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OBGYN - Infectious diseases Flashcards

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1
Q

What is the most common cause of CAP in pregnancy

A

S. pneumoniae

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2
Q

What is the most common cause of influenza pneumonia?

A

Influenza A and B

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3
Q

What is the most frequent complication of pneumonia?

A

premature rupture of membranes

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4
Q

What is the DOC for initial therapy in pneumonia in pregnancy?

A

Macrolide

If sever, Fluoroquinolones

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5
Q

What is the vaginal pH in patients suspected with Bacterial Vaginosis?

A

pH >4.7

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6
Q

What is the Amsel’s criteria for vaginal vaginosis?

A
  1. pH >4.7
  2. Clue cells
  3. Milky white discharge
  4. Fishy ordor when KOH is added

BacVag is 3 out 4

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7
Q

What is the DOC for BacVag?

A

Metronidazole 500mg/tab BID x 7 days

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8
Q

[Diagnosis]

Green-yellow frothy vaginal discharge
offensive odor
strawberry cervix
dyspareunia
vulvovaginal soreness, itching
A

Trichomoniasis

Gold standard: culture

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9
Q

What is the vaginal pH in patients with trichomoniasis?

A

pH >4.5

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10
Q

What is the treatment for Trichomoniasis?

A

Metronidazole 2grams single dose

treat partner

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11
Q

In breastfeeding woman with trichomoniasis,what will you advise the mother?

A

Stop breastfeeding for 12 to 24 hours AFTER the last dose

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12
Q

Pregnant patient on her 1st trimester had trichomoniasis, what will you advise?

A

Withold metronidazole until after first trimester

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13
Q

What is the most common clinical presentation of vulvovaginal candidiasis?

A

Vulval pruritus

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14
Q

what will you see under the microscope in patients with vulvovaginal candidiasis?

A

Pseudohyphae (mycelia) and or budding yeast (coinidia)

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15
Q

What is the vaginal pH in patients with vulvovaginal candidiasis?

A

Normal 4.0 to 4.5

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16
Q

What topical azole is contraindicated in pregnant patients with VVC?

A

Fluconazole

The rest, give for 7 days as cream, suppository or tablet

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17
Q

What is the DOC for C. trachomatis in pregnancy

A

Azithromycin 1g PO SD

alternative: amoxicillin 500mg PO TID x 7 duas

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18
Q

How will you treat the partner of a pregnant patient infected with C. trachomatis?

A

Treat sexual partners during the 60 days preceding the onset of symptoms

Give Azithromycin 1g PO SD

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19
Q

What is the culture medium used to culture N. gonorrheae?

A

Thayer-Martin

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20
Q

What are the perinatal complications of gonorrhea?

A
  1. Ophthalmia neonatorum
  2. Pharyngeal and respiratory tract infection
  3. Anal canal infection
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21
Q

What is the DOC for gonorrhea in pregnant patients?

A
  1. Ceftriaxone 250mg IM SD OR
  2. Cefixime 400mg/tab SD
  3. Cephalosporin Injectible PLUS Azithromycin 1g PO single dose PLUS treatment for chlamydia
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22
Q

What are the ocular prophylaxis for gonorrhea in infants

A
  1. 1% silver nitrate solution
  2. 1% tetracycline ointment or solution
  3. 0.5% erythromycin ointment within one hour after borth
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23
Q

