

2) Pulmonary stenosis

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18
Q

How is CRS diagnosed? When does diagnosis need to be made?

A
  • Must be done in the first year of life*
    1) Culture
    2) Serum IgM titers
    3) PCR
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19
Q

What is the treatment for CRS?

A

There is no treatment; only supportive care

*This is preventable with vaccination

20
Q

What finding in the neonate should make you think CMV?

A

Jaundice

21
Q

What type of virus is CMV?

A

DNA, part of the herpes virus family

22
Q

What is the most common congenital infection in developed countries?

A

CMV

23
Q

What is the classic triad of symptoms in neonatal CMV infections?

A

1) Petechia/ecchymosis (Blueberry muffin rash)
2) Jaundice at birth or within a few hours*
3) Hepatosplenomegally

24
Q

When should a physiologic jaundice develop?

A

Days 2,3,4,or 5

25
Q

Where are intracranial calcification seen in CMV?

A

PeriVentricular

26
Q

How is CMV diagnosed?

A

1) Urine CMV
2) Serum IgM
3) Head CT

27
Q

What is the treatment for congenital CMV infections?

A

Gancyclovir

28
Q

What is the leading cause of childhood sensorineural hearing loss in developed countries?

A

Congenital CMV

29
Q

What is the presentation of disseminated congenital HSV?

A

Febrile ill-appearing neonate

30
Q

When does disseminated congenital HSV occur?

A

Before week 2

31
Q

What is SEM congenital HSV infection?

A

Skin-Eye-Mouth

Vesicles found in those locations without disseminated disease

32
Q

When does SEM HSV occur?

A

Before week 1

33
Q

asdf

A

asdf

34
Q

How is HSV diagnosed?

A

1) Tzanck smear

2) PCR

35
Q

What is a clue to congenital HSV infection?

A

Elevated LFTs

36
Q

What is the treatment for HSV?

A

Acyclovir

37
Q

How is congenital HSV prevented?

A

1) C-section with active lesions
2) Obtain culture if born with active lesions
3) Treat with ayclovir empirically

38
Q

If a mother is positive for Hepatitis B, what do you do?

A

1) Give HepB immunoglobulin

2) HepB vaccine

39
Q

What are the early classic symptoms for congenital syphillis?

A

1) Mucocutaneous lesions
2) Lymphadenopathy
3) Rash
4) Snuffles
5) Metaphyseal Dystrophy
6) Periositis

40
Q

What are the late stage congenital syphilis findings?

A

1) Hutchinson teeth
2) Saber shins
3) Frontal bossing

41
Q

If the mother has gotten proper treatment for syphillis, what do you need to do for the infant?

A

Nothing

42
Q

If the mother has NOT gotten proper treatment for syphillis, what do you need to do for the infant?

A

PCN

43
Q

What should mothers with HIV not do post-natally?

A

Breastfeed

44
Q

How is congenital HIV diagnosed?

A

PCR

45
Q

When are neonates tested for HIV? What is a positive test?

A

2 weeks, 2 months, 6 months

  • Positive= 2x
  • Negative= 3x negative
46
Q

Should women be tested for HIV during pregnancy?

A

Yes

47
Q

What drug is given to babies of HIV infected mothers?

A

AZT

Infectious Disease (21 decks)

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