Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pediatrics > Lecture 4: Congenital Infections > Flashcards

Lecture 4: Congenital Infections Flashcards

(82 cards)

Start Studying
1
Q

What characterizes a congenital infection?

A
  • Growth retardation
  • Congenital malformation
  • Fetal loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the ToRCHeS VP infections?

A
  • TOxoplasmosis
  • Rubella
  • CMV
  • HIV
  • HErpes
  • Syphilis
  • Varicella
  • Parvo

Hep

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

What kind of pathogen is toxoplasmosis?

A

Protozoan, toxoplasma gondii

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

When is toxoplasmosis screening indicated?

A
  • High index of suspicion + significant cervical LAN and high fever
  • US of fetus shows calcifications or effusions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What risk factors are associated with toxoplasmosis transmission for maternal to fetal?

A
  • Maternal infection at advanced gestational age
  • High parasite load
  • Cat feces more infective than meat
  • Maternal immunocompromised
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the S/S of congenital toxoplasmosis infection?

A
  1. Cataracts/chorioretinitis
  2. Calcifications in brain
  3. Hearing loss
  4. Anemia
  5. Seizures
  6. Hydrocephalus
  7. Microcephaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the typical lesion seen in congenital toxoplasmosis?

A

Focal necrotizing retinitis

Cataracts/chorioretinitis is the primary sign of congenital toxo

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

How is congenital toxoplasmosis diagnosed?

A
  • ELISA
  • CT/XRAY showing diffuse cortical calcifications
  • IgM will appear within 1 week
  • IgG Ab will appear after 2 weeks and persist.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is congenital toxoplasmosis treated?

A
  • < 14wks gestation = spiramycin
  • > 14wks gestation = pyrimethamine + Sulfadiazine + folic acid

TREAT MOTHER

Young SPYro the dragon
PYRo and SULFur are FOUL

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

If a infant is diagnosed with congenital toxoplasmosis prenatally, what is the postnatal tx?

A
  • Pyrimethamine + sulfadiazine + folinic acid for 1 yr
  • Must treat even if mother was not treated
  • Eye exams every 3 months until 18 months.

Same as mom’s tx after 14wk gest

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

How do we prevent toxoplasmosis?

A
  • No raw meat or exposure
  • Avoid cat litter
  • Wash stuff
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is rubella also known as?

A

German measles

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

What is the main concern with congenital rubella infection?

A

High risk of fetal death or preemie stillborn

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

What are the two main infections that lead to miscarriage?

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

What are the findings associated with congenital rubella?

A
  • Blueberry muffin syndrome (bluish hue with purpura
  • Ophthalmologic (Cataracts)
  • Cardiac (PDA and pulm artery stenosis)
  • Hearing loss (sensorineural)
  • Mental retardation
  • Microcephaly

Eye Heart Ruby Earrings

I heart Ruby Earrings

Eye, heart, rubella, hearing!

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

How is rubella diagnosed?

A

Antibody tests

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

How does plt count present in a newborn?

A

Low, seen with petechiae and purpura

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

What kind of virus is CMV and how is it transmitted?

A
  • Doublestranded DNA Herpes Virus
  • Intimate contact (blood, saliva)
  • Transmissible through breast milk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How common is CMV and when is exposure the most risky?

A
  • MC congenital infection!
  • Occurs worse if first trimester

Rarely symptomatic, but if it is, it is severe

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

What is the leading cause of non-hereditary sensorineural hearing loss?

A

CMV

All congenital infections seem to affect hearing ):

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

Image of baby with congenital CMV

A

Reminds me of dave bautista

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

How is CMV diagnosed?

A
  • Elevated LFTs
  • Thrombocytopenia
  • Elevated bilirubin
  • Urine/Saliva within first 3 weeks of life
  • CT showing periventricular lesions
  • If found within first 3 weeks, congenital. If after, perinatal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is congenital CMV treated?

A
  • Ganciclovir and Valganciclovir for symptoms.
  • Must request approval for tx for severe symptoms.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which HSV is the primary cause of congenital herpes?

