EXAM #2: PERINATALLY ACQUIRED INFECTIONS Flashcards Preview

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

Flashcards in EXAM #2: PERINATALLY ACQUIRED INFECTIONS Deck (47):
1

What are the TORCHES infections?

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

2

How is Toxoplasmosis acquired?

CATS via cat feces AND:
- Undercooked meat
- Uncooked eggs
- Unpasteurized milk

3

What should pregnant mothers be told not to do?

Change the litter box

4

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

- Increased RISK with gestational age
- Decreased SEVERITY with gestational age

5

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

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

6

What is chorioretinitis?

Inflammation of the posterior portion of the uveal tract and retina

7

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

CMV and Toxoplasmosis
- CMV= periVentricular
- ToXoplasmosis= diffuse

8

How is the diagnosis of Toxoplasmosis made?

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

9

How is Toxoplasmosis treated post-natally?

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

10

What are the major clinical outcomes of Toxoplasmosis?

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

11

What type of virus is Rubella?

Togaviridae

12

What are the only known source of Rubella infection?

Humans

13

What is the alternate name for Rubella?

German Measles (in adults)

14

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

Congenital Rubella Syndrome (CRS)

15

What are the classic symptoms of CRS?

1) Deafness
2) Cataracts
3) Congenital heart disease

16

What is the most common isolated sequelae of CRS?

Deafness

17

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

1) PDA
2) Pulmonary stenosis

18

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

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

19

What is the treatment for CRS?

There is no treatment; only supportive care

*This is preventable with vaccination

20

What finding in the neonate should make you think CMV?

Jaundice

21

What type of virus is CMV?

DNA, part of the herpes virus family

22

What is the most common congenital infection in developed countries?

CMV

23

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

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

24

When should a physiologic jaundice develop?

Days 2,3,4,or 5

25

Where are intracranial calcification seen in CMV?

PeriVentricular

26

How is CMV diagnosed?

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

27

What is the treatment for congenital CMV infections?

Gancyclovir

28

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

Congenital CMV

29

What is the presentation of disseminated congenital HSV?

Febrile ill-appearing neonate

30

When does disseminated congenital HSV occur?

Before week 2

31

What is SEM congenital HSV infection?

Skin-Eye-Mouth

Vesicles found in those locations without disseminated disease

32

When does SEM HSV occur?

Before week 1

33

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34

How is HSV diagnosed?

1) Tzanck smear
2) PCR

35

What is a clue to congenital HSV infection?

Elevated LFTs

36

What is the treatment for HSV?

Acyclovir

37

How is congenital HSV prevented?

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

38

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

1) Give HepB immunoglobulin
2) HepB vaccine

39

What are the early classic symptoms for congenital syphillis?

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

40

What are the late stage congenital syphilis findings?

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

41

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

Nothing

42

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

PCN

43

What should mothers with HIV not do post-natally?

Breastfeed

44

How is congenital HIV diagnosed?

PCR

45

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

2 weeks, 2 months, 6 months
- Positive= 2x
- Negative= 3x negative

46

Should women be tested for HIV during pregnancy?

Yes

47

What drug is given to babies of HIV infected mothers?

AZT