What antibiotic can you give for patients allergic to penicillin

A

Azithromycin

Cephalosporin is not tolerated for patients allergic to penicillin

NEVER GIVE QUINOLONES OR TETRACYCLINE

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24
Q

Most common method of transmission of syphilis to infants

A

Transplacental

Neonatal - contact with genital lesions and emmbranse

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25
What is the screening test for syphilis
Non-treponemal tests VDRL or RPR
26
What are the confirmatory test for syphilis during pregnancy?
1. FTA-ABS 2. TP-PA 3. MHA-TP, TP PA
27
What is the recommended treatment for early syphilis during pregnancy?
Benzathine penicillinG as single IM dose
28
What is the recommended treatment for early syphilis during pregnancy?
1. Aqueous crystalline penicillin G OR | 2. Aqueous procaine penicillin
29
___ reaction often appears after penicillin treatment of women with primary and secondary syphilis characterized by uterine contractions accompanied by late fetal heart decelerations
Jarish-Herxheimer reaction
30
What is the DOC for herpes simplex in pregnancy?
Acyclovir for >/36 weeks AOG They can breastfeed as long as there are no active breast lesions
31
What is the fetal immunoglobulin which responds to infection?
IgM
32
When does fetal cell mediated and humoral immunity begin to develop?
9 to 15 weeks
33
[Diagnosi] pruritic vesicles over the trunk and extremities some with crusting
Varicella = chickenpox
34
How many doses of varicella vaccine do you need to give?
2 doses
35
How will you manage a pregnant woman with significant exposure to a person with varicella
Get a VZV serology if seropositive, patient is immune if seronegative, give VZIg within 96 hours up to 10 days of exposure
36
What are the components of Congenital Varicella Syndrome?
1. Chorioretinitis 2. Micropthalmia 3. Cerebral Cortical atrophy 4. Growth restriction 5. Hydronephrosis 6. Limb hypoplasia 7. Cicatricial skin lesion
37
In mothers with clinical evidence of varicella 5 days before and up to 2 days after delivery, what will be your management to the infant
give VZIg to neonate
38
[Rubella] What immunoglobulin will you check if patient had rubella 4-5 days after onset of clinical disease up to 6 weeks after appearance of rash?
Serum IgM
39
[Rubella] Immunoglobulin that peaks 1-2 weeks after appearance of rash
Serum igG
40
A woman should not get pregnant after receiving MMR vaccine within ____ month
1 month
41
What are the components of congenital rubella syndrome?
1. Sensorineural deafness 2. Cataracts 3. congenital glaucoma 4. Central nervous system degect
42
What is the most common perinatal infection?
CMV Present in body fluids including breastmilk
43
___ can cause tetanus neonatorum
C. tetani
44
Clostririum species know to cause septic abortion
C. perfringes
45
[Diagnosis] fever tachycardia out of proportion of the fever; uterin discharge, marked leukocytosis; intravascular hemolysis, jaundice, hemogloninuria hypotension, renal shutdown, DIC
C. perfringes
46
Symotoms of infant tetanus can appear from ___ to ___ days
1 day to 30 days
47
What is the schedule in giving Td/Tdap in pregnancy?
0,1,6-12 months then every 10 years
48
Universal vaginal and rectal GBS screening and culture should be done at ___
35 to 37 weeks
49
Intrapartum prophylaxis for tetanus is indicated in the following
1. Previous infant with GBS disease 2. GBS bacteriuria during current pregnancy 3. Positive GBS screening culture 4. Unknown GBS status
50
What are the recommended Intrapartum prophylaxis for C. tetany?
1. Penicillin G (IV) Alternative: Ampicillin (IV) Alternative to penicillin: Cefaz, Clinda
51
Unkown GBS status and the following requires intrapartum tetanus prophylaxis
1. Delivery <37 weeks 2. Amniotic membrane rupture >18 hours 3. Intrapartum temperature >38 degC 4. Intrapartum NAAT positive for GBS
52
[Diagnosis] Stillborn preterm delivered at 30weeks AOG; amniotic fluid is brownish during delivery
Listeriosis
53
What is the characteristic placental finding associated with listeriosis?
pale placenta
54
Stage of toxoplasma that can cross the placenta and affect the fetus
Tachyzoites Toxoplasmosis has no vaccine
55
What are the characteristic ultrasound findings of toxoplasmosis in the fetus?
1. Intracranial calcifications 2. Hydrocephay 3. Liver calcifications 4. Hyperechoic bowel 5. ascites 6. Placental thickening 7. Growth restriction
56
What are the triad of toxoplasmosis in the fetus?
1. Chorioretinitis 2. Intracranial calcifications 3. hydrocephalus (convulsions)
57
What drug can reduce congenital infection of toxoplasmosis?
Spiramycin
58
Drugs that can be given to eradicate toxoplasmosis parasites in the placenta and fetus
1. Pyrimethamine 2. Sulfonamides 3. Folinic acid only after 18 weeks or suspected fetal infection
59
In pregnant women with malaria, what accumulates in the palcenta?
infected erythrocytes A. flavoristris
60
What is the gold standard for the diagnosis of malaria?
Blood smear
61
What antimalarial drug can you give to pregnant patients during the 2nd and 3rd trimester
Sulfadoxine-pyrimethamine
62
What drug decreases the placental infection of malaria?
Chlorquine and hydroxychlorquine
63
What drugs used for malaria are contraindicated during pregnancy
Primaquine | Doxycycline
64
What drugs used for malaria are contraindicated during pregnancy
Primaquine | Doxycycline
65
[Prevention of Zika] What will you advise to women planning to conceive?
Delay conception at least 8 weeks after symptom onsent
66
[Prevention of Zika] What will you advise men planning to conceive?
Delay conception at least 6 months
67
What is the criteria for asymptomatic bacteriuria?
>100,000 organisms/mL
68
What is the treatment for asymptomatic bacteriuria?
1. Amoxicillin 3g SD 2. Ampicilin 2g SD 3. Nitrofurantoin 200mg SD
69
What is the most common GI cause of surgery during pregnancy?
appendicitis
70
What are the complications of hyperemesis gravidarum?
1. Weight loss 2. Dehydration 3. Ketosis 4. Alkalosis - (loss of HCl, Low K) 5. Transient hepatic dysfunction
71
What causes crab louse?
Phthirus pubis pepper grain feces in hair shafts
72
What is the most contagious of all STIs
Phthirus pubis
73
What is the most common viral STD?
HPV 6, 11 Tx: Podofilox 0.5% solution or gel; Imiquimod 5% cream (contraindicated to pregnant patients)
74
What is the most accurate and sensitive test to diagnose HSV?
PCR
75
What test determines antibodies to HSV for its definitive diagnosis?
Western blot
76
"school of fish" in microscopy
Chancroid H. ducreyi Tx: azithromycin 1g orally
77
[Phase of LGV] shallow painless ulcer
primary infection
78
[Phase of LGV] painful adenopathy or bubo
secondary infection
79
[Phase of LGV] multiple draining sinuses
tertiary infection
80
Bipolar safety pin appearance
Donovanosis K. granulomatis Tx: Doxycycline 100mg twice daily
81
[Diagnose] Yellow, frothy, increased odor, cervical erythema pH >4.5
Trichomoniasis
82
What is the gold standard for diagnosis of Bacterial Vaginosis
Gram Stain
83
[Diagnosis] white cheesy discharge, pruritus, vulval burning, external dysuria, dypareunia
candidiasis Tx: Butoconazole
84
What is the gold standard in diagnosng N. gonorrheae
NAAT Tx: Ceftriaxine 250mg IM or Cefixime 400mg PO + Chlamydia therapy

Infectious Disease (OSI type) (24 decks)

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