Infectious Disease

Question 1

When do you screen women for GBS?

Answer 1

Between 35-37 weeks

Question 2

If a patients GBS status is unknown, you would give prophylaxis for? (Name all situations)

Answer 2

• Preterm labor (less than 37 weeks)
• PPROM
• ROM for 18 hours or more
• Maternal fever during labor

Question 3

Sudden onset of fever (within 24 hours) postpartum, usually accompanied by fundal pain (lower abdominal pain).

Answer 3

Endometritis

Question 4

This type of HSV infection occurs in a woman with no evidence of prior infection

Answer 4

Primary HSV

Question 5

This type of HSV infection occurs in a woman with a history of heterologous infection (i.e., first HSV-2 infection with a prior HSV-1 infection)

Answer 5

Nonprimary first episode

Question 6

This type of infection occurs in a woman with clinical or serological evidence of prior genital herpes (of the same serotype)

Answer 6

Recurrent infection

Question 7

Which type of HSV infection poses the greatest risk to the fetus?

Answer 7

Primary infection

Question 8

During labor, if you see herpetic lesions, or suspect the patient has herpes, what is the appropriate course of action?

Answer 8

Perform a C section and give acyclovir

Question 9

When do you give acyclovir to patients with herpes?

Answer 9

Begin treatment at 36 weeks

Question 10

Symptoms of rubella infection.

Answer 10

Fever, rash involving the face and spreading to the trunk and extremities, arthralgias, head and neck lymphadenopathy, conjunctivitis.

Question 11

What are the defects associated with congenital rubella syndrome?

Answer 11

Heart disease (PDA), mental retardation, deafness, cataracts.

Question 12

Can the hepatitis A vaccine be given during pregnancy?

Answer 12

You betcha. You can also give the HAV Ig for both pre and lost exposure prophylaxis and is also safe during pregnancy

Question 13

This type of hepatitis can cause neonatal infection via breast milk

Answer 13

Hep B

Question 14

A baby is born to a mother who is HBV positive, when do you start the vaccination in the infant?

Answer 14

Within 12 hours of birth. (If the mom wasn’t infected you start the vaccine series between 2 days and 2 months post partum)

Question 15

What do you do if a mother is found to have HCV during labor?

Answer 15

Nothing. There is no preventative measure to reduce the risk of mother to child transmission.

Question 16

This type of hepatitis has the highest mortality rate amount pregnant women.

Answer 16

Hep E

Question 17

Treatment used to prevent perinatal transmission of HIV

Answer 17

Zidovudine and another type of ART (combination therapy)

Question 18

This test is used to confirm the diagnosis of HIV

Answer 18

Western blot

Question 19

Most useful test to determine someone’s HIV status during labor

Answer 19

Rapid HIV testing

Question 20

When do you do a C section for a woman with a high HIV viral load (>1000) to prevent fetal transmission?

Answer 20

38 weeks

Question 21

Can a mother pass on HIV via breast milk?

Answer 21

Yes

Question 22

What does transmission of HPV from mother to fetus manifest as?

Answer 22

Laryngeal papillomatosis

Question 23

Complications of syphilis infection on the baby

Answer 23

Spontaneous abortion, still birth, neonatal death

Question 24

What type of syphilis is more likely to cause neonatal infections?

Answer 24

Primary or secondary syphilis

Question 25

Physical features of infants with syphilis?

Answer 25

Maculopapular rash, mucous patches on the oropharynx, hepatosplenomegaly, jaundice, chorioretinitis, Hutchinson teeth, mulberry molars, saddle nose, saber shins

Question 26

Treatment for syphilis

Answer 26

Penicillin (if allergic, desensitize the patient and then give penicillin)

Question 27

Acute febrile reaction that occurs more commonly after treatment of a patient with primary syphilis

Answer 27

Jarisch-Herxheimer reaction

Question 28

What complication of the fetus do you worry about in a mother wth gonorrhea?

Answer 28

Gonococcal ophthalmia

Question 29

Treatment for a neonate who was born to a mother with gonorrhea?

Answer 29

Ophthalmic erythromycin ointment

Question 30

Neonatal complications of chlamydia

Answer 30

Conjunctivitis and pneumonia

Question 31

Treatment for chlamydia infection during pregnancy

Answer 31

Azithromycin (macrolide) or amoxicillin

Question 32

Signs of CMV infection in neonate

Answer 32

Petechiae, hepatosplenomegaly, jaundice, thrombocytopenia, microcephaly, chorioretinitis

Question 33

Signs of toxoplasmosis infection in neonate

Answer 33

Severe mental retardation, chorioretinitis, blindness, epilepsy, intracranial calcifications, hydrocephalus

Question 34

Treatment shown to reduce the risk of congenital toxoplasmosis infections and manifestations

Answer 34

Pyrimethamine and sulfadiazine

Question 35

Complications of neonatal varicella infection

Answer 35

Skin scarring, limb hypoplasia, chorioretinitis, microcephaly