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GERR > Infection - Obstetric and perinatal infection > Flashcards

Infection - Obstetric and perinatal infection Flashcards

1
Q

immune tolerance

A

adaptation of normal immune system in pregnancy
foetus acts as non self allograft

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2
Q

what does a foetus act as in pregnancy

A

non self allograft
different immune system

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3
Q

what does the placenta act as

A

immunological barrier
certain components eg IgG antibodies can get through
pathogens/immune cells cannot
cloaking effect

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4
Q

which type of antibody can go through the placenta

a.igA
b.igM
c.igG

A

c.igG

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5
Q

how do placental cells differ to normal cells

A

reduced depression of class 1 MHC antigens
syncytium blocks immune cells
T cells inhibited

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6
Q

which cells are inhibited by the placenta

a.B cells
b. D cells
c.F cells
d.T cells

A

d.T cells

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7
Q

which antigens have decreased expression in the placenta

a.class 1 MHC
b.class 2 MHC
c.class 3 MHC

A

c.class 3 MHC

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8
Q

what happens to systemic immunity in pregnancy

a.surpression
b.increase

A

a.surpression

down regulation of T cells

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9
Q

pregnant worm are at ……… risk of infection

a.lower
b.higher

A

b.higher

eg hep A

also rheumatoid arthritis decreases

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10
Q

what happens in some inflammatory disease in pregnancy eg rheumatoid arthritis and IBD

a.worsens
b.imrpoved

A

b.imrpoved

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11
Q

what happens if the maternal immune system is fully functional

a.graft rejection
b.foetal abnormalities
c.graft vs host reaction

A

a.graft rejection

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12
Q

synthesis of which antibody is entirely lacking in pregnancy

a.igG
b.igM
c.IgA

A

a.igG

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13
Q

which fetal antibodies are not produced in significant amounts until the second half of pregnancy

a.IgM AND IGg
B.IGM and IgA
c.IgA and IgG

A

B.IGM and IgA

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14
Q

which infections are more severe in pregnancy

A

malaria

UTI -> presses on uterus limitation of flow
influenza -> mechanical issues (lungs inflating H1M)
candidiasis
listeriosis
varicella

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15
Q

which transmission occurs during pregnancy

a.intrauterine
b.perinatal

A

a.intrauterine

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16
Q

which transmission occurs during birth

a.intrauterine
b.perinatal

A

b.perinatal

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17
Q

rubella, parvovirus, cmv, syphillis are all spread via which transmission

a.intrauterine
b.congenital
c.perinatal

A

a.intrauterine

during pregnancy via placenta

they are known as congenital infections - present at time of birth

TORCH infections

toxoplasma , rubella , cmv , herpes

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18
Q

HIV, HBV, group b streptococci. listeria , chlamydia and neisseria gonorrhoea are spread via which transmision

a.intrauterine
b.congenital
c.perinatal

A

c.perinatal

(blood mixing, organisms present in GU tract of mother)

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19
Q

which of these is an example of post natal transmission

a.via placenta
bb.via blood mixing in birth
c.via GU tract in birth
d.via breastmilk

A

d.via breastmilk

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20
Q

how is HTLV spread

a.intrauterine
b.perinatal
c.postnatal

A

c.postnatal

via breast milk

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21
Q

what is the incubation period of rubella

a.7-14 days
b..14-21 days
c.21-30 days

A

b..14-21 days

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22
Q

fever, malaise(joint pain) ,nodes behind the ear,athralgia and irregular maculopapular rash (non specific)lasting 3 days indicates which disease

a.rubella
b.erythrovirus b19
c.cmv
d.syphillis

A

a.rubella

often unoticed in adults/healthy

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23
Q

what type of rash is present for 3 days in rubella

a.irregular maculopapular rash
b.regular maculopapular rash

A

a.irregular maculopapular rash

redness non specific (could be flat or slightly raised)

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24
Q

congenital rubella syndrome

A

mother contracts rubella in first 16 weeks of pregnancy
moves across placenta

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25
Q

how is congenital rubella syndrome spread

a.intrauterine
b.perinatal
c.post natal

A

a.intrauterine

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26
Q

sensorineural deafness, insulin dependent diabetes and type1 diabetes , cataracts, brain and heart problems occur in which situation

a.rubella
b.congenital rubella syndrome
c. cmv
d.syphillis
e.eryhtorvirus

A

b.congenital rubella syndrome

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27
Q

febrile illness in children and maculopapular rash on the face (slapped cheek syndrome) are present in which infection

a.rubella
b.congenital rubella syndrome
c. cmv
d.syphillis
e.erythrorvirus

A

e.erythrorvirus b19

28
Q

what has caused the decrease in congenital rubella syndrome since the 1970s

a.MMR vaccine ]
b.HPV vaccine

A

a.MMR vaccine

29
Q

when is maternal infection with eryhrovirus b19 dangerous

a.first 16 weeks
b.10-20 weeks
c.20-30 weeks

A

b.10-20 weeks

asymptomatic in adults

30
Q

w
erythrovirus 19 is ………. in adults

a.symptomatic
b.symptomatic

A

a.symptomatic

31
Q

in which perinatal infection is there destruction of foetal red cells (anaemia) and fetal heart failure (hydros fatales) leading to a swollen pale foetus and fatality for the foetus

a.rubella
b.erythrovirus 19
c.cmv
d.syphillis
e.congenital ribella syndrome

A

b.erythrovirus 19

32
Q

if mother in contact with person with macropapular rash which antibodies are looked for in serology when looking for erthrovirus 19

a.igG and IgM
b.igG and iGA

A

a.igG and IgM

igg = previous infection
iGm = current infection

repeat after 4 weeks if none found

if present then infection occurred

treated with intrauterine blood transfusion

33
Q

what is done if rubella is detected in pregnancy

a.intrauterine blood transfusion
b.termination options
c.further tests to define risk