A

HSV2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What combination in reference to herpes is the highest risk of infecting a baby?
Primary genital herpes + vaginal birth | 25-50%
26
What is more common: neonatal or congenital?
Neonatal
27
What is unique about up to 75% of all infants with acquired HSV infections?
Mothers had no previous hx or clinical findings.
28
Who should we consider disseminated HSV infection in?
* Sepsis * Liver dysfunction * Negative bacteriologic cultures * Fever * Abnormal CSF * Irritability | HSV is often very severe.
29
What is the triad of congenital herpes?
1. Skin vesicles 2. Ulcerations 3. Scarring eye damage | Herpes is SUS
30
How is congenital HSV diagnosed?
* Specimen cultures (practically anything amniotic fluid touched) * PCR for blood/urine/CSF detection
31
What is the TOC for congenital HSV?
IV Acyclovir (60mg/kg/d) for 2-3 weeks | Give to **any infant that is suspected to have it.**
32
What is the primary intervention for a mother if she has active genital lesions?
C-section!
33
When does an infant MC get VZV infections?
Mother infected between weeks 8-20. | Perinatal transmission is severe and disseminated. ## Footnote Perinatal VZV = 5 days prior or 2 days post delivery.
34
How does congenital varicella present?
* Cicatricial skin lesions (**zig zag lesion + limb atrophy**) * Cataracts, retinitis * Hydrocephalus, microcephaly, seizures, mental retardation * High death rate if Mother develops VZV 5-7 days postpartum. | Congenital VZV looks BAD
35
How is congenital varicella diagnosed?
* Characteristic skin lesion * PCR of vesicle base
36
How is congenital varicella treated?
* **Prophylaxis:** VariZIG given to infants younger than 28wks gest following postnatal exposure * Active tx: Acyclovir 30mg/kd/d TID * **Breastfeeding encouraged!** | BFeeding has antibodies in it i think to help
37
What are the alternative names to Parvo B19?
* Human Parvovirus B19 * Fifth's disease * Erythema infectiosum | Hand slap
38
Who is infection rate highest in for parvo B19?
* Teachers * Daycare workers
39
What % of women are usually immune to parvovirus B19?
1/2
40
What are the S/S of Congenital Parvo B19?
* **Fetal anemia (aplastic)** * Myocarditis * **Hydrops fetalis** * **Rash (slapped cheeks)** * Arthropathy | a plastic parvo ## Footnote Hydrops fetalis = abnormal accumulation of fluid in 2+ fetal compartments
41
How is Parvo B19 diagnosed?
* Serology * Percutaneous umbilical cord blood sample
42
If a mother is diagnosed with Parvo B19, how is the fetus monitored?
**US weekly** for signs of hydrop fetalis | Drop the Parv
43
What causes syphilis?
Spirochetes, treponema pallidum
44
How is syphilis MC transmitted congenitally and what does it usually result in?
**Transplacental infection**, resulting in a 40% chance of spontaneous abortion
45
How do most infants present with congenital syphilis?
Asymptomatic at birth.
46
If congenital syphilis appears prior to age 2, how does it usually present?
1. **Nasal Snuffles** (persistent, white) 2. Rash 3. Hepatomegaly 4. Generalized LAN 5. Skeletal abnormalities
47
**If congenital syphilis appears after age 2**, how does it usually appear?
* CNS Abnormalities * Teeth abnormalities
48
What are the late S/S of congenital syphilis?
* **Hutchinson's triad: interstitial keratitis, 8th CN deafness, hutchinson's teeth** * Rhagades * Bowing shins * Saddle nose * Mulberry molars * Clutton joints
49
How is syphilis diagnosed?
**Direct visualization via dark field exam** of bodily fluids
50
What is the treatment for congenital syphilis?
* **IV Pen G** for 10 days * **Procaine Pen G** for 10 days * Repeat antibody titers at 3/6/12 months to make sure its falling
51
What is the MCC of **sexually transmitted genital infections** in the US?
Chlamydia | Chlamydia is Common
52
