Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCOG Antenatal Part 2 Revision - Hay > Infectious diseases pregnancy - TORCH > Flashcards

Infectious diseases pregnancy - TORCH Flashcards

1
Q

What is the incubation of parvovirus? How is it spread?

A

Respiratory

5-10days

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

When does the rash appear with parvovirus?

A

Rash does not occur until 17-18 days after infection and about 5 days after the disappearance of virus from serum and respiratory droplets.

Therefore patients presenting with the clinical features of infection are usually no longer infectious

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

What % of people are sero+ve?

A

60%

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

How do children commonly present with parvovirus?

A

Erythema infectious/fifths disease ‘slapped-cheek’

Fever, facial rash

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

How do adults present B19?

A

Variable
Some asymptomatic
Fever, malaise, arthraligia
Rare - aplastic crisis

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

Risk of vertical transmission:
<15 weeks
15-20 weeks
Term
Generally

A

<15: 15%
15-20% - 25%
Term 70%
30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Risks to pregnancy effected by parvovirus?

A

Fetal death 5-10% (highest risk 2nd tri)
Nonimmune fetal hydrops - 3% 9-20 weeks
Fetal anaemia

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

If B19 IgM +ve what does this suggest

A

Recent infection, will be detect days 3 after symptoms but can remain high for up to 6 months

If negative repeat after 2-3 weeks

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

If B19 IgG +ve what does this suggest

A

Immunity, rises on day 7 but remains high for life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

IgG and IgM -ve

A

Susceptible

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

What other infections should you always test for?

A

Rubella

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

If maternal Dx of parvovirus is confirmed, how should the foetus be monitored?

A

Refer FMU 4 weeks after onset of Sx, for serial USS and doppler
Assessing for anaemia, heart failure and hydros
1-2 weeks MCA and peak systolic velocity

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

B19 when should cordiocentesis be considered/

A

If MCA peak systolic resistance is >18

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

Who is at higher risk of aplastic crisis with B19?

A

Sickle cell, heredity anaemias (spherocytosis, thalassaemia, pyruvate kinase deficicency ,auto-immune haemolytic anaemia

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

How Is Rubella spread?

A

Resp droplet

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

What % of infected with rubella have symptoms?

What symptoms may there experience?

A

50-75%

Fever, rash, arthralgia, lymphadenopathy (post-auricular/sub-occiptal)

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

Describe finding with congenital rubella syndrome?

A

Eyes - cataracts, retinopathy, glaucoma
Heart - patent ductus/valve stenosis, VSD
Ear - deafness

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

What is the risk of congenital rubella syndrome? Management?
< 11 weeks

A

90% - Offer TOP

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

What is the risk of congenital rubella syndrome? Management?
11-16 weeks

A

10-20%, deafness common = Amniocentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the risk of congenital rubella syndrome? Management
> 20 weeks

A

No babies effected.- NAD

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

What advice should you give a person who has rubella

A

Inform PHE (notifiable)
Avoid contact with pregnancy women, stay off work, contact health protection taeam

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

How is measles spread

A

Resp illness

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

What type of pathogen is measles?

A

Single-stranded, enveloped RNA virus

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

What is the common presentation of measles?

A

Prodrome: Fever, malaise, cough, coryza & conjucitivits
3-4 days later
Maculopapular rash, head to truck to lower extremes
Koplik spots - small white lesions on erythematous base.

25
Q

Incubation of measles?

A

10-12 days, rash appears 14 days after expose

26
Q

When is someone with measles infective?

A

4 days before to 4 days after onset of rash

27
Q

If susceptible what % of people expose to measles will become infected

A

90%

28
Q

Possible compilations of measles to mother?

A

Pneumonia
Encephalitis
Preg women - high risk morbidity/mortaility

4-10 years later subacute sclerosing pan encephalitis

29
Q

Management of non-immune pregnant women who are exposed to measles?

A

IVIG within 6 days of exposure

30
Q

How should patients with measles be managed?

A

Supporive, isolated in airborne isolation room.

31
Q

Impact of measles on foetus?

