Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

RC OBGYN (CG) > Infectious disease > Flashcards

Infectious disease Flashcards

(64 cards)

Start Studying
1
Q

What type of virus is Hep B virus?

A

Enveloped DNA virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the definition of chronic hepatitis B?

A

HBsAg positive for > 6 mo AND absence of anti-HBs antibody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common route of transmission of HBV?

What are the other routes?

A

Vertical is the MOST common route of transmission

High prevalence areas –> perinatal transmission

Intermediate prevalence –> horizontal (child to child) in early childhood

Low prevalence –> Unprotected sex, IDU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Is breastfeeding contra-indicated in HBV?

A

No, HBV is not spread through breast milk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the significance of HBeAg?

A

Active replication of the virus

(CAUTION: 30 % have mutation that prevent HBeAg expression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the rate of neonatal transmission of hep B with and without PEP?

A

With: 2 %

Without:

  • 90 % (mother HbeAg+)
  • 15 % (mother HbeAg-)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name factors that increase perinatal transmission of Hep B (5)?

A

HbeAg +

High viral load (DNA)

Genotype

Resistant virus

Altered timing of PEP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the single strongest factor driving perinatal transmission of Hep B?

A

HBV DNA viral load

(Often in viral load > 200 000 ≈106)

Even in the presence of appropriate neonatal PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Does Hep B increase adverse pregnancy outcomes?

A

Chronic: None (no increase in SAB, PTB etc)

Acute:

Low birth rate

Prematurity

Increased perinatal transmission:

  • 10 % if maternal infection in early pregnancy
  • 60 % if maternal infection at or near the time of delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In cases of pre-natal serologies positive for HBsAg, what other test should you order?

A

HBeAg

HbeAb (anti-HBe)

HbcAb (anti-HBc)

Hbc IgM (Anti-HBc IgM)

HBV DNA levels

Liver enzymes, bili, coags, CBC

Ultrasound of the liver

Hepatology/ ID consult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What the indications for HBV treatment in pregnancy?

A

1- Maternal reasons

2- Prevent transmission

HBV viral load > 200 000 (>106)→ start treatment at 28+32 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the PEP regimen to prevent Hep B transmission to newborn

A

HBIG 0.5 mL IM

+

Hep B vaccine 0.5 mL IM (1st of 3 doses)

Given within 12h of birth

**f baby is preterm or wt < 2000g, needs 4 doses of vaccination (vs 3)**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What additional testing does complicated VVC warrant?

A

Testing for HIV and DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the definition of complicated VVC?

A

Recurrent (> 4 episodes in 12 month)

Associated with severe symptoms

Non-albicans species

Present in immunocompromised host

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Laboratory findings in Candida infections (3)

A

pH < 4.5

Wet mount: Budding yeast and pseudohyphae

Gram stain: polymorphonuclear cells, budding yeast, pseudohyphae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the RF for yeast infection (4)?

A

Sexual activity

Recent abx use

Pregnancy

Immunosuppression (HIV, poorly controlled DM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the options to treat non albicans VVC?

A

Boric acid insert

Flucytosine cream

Amphotericin B suppository

Nystatis suppository

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the other name for strawberry cervix and what is it associated to?

A

Colpitis macularis

Associated to trichomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the Amsel criteria (4)

A

3 out of 4 for BV diagnosis

  • Adherent and homogenous vaginal discharge
  • Vaginal pH > 4.5
  • Detection of clue cells on saline wet mount
  • Positive wiff test (amine odour after addition of K hydroxide)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name the reasons to prescribe supressive treatment for HSV (5)?

A

At least 6 recurrences per year

Less than 6 recurrences but significant complications with recurrences

Need to lower risk of transmission to partner, fetus, neonate

Problem with QoL

Social or sexual dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the treatment schemes for herpes ?

A

1- Episodic treatment

2- Supressive treatment (only effective during treatment)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the classic triad of NEONATAL HSV infection

A

Skin lesions

Chroniretinitis

CNS abnormalities (seizures, lethargy etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the risk of neonatal HSV infection in :

1- Primary infection

2- Recurrence

What is the risk of post-natal infection without prevention?