How does congenital chlamydia usually present?
* **Conjunctivitis (bilateral)** * Pneumonia | The main reason for erythromycin ointment at birth
53
How is chlamydia diagnosed?
* Suspected in **any infant under 1 month with conjunctivitis** * **Gold standard: Culture of conjunctival and NP**
54
How is chlamydia treated in an infant?
* **Oral erythromycin** QID x2wk * Screen all pregnant women at first visit | Cannot use topical if they are born with it?
55
What kind of organism is gonorrhea?
G- diplococci
56
How does congenital gonorrhea present?
* Bilateral **purulent** conjunctivitis * Profuse exudate
57
Who is at increased risk for gonorrhea?
* Previous STD * Multiple partners * Inconsistent condom use * Sex workers * Drug use * High endemic area
58
What is the prophylaxis for congenital gonorrhea?
Erythromycin ointment | Prevention of conjunctivitis
59
How is congenital gonorrhea diagnosed?
Gram stain of conjunctival exudate
60
How is congenital gonorrhea treated?
Single dose of Rocephin | Also treat asymptomatic infants if mother is untreated ## Footnote GR
61
How is HIV transmitted to a baby?
Transplacental or **breastfeeding**
62
How is congenital HIV diagnosed?
HIV DNA PCR
63
How is congenital HIV treated?
Antiviral prophylaxis (Zidovudine) for 6 weeks
64
How is Congenital Hep C transmitted primarily?
Vertical | **Breastfeeding is not CI.**
65
How is congenital Hep C diagnosed?
**Anti-HCV present in blood at 18 months of age**, confirmed with HCV RNA, then HCV genotyping.
66
What are the primary treatment options for congenital Hep C and what determines it?
Interferon and ribavirin, determined by GI.
67
How does congenital HPV present?
Hoarseness (airway)
68
What kind of virus is zika virus and how is it transmitted?
Arthropod flavivirus from mosquitoes, with **placental transmission.**
69
How does congenital zika present?
* FGR * Fetal demise * Ventriculomegaly * Microcephaly * Ocular scarring * Sensorineural deafness * Arthrogryposis (weird limb formation) * ASD/VSD/PFO * Hypertonia/Spasticity/Hyperreflexia/seizures * SGA
70
How is congenital zika evaluated?
* H&P (head circumference and development) * Labs * Cranial US (anterior fontanelle is still open) * Hearing assessment
71
What two labs being negative make zika very unlikely?
* Serum Zika IgM * CSF for RNA and IgM
72
What lab combination is definite for congenital zika?
Serum + Urine for Zika RNA via PCR | Both positive = definite
73
What is the primary imaging screening tool for congenital zika?
Cranial US
74
What referrals are indicated for congenital zika?
* Ophthalmology * Hearing screen (ABR) * Neurology, ID, genetics, development ## Footnote ABR = auditory brainstem response test
75
What is the definition of a newborn/neonate?
First 28d of life
76
What are the 3 major routes of perinatal infection?
1. Bloodborne transplacental (CMV) 2. Ascending due to disruption of amniotic barrier 3. Infection via birth canal (HSV, HIV, GBS)
77
What is the MC pathogen to cause bacterial sepsis in a newborn?
Group B strep
78
How does early-onset newborn sepsis present?
1. Respiratory distress 2. Hypotension 3. Acidemia 4. Neutropenia 5. Temperature instability 6. Poor feeding 7. Irritability 8. Lethargy | Within 24 hrs
79
What temperature is considered suspicious for newborn sepsis and requires full W/u?
Rectal temp of 100.4 for any infant younger than 60d = full workup. | Anything under 90d is just newborn sepsis.
80
What is in a newborn sepsis workup?
* CBC/BMP * Urine cath and culture * CXR * CRP and procalcitonin * Blood cultures * NP swab * LP cultures
81
What is the empiric prophylaxic ABX therapy for newborn sepsis?
1. Ampicillin + cefotaxmine 2. Ampicillin + gentamicin 3. Acyclovir +/- | amp and tax the neonate
82
Summary of ToRCHeS VP

Pediatrics (23 decks)

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