A

No increased in congenital abnormalities

Increased risk
- low birth weight
- NICU
- pregnancy loss
- neonatal mortality

32
Q

When is congenital measles most likely to occur?

A

Presence of rash at birth or within 1st 10 days of life

Risk mortality and subacute sclerosis panencephlitis

33
Q

What is the most common congenital viral infection in pregnancy?

A

Cytomegalovirus

34
Q

What type of pathogen is cytomegalovirus?

A

DNA

35
Q

Most common maternal symptoms of cytomegalovirus?

A

Asymptomatic
- self-limiting febrile illness

If immunocompromised - pneumonia, hepatitis

36
Q

Risk of fetal infection with primary infection of cytomegalovirus?

A

30-40%

Risk highest in 1st/early 2nd trimester

37
Q

Risk of fetal infection with reactivation of cytomegalovirus?

A

1-2%

38
Q

What % of women seroconvert cytomegalovirus in pregnancy?

A

2%

39
Q

What is the incubation of cytomeaglovirus?

A

3-12 weeks

40
Q

How is cytomegalovirus spread?

A

Sexual contact/bodily fluids (blood/breast/urine)

41
Q

What % of congenital CMV show symptoms at birth?

What % later become symptomatic?

A

90% show no manifestation at birth (10% do)

A further 10% later develop signs in later life

42
Q

What is the most common cause of congenital sensorineural deafness?

A

Cytomegalovirus

43
Q

Fetal risks of CMV

A

Sensorineural deafness
Hepatopsplenomegaly
IUGR
Microcepahly
Thrombocytopenia
Seizures

44
Q

How to diagnose fetal infection of CMV?

A

Amniocentesis 6-8 weeks after seroconversion/reactiveation or >20 weeks

45
Q

How to manage pregnancy if fetal CMV confirmed?

A

Detailed USS every 2-3 weeks
Fetal MRI 28-32 weeks

46
Q

If high avidity IgG CMV are high (>60%), what does this mean

A

Suggests infection >3 months ago

47
Q

Advise to avoid contracting CMV - consider for women working in childcare who are pregnancy

A

Wash hands after changing nappies, wash toys, avoid charing food/cutlery with children, avoid kissing young children

48
Q

What type of pathogen is toxoplasmosis?

A

Obligate intracellular protozoan

49
Q

What is the incubation period of toxoplasmosis

A

5-23 days

50
Q

How is toxoplasmosis spread?

A

Becomes sexually mature in cat intestines, producing oocysts which are excreted in stool. Infection occurs through ingestion of contaminated food including vegetable or infected meat.

51
Q

Presentation in adults?

A

Human infection usually asymptomatic / produces glandular fever - like illness. Lymphadenopathy involving the posterior cervical chain is commonest clinical manifestaton.

52
Q

What % of women become infected with toxoplasmosis during pregnancy?

A

1:500

53
Q

Risk of fetal infection with toxoplasmosis if primary infection occurs in:
1st trimester

A

17%

54
Q

Risk of fetal infection with toxoplasmosis if primary infection occurs in:
2nd trimester

A

25%

55
Q

Risk of fetal infection with toxoplasmosis if primary infection occurs in:
3rd trimester

A

60%

56
Q

Risk to foetus with toxoplasmosis infection in pregnancy

A

10% Eye problems only - choriorentinitis can lead to blindness

20-30% - multiple anomalies - hydrocephalus, cerebral microcalcifications, jaundice, thrombocytopenia

60% no symptoms

Organ most commonly effect is the eyes 👀

57
Q

How to Dx toxoplasmosis in pregnancy, in mother and foetus

A

Mother - serology - high IgM or 4 fold increase IgG

Fetus - amniocentesis 6 weeks after seroconversion

58
Q

What medication can given to reduce the risk of transmission of toxoplasmosis?

By what % do these medications reduce the risk of transmission?

A

Spiromycin
or
Pyrimethamine + sulfadazine and colonic acid

70%

MRCOG Antenatal Part 2 Revision - Hay (72 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions