Infections in Pregnancy

Question 1

MC bacterial infection in pregnancy

Answer 1

UTIs

Question 2

what are UTIs and bacteriuria

Answer 2

with preterm delivery, preeclampsia, maternal anemia, amnionitis, and low birth weight

Question 3

when should preggers get screened for UTIs

Answer 3

at first prenatal visit

Question 4

MC UTI bug

Answer 4

E. coli

Question 5

what does asymptomatic bacteriuria have increased risk of

Answer 5

pyelonephritis

Question 6

is cystitis multiple or single organsim

Answer 6

single

Question 7

most significant symptoms of cystitis

Answer 7

dysuria

Question 8

what should you NOT use for UTIs in preggers

Answer 8

Sulfa (Bactrim or Septra) – inhibits folate (increased NTD)
and raises bilirubin late in pregnancy (kernicterus)
Fluoroquinolones – fetal arthropathy
Tetracyclines – affect fetal bones and teeth

Question 9

what do you do after treating UTIs

Answer 9

test for cure

Question 10

what meds do you use for UTIs

Answer 10

nitrofurantoin
augmentin
fosfomycin

Question 11

MC urinary tract complication in preggers

Answer 11

pyelonephritis

Question 12

what is pyelo frequently associated with

Answer 12

septicemia

Question 13

when is pyelo MC

Answer 13

2nd trimester

Question 14

pyelo tx

Answer 14

ceftriaxone favored

Question 15

MC cause of neonatal sepsis

Answer 15

GBBHS

Question 16

infant mortality of GBBHS

Answer 16

Infant mortality – 25% preterm, 5% term

Question 17

tx of GBBHS

Answer 17

ampicillin or penicillin or clinda for allergies

Question 18

what does TORCHES stand for

Answer 18

Toxoplasmosis
Other (Hep B, Coxsackie, VZV, West Nile, Measles, HIV, Zika) 
Rubella
Cytomegalovirus
Herpes simplex
Erythema infectiosum
Syphilis

Question 19

what can happen with untx toxoplasmosis

Answer 19

sensorineural hearing loss if untreated (28%)

Question 20

congenital rubella syndrome risk highest risk in wks

Answer 20

8-10

Question 21

what is congenital rubella syndrome

Answer 21

cataracts, heart defects, hearing defects

Question 22

how long can you shed rubella

Answer 22

up to 1yr in stool

Question 23

do maternal antibodies protect fetus against CMV

Answer 23

no

Question 24

prognosis of CMV to child and what is the MC sequela

Answer 24

Disseminated- Mortality 12% (some statistics up to 30%)

Sensorineural hearing loss is the most common sequela of congenital CMV infection.

Question 25

how is HSV contracted by the baby

Answer 25

**through the birth canal

Question 26

when do you consider HSV

Answer 26

any septic neonate

Question 27

do you need informed consent for HSV vaginal birth

Answer 27

yes

Question 28

how likely is a syphilis mother to have normal baby

Answer 28

Mother with primary/secondary syphilis UNLIKELY to have normal infants

Question 29

where can the syphilis rash appear

Answer 29

palms and soles!

Question 30

what is pseudoparalysis of parrot and what is it associted with

Answer 30

syphilis and pt refuses to weight bear on painful bones

Question 31

what is the only drug that can be used with infected syphilis mother

Answer 31

PCN

Question 32

is maternal herpes zoster associated with congenital varicella syndrome?

Answer 32

no

Question 33

when is the most critical period for parvovirus to strike

Answer 33

13-16wks

Question 34

CHORIOAMNIONITISINTRA-AMNIOTIC INFECTION SYNDROME tx

Answer 34

delivery! + abx (ampicllin + gentamycin)

Question 35

what drugs to NOT use in pregnancy (but could be used if its the only choice and the infection is worse than using it)

Answer 35

Fluoroquinolones – arthropathy (animal studies) Streptomycin-ototoxicity Tetracyclines- Teeth staining, growth stunting

Question 36

what meds do yo avoid in 1st trimester

Answer 36

metronidazole

Question 37

what drugs do you avoid in the 3rd trimester

Answer 37

Sulfonamides (hyperbilirubinemia-kernicterus) | Nitrofurantoin (hemolysis in G6PD deficiency)

Question 38

postpartum fever after day 1 suspect

Answer 38

assume to be pelvic infection until proven otherwise

Question 39

what is the most important RF in endometritis

Answer 39

c-section

Question 40

how many organsims are involved in post partum endometritis

Answer 40

multiple

Question 41

tx for post vaginal deliver of post partum endometritis

Answer 41

Gentamicin & clindamycin

Question 42

tx for postc-section deliver of post partum endometritis

Answer 42

Ampicillin/Gentamicin & clindamycin

Question 43

tx for chlamydia

Answer 43

Azithromycin (Zithromax) 1 gm po one dose (first-line) | Probs gonnna have terrible stomach SA

Question 44

MC STI

Answer 44

chlamydia

Question 45

gonorrhea tx

Answer 45

Ceftriaxone (Rocephin) 250 mg IM + azithromycin 1 g po x 1 dose