A

c.further tests to define risk

and termination options

34
Q

presece of which antibody indicates current infection with E19/ rubella

a.igG
b.igM

A

b.igM

35
Q

what is the best sample to take for cmv in newborns

a.blood
b.urine
c.swab

A

b.urine

36
Q

what family is cmv

a.herpes
b.strep
c.staph

A

a.herpes

37
Q

n cmv which infection is higher risk in pregnancy

a. reactivation
b.primary infection

A

b.primary infection

more likely severe infection and more likely transmission

reactivation - less risk of mother and transmission

38
Q

CMV inclusion disease refers to….

A

what happens inside cells
marked multisystem cells

39
Q

symptoms of cmv are…

a.a spectrum
b.set

A

a.a spectrum

asymptomatic - CMV inclusion disease

40
Q

how is cMV diagnosed in babies

a.PCR urine
b.blood
c.serology

A

a.PCR urine

41
Q

how is cMV diagnosed in mothers

a.PCR urine
b.blood
c.serology

A

c.serology

42
Q

syphylis is……….

a.acute
b.chronic

A

b.chronic

tested for antenatally
if detected maternal infection can be detected

43
Q

which infection causes hepatosplenomegaly, jaundice , anaemia affects teeth brain and ears and can lead to miscarriage

a.rubella
b.erythrovirus 19
c.cmv
d.syphillis
e.congenital ribella syndrome

A

d.syphillis

44
Q

what is syphillis in mothers treated with

a.penicillin
b. clarithrmycin
c, doxycycline

A

a.penicillin

45
Q

which infection prior to 20 weeks causes limb deformities, brain and eye abnormalities and maternal pneumonitis

a.rubella
b.erythrovirus 19
c.cmv
d.syphillis
e.congenital ribella syndrome
d.varicella

A

d.varicella

chickenpox

46
Q

what is tested for to test for immunity when mother in contact with chicken pox

a.urine PCR
b.VZV IgG
c.IgM

A

b.VZV IgG

47
Q

if mother has a VZV gig negative result and has been in contact with chickenpox what is given

a.VZIG given
b.penicillin given

A

a.VZIG given

48
Q

what is screened for in pregnancy

A

HBV
HIV
syphyllis
rubella

49
Q

When screening for HBV what is screened for

a.current infection
b.past or present infection
c.immunity

A

a.current infection

screen for HBsAg

50
Q

When screening for HIV what is screened for

a.current infection
b.past or present infection
c.immunity

A

a.current infection

51
Q

If hep B is present what is given

a.penicillin to mother
b.VZIG given
c.antiretrovirals
d.HBV vaccine for baby

A

d.HBV vaccine for baby

52
Q

if HIV present what is given

a.penicillin to mother
b.VZIG given
c.antiretrovirals
d.HBV vaccine for baby

A

c.antiretrovirals

elective c section
NO breast feeding

need to follow up baby until after 18 months

53
Q

what week is booking blood taken at

a.10
b.12
c.13
d.16

A

c.13

54
Q

infections around time of birth

A

choriamniotis - 2nd half of pregnancy, bacterial infection from GU tract

bacterial meningitis

neonatal varicella

HSV

55
Q

which part of pregnancy does Chorioamnionitis normally occur

a.1st half
b.2nd half
c,1st trimester

A

b.2nd half

56
Q

neonatal conjunctivitis are associated with which bacteria

a.neisseria gonorrhoea
b.strep pnneumoniae
c.staph aureus
d.e coli

A

a.neisseria gonorrhoea

and chlamydia (STIs in GU tract)

c trachomitis can lead to pneumonia

57
Q

which neonatal infections can present as sepsis / meningitis

A

group B strep
listeria monocytogenes
e coli

specific sepsis and meningitis to first 3 months

58
Q

listeria monocytogenes is..

a.gram neg
b.gram pos
c.gram pos rod
d, gram pos cocci

A

c.gram pos rod

risk in food stuffs and unpasterized milk

59
Q

pregnant women are advised to avoid unpasteurised milk etc to avoid which bacteria

a.group B strep
b. listeria monocytogenes
e coli

A

b. listeria monocytogenes

early onset neonatal meningitis

60
Q

what is listeria treated with

a.penicillin
b.ZGIG
c.amoxicillin
d.doxycycline

A

c.amoxicillin

may need to give gentamicin too

61
Q

group B strep is ………. for neonate

a.mild
b.serious

A

b.serious

62
Q

if problems with group b strep previously when is it screened for in mother

a.16 weeks
b.13 weeks
c.36 weeks

A

c.36 weeks

given prophylactic penicillins during birth

63
Q

what is given for group b strep in pregnancy

a.penicillin
b.ZGIG
c.amoxicillin
d.doxycycline
e.prophylactic penicillin

A

e.prophylactic penicillin

64
Q

puerperal sepsis

A

sepsis of uterus and genital tract post partum

65
Q

how is puerperal sepsis diagnosed

a.bloods
b.serology
c,vaginal swab

A

c,vaginal swab

66
Q

what is the main cause of puerperal sepsis

a.neisseria gonorrhoea
b.strep pnneumoniae
c.staph aureus
d.e coli
e.group a strep

A

e.group a strep

GERR (53 decks)

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