A

1- Primary infection: 30 - 50 %

2- Recurrence: < 1 %

Post-natal infection without prevention: 15 %

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe CONGENITAL neonatal HSV

A

Microcephaly, hydrocephaly, ventriculomegaly

Hepatosplenomegaly

Echogenic bowel

Spasticity, flexed extremities

IUGR

IUFD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the treatment of maternal primary HSV infection?
**Non severe maternal disease** Acyclovir 400 mg po tid × 7–10 days Valacyclovir (Valtrex) 1 g po bid × 7–10 days **Severe maternal disease** Acyclovir 5-10 mg/ kg q 8h until clinical improvement then PO tx x 10 days **Prophylactic regimen at 36 weeks**
26
How do you manage a HSV discordant couple (male infected, mother non infected) in pregnancy?
Type specific serologies in the mother before or as soon as pregnant Repeat maternal serologies at 32 -34 weeks Abstinence for any relations Condom + supressive therapy in partner
27
What are the different types of HSV infection?
**Primary infection** (flu like, lesions, tender LN + miction) **Non-primary first episode** (infection with other virus type) **Recurrent** **Asymptomatic shedding**
28
What are the tests to diagnose HSV (2+2) + (2)?
**1- Viral identification tests** - Viral culture - Viral NAAT - Immunofluorescent staining (lack sensitivity) - Tzanck test (lack sensitivity) **2- Serologies** (good negative predictive value) - Type specific - Non type specific
29
Name risk factors to HSV infection (8)
Female Older age Non-caucasian Immunocompromised Hx of any STI Hx of genital lesions in self or partner Multiple sexual partners Low socio-economic level
30
What kind of organism is Trichomonas Vaginalis? To what kind of cells does it adhere?
Anaerobic parasitic protozoan (flagellated) Adheres to epithelial cells
31
What is the most common non viral STI?
Trichomonas vaginalis
32
Describe symptoms of Trichomonas
**Asymptomatic 60 - 90 %** **Symptomatic** Significant increase in vaginal discharge Green, yellow, Malodorous, Frothy appearance Pruritus: Vulvitis, vaginitis Dysuria, Dyspareunia Colpitis macularis on genital mucosa and cervix (strawberry cervix)
33
Describe the 3 diagnostic methods for Trichomonas vaginalis
**- Wet mount** (direct visualization of parasite) **- Vaginal culture** **- Antigen testing (most specific/sensitive)** NAAT or immunoassays
34
What is the treatment of Trichomonas?
Flagyl 500 mg PO BID x 7 days OR 2g PO x 1
35
What are the treatment options for Trichomonas resistant to Flagyl?
Tinidazole 2 g PO x 1 Longer/ higher doses of flagyl
36
Is a test of cure required for Trichomonas?
NO according to SOGC Guidelines UpToDate Between 2 weeks - 3 months after completion of treatment High re-infection rate (20%)
37
Should you treat the partner of a patient with trichomonas?
Yes - even without testing them
38
What is the recommended treatment for BV ?
Flagyl 500 mg PO BID x 7 days Flagyl gel 0.75 % - 5g PV daily x 5 days Clinda cream 2 % - 5 g PV daily x 7 days Alternative Flagyl 2g PO x 1 Clinda 300 mg PO daily x 7 days
39
What are the indications for long term supressive BV therapy? What are the treatment regimen?
\> 3 documented episodes in 12 months * Metronidazole gel 0.75 % * Oral nitroimidazole x 7-10 days then twice weekly gel x 4-6 mo * Clinda gel less effective but ok if allergic to flagyl -- can also desensitize
40
What is the treatment of vaginal warts in pregnancy?
TCA only
41
What therapies are effective for treating vaginal warts (4)?
TCA BCA Interferons Laser ablation
42
When should you test for HIV status is pregnancy (3)? (# 185)
**At first appointment** (tx initiated at 15 -19 wks) **In every trimester** if HIV neg but **high risk behaviours** **In labour** if HIV status unknown (if high risk, offer prophylaxis + fetal tx)
43
Name high risk behaviours for HIV (5)? | (#185)
