Congenital, Perinatal & Neonatal

Question 1

Beta hemolytic streptococci main vitulence factor is…..

Answer 1

Polysaccharide capsule

Question 2

……is not recommended as diagnostic specimen for GBS colinization in pregnant females

Answer 2

Cervical swabs

Question 3

Describe ttt of GBS colonized pregnant women

Answer 3

Durong pregnancy at the time of diagnosis as well as at delivery: ampicillin and aminoglycosides
All vaginal and rectal carriers: intrapartum ampicillin

Question 4

List causative agents of neonatal meningitis & septicemia

Answer 4

GBS
Listeria monocytogenes
E.coli K1

Question 5

Mention identification criteria for L.monocytogenes

Answer 5

Gram +ve bacilli
Chct tumbling motility at 18-22degC
Catalase +ve, oxidase/urease/indole -ve

Question 6

Describe pathogenesis of L.monocytogenes

Answer 6

It is a facultative intracellular parasite infecting epithelial cells, macrophages & other parenchymal cells. After ingestion they enter target cells & by help of listeriolysin O escape the phagocytic vacuole to multiply in cytoplasm then attached to cytoskeleton to spread to other cells. Thus they are not exposed to humoral immunity of PMNL. Immunity is cell mediated

Question 7

Describe CP of neonatal listeriosis

Answer 7

1. Early: granulomatosus infantiseptica causes abscesses & granulomas in multiple organs leading to abortion, uterine fetal death or death after delivery
2. Late: meningo-encephalitis or meningitis with sepsis within 2-3 wks

Question 8

CP of neonatal syphilis

Answer 8

1. Early: in first 2 yrs: rhinitis, skin & mucosal lesions, hepatosplenomegaly, lymphadenopathy, abnormalities of bones, teeth, cartilage
2. Later: above 2 yrs, interstitial keratitis, Hutchinson’s teet, saddle nose, deafness, atrophy of optic nerve periostitis & CNS abnormalities

Question 9

Describe lab diagnosis for congenital syphilis

Answer 9

1. An abnormal physical exam consistenet with congenital syphilis
2. Serum quantitative non-specific test (VDRL) serologic titer that is 4-fold higher than mother
3. +ve dark field test or PCR of lesions or body fluids

Question 10

Fetus is particularly susceptible to Rubella virus if infection occurs..

Answer 10

Before 16 wks

Question 11

Mention CP of congenital rubella

Answer 11

LBW, congenital heart and eye defects esp cataract, deafness, nwurological abnormalities, effects on brain and ear may not be detectable till later.

Question 12

Describe lab diagnosis of congenital rubella

Answer 12

Fetal rubella IgM in cord and infant blood, viral isolation from urine or throat, RT-PCR

Question 13

Pregnancy is CI……after rubella vaccination

Answer 13

1 month

Question 14

CMV infection is most severe on fetal CNS in….trimester of pregnancy

Answer 14

1st

Question 15

Mention CP of CMV infection

Answer 15

Mental retardation, microcephaly, optic atrophy, hearing defects, hepatosplenomegaly, thrombocytopenic purpura and anemia, deafness and mental retardation but detectable later

Question 16

Describe lab diagnosis of CMV

Answer 16

Detecting CMV-specific IgM Abs in infant blood within 3 wks of delivery, detect CMV DNA in blood or culture during this period, virus can be isolated from throat swab or urine samples

Question 17

Ttt of CMV infection is…….

Answer 17

Gancyclovir and valgancyclovir

Question 18

Compare manifestations of congenital and neonatal VZV

Answer 18

C, LBW, sacrring of skin, abnormally small head, neurologic and vision problems.
N, chance of death as hifh as 30% as immune system of neonate is not well-developed

Question 19

Describe lab diagnosis and prevention of neonatal HIV

Answer 19

-PCR is mainstay, IgG Abs may be materal and persist for a year
-Transmission rates are reduced by lowering HIV load by offering antiretroviral drugs during pregnancy, C-section, avoid breastfeeding.

Question 20

Parvovirus B19 infection affects the fetus the most if it occurs in…..
Describe its effect

Answer 20

Between 10th and 20th wks
Arrest of fetal RBCs, non-immune hydrops fetalis and fetal death from severe anemia

Question 21

Mention CP of congenital HSV infection

Answer 21

1. Cutaneous lesions of HS may develop 1 wk after delivery with generalized infection amd sever CNS involvement
2. May be missed as 39% have not skin lesion
3. Morbidity and mortality rates are higher with encephalitis and disseminated disease

Question 22

What is lab diagnosis for HPV

Answer 22

Juvenile larygeal papillomas are diagnosed through larygoscopy and can be confirmed thrpigh biopsy and DNA detection