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GERR > Infection - Obstetric and perinatal infection > Flashcards

Infection - Obstetric and perinatal infection Flashcards

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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
how is congenital rubella syndrome spread a.intrauterine b.perinatal c.post natal
a.intrauterine
26
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
b.congenital rubella syndrome
27
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
e.erythrorvirus b19
28
what has caused the decrease in congenital rubella syndrome since the 1970s a.MMR vaccine ] b.HPV vaccine
a.MMR vaccine
29
when is maternal infection with eryhrovirus b19 dangerous a.first 16 weeks b.10-20 weeks c.20-30 weeks
b.10-20 weeks asymptomatic in adults
30
w erythrovirus 19 is .......... in adults a.symptomatic b.symptomatic
a.symptomatic
31
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
b.erythrovirus 19
32
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.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
what is done if rubella is detected in pregnancy a.intrauterine blood transfusion b.termination options c.further tests to define risk
c.further tests to define risk and termination options
34
presece of which antibody indicates current infection with E19/ rubella a.igG b.igM
b.igM
35
what is the best sample to take for cmv in newborns a.blood b.urine c.swab
b.urine
36
what family is cmv a.herpes b.strep c.staph
a.herpes
37
n cmv which infection is higher risk in pregnancy a. reactivation b.primary infection
b.primary infection more likely severe infection and more likely transmission reactivation - less risk of mother and transmission
38
CMV inclusion disease refers to....
what happens inside cells marked multisystem cells
39
symptoms of cmv are... a.a spectrum b.set
a.a spectrum asymptomatic - CMV inclusion disease
40
how is cMV diagnosed in babies a.PCR urine b.blood c.serology
a.PCR urine
41
how is cMV diagnosed in mothers a.PCR urine b.blood c.serology
c.serology
42
syphylis is.......... a.acute b.chronic
b.chronic tested for antenatally if detected maternal infection can be detected
43
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
d.syphillis
44
what is syphillis in mothers treated with a.penicillin b. clarithrmycin c, doxycycline
a.penicillin
45
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
d.varicella chickenpox
46
what is tested for to test for immunity when mother in contact with chicken pox a.urine PCR b.VZV IgG c.IgM
b.VZV IgG
47
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.VZIG given
48
what is screened for in pregnancy
HBV HIV syphyllis rubella
49
When screening for HBV what is screened for a.current infection b.past or present infection c.immunity
a.current infection screen for HBsAg
50
When screening for HIV what is screened for a.current infection b.past or present infection c.immunity
a.current infection
51
If hep B is present what is given a.penicillin to mother b.VZIG given c.antiretrovirals d.HBV vaccine for baby
d.HBV vaccine for baby
52
if HIV present what is given a.penicillin to mother b.VZIG given c.antiretrovirals d.HBV vaccine for baby
c.antiretrovirals elective c section NO breast feeding need to follow up baby until after 18 months
53
what week is booking blood taken at a.10 b.12 c.13 d.16
c.13
54
infections around time of birth
choriamniotis - 2nd half of pregnancy, bacterial infection from GU tract bacterial meningitis neonatal varicella HSV
55
which part of pregnancy does Chorioamnionitis normally occur a.1st half b.2nd half c,1st trimester
b.2nd half
56
neonatal conjunctivitis are associated with which bacteria a.neisseria gonorrhoea b.strep pnneumoniae c.staph aureus d.e coli
a.neisseria gonorrhoea and chlamydia (STIs in GU tract) c trachomitis can lead to pneumonia
57
which neonatal infections can present as sepsis / meningitis
group B strep listeria monocytogenes e coli specific sepsis and meningitis to first 3 months
58
listeria monocytogenes is.. a.gram neg b.gram pos c.gram pos rod d, gram pos cocci
c.gram pos rod risk in food stuffs and unpasterized milk
59
pregnant women are advised to avoid unpasteurised milk etc to avoid which bacteria a.group B strep b. listeria monocytogenes e coli
b. listeria monocytogenes early onset neonatal meningitis
60
what is listeria treated with a.penicillin b.ZGIG c.amoxicillin d.doxycycline
c.amoxicillin may need to give gentamicin too
61
group B strep is .......... for neonate a.mild b.serious
b.serious
62
if problems with group b strep previously when is it screened for in mother a.16 weeks b.13 weeks c.36 weeks
c.36 weeks given prophylactic penicillins during birth
63
what is given for group b strep in pregnancy a.penicillin b.ZGIG c.amoxicillin d.doxycycline e.prophylactic penicillin
e.prophylactic penicillin
64
puerperal sepsis
sepsis of uterus and genital tract post partum
65
how is puerperal sepsis diagnosed a.bloods b.serology c,vaginal swab
c,vaginal swab
66
what is the main cause of puerperal sepsis a.neisseria gonorrhoea b.strep pnneumoniae c.staph aureus d.e coli e.group a strep
e.group a strep

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