Sharing needles during **IV drug use** Unprotected sex with **multiple partners** Unprotected sex with a **known HIV-positive individual** Unprotected sex with a partner from a known **endemic area** Unprotected sex with a partner participating in **known high risk behaviours**
44
After how long on cART is it considered safe to have condomless intercourse? (#354)
**Minimum:** on cART for a minimum of **3 months** AND **2 negative viral loads one month apart** Ideal: viral load negative x 6 months Acceptable: viral load negative x 3 months
45
Are HCV medication safe during pregnancy? (#354)
**Not safe in pregnancy and immediate pre-conception** Should treat (and cure) HCV pre-conceptin For male, new HCV Rx are safe during pre-conception except for Ribavarin (to stop 6 months before)
46
What are the outcomes of HIV + patients in fertility treatments (4) (#345)
↓ implantation ↓ clinical pregnancies ↓ birth rates Possible tubal factors for non IVF pregnancies
47
When should you refer a HIV + couple to fertility ? (#345)
After 6- 12 months of attempts at home (condomless sex, home insemination)
48
49
What is the riskf of HIV transmission through breast milk ? (# 310)
Approx 10 % 9.3 (3.8 - 14.8)
50
What are the criteria to plan a elective CS for HIV infected mother? (#310)
Unknown viral load Viral load \> 1000 copies/mL No cART during pregnancy, regardless of viral load \*\* Only benefit is for scheduled CS (not in labour)
51
What medication should be given to HIV + mother that present in labour? (#310)
IV ZVD = Zidovudine (2 mg/kg/h then 1 mg/kg/h) - to everyone +/- Nevirapine 200 mg PO x 1 -- if no cART If unknown status and high risk, give ZVD Nevirapine
52
What is the only pre-requisit for a SVD in HIV + patient? (#310)
Viral load \< 1000 within 4 weeks of delivery
53
Which cART should be stopped in labour and why? (#310)
Stavudine (d4T) as it interacts with ZVD= Zidovudine
54
What blood work HIV related should you ask for at the first visit? (#310)
CD4 count HIV Viral load HIV genotype drug resistance HLA-B\*5701 at baseline
55
What common obstetrics Rx should not be used in combination to cART? (#310)
**PPH**: Ergotamine **Stop breast milk** : Bromocriptine + Cabergoline (borth derivative of ergot) Ergotamine causes exaggerated vasoconstriction in patients on Protease inhibitors
56
When should you test an infant for HIV infection ? (#310)
**Basic testing with HIV PCR** * At birth * 4 weeks * 3-4 months **To exclude HIV** 2 HIV virological test non reactive: - After 4 weeks of age and - \> 4 weeks after end of prophylactic antiretrovirals
57
How long can mother's HIV AB stay in infant's blood? (#310)
18 -24 months
58
What is the gloves and socks rash associated with ? (# 316)
Parvo B19 Mostly in adults - Children get Slap cheeks rash
59
What is the most common symptom in adults with parvo B19? (#316)
Arthropathy Symmetric polyarthralgia (hands, wrists, ankles, knees) May last weeks to months
60
What are the different presentations maternal and fetal of parvo infection (5 + 3)
Maternal * Asymptomatic * Erythema infectiosum * Arthralgia * Anemia + transcient aplastic crisis * Myocarditis Fetal * Anemia (+ hydrops) * Myocarditis * Fetal loss
61
62
How long can IgM remain positive in Parvo/ CMV/Toxo?
Parvo : 6 months Toxo: years CMV: months
63
% Spontaneous resolution of hydrops in Parvo ?
30 % over course of 4+6 weeks (more common in older fetuses as immune sme more developped)
64
Name reasons to perform amnio in Toxo infection (3) (285)
* Confirmed diagnosis of maternal infection * Cannot confirm or exclude maternal infection by serologic testing * Abnormal US findings (Intracranial calcifications, microcephaly, hydrocephalus, ascites, hepatosplenomegaly, severe IUGR)

RC OBGYN (CG) (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions