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AHN 548 Exam 1 Questions with
Detailed Verified Answers
Congenital infections- essentials of dx and typical features
Answer: can be acquired in utero, perinatally and postnatally
-Can be asymptomatic in newborn period
-clinical sx complexes include IUGR, chorioretinitis, cataracts,
cholestatic jaundice, thrombocytopenia, skin rash and brain
calcifications
-Dx: PCR, antigen and antibody studies and culture
CMV
(Congenital) Answer: MOST COMMON TRANSMITTED IN
UTERO
Sx: hepatosplenomegaly, petechiae, growth restriction,
microcephaly, direct hyperbili, thrombocytopenia, intracranial
calcifications and chorioretinitis, HEARING LOSS
TX: Ganciclovir therapy 6mg/kg IV q12h for 6 weeks for
symptomatic neonates affecting the CNS and prevent hearing
loss progression
Rubella
(Congenital) Answer: risk of fetal infection and congenital
defects as high as 85% in mothers infected during 1st
trimester.
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SX: microcephaly, encephalitis, cardiac defects (PDA and pul
art stenosis and arterial hypoplasia), cataracts, retinopathy,
and micropthalmia, hepatosplenomegaly, thrombocytopenia
and deafness
Dx: characteristic clinical illness in mother, inc serum rubella-
specific IgM or culture of pharyngeal secretions
Varicella
(Congenital) Answer: Congenital varicella is rare
Sx: limb hypoplasia, cutaneous scars, microcephaly, cortical
atrophy, chorioretinitis and cataracts
Perinatal caricella --> neonate should receive varicella-zoster
immune globulin or IVIG, or if that's not done --> acyclovir.
Toxoplasmosis
(congenital) Answer: Most infants initially asymptomatic
Sx: mental retardation, visual impairment, learning disabilities,
growth restriction, jaundize, chorioretinitis, sz,
hepatosplenomegaly, adenopathy, cataracts, maculopapular
rash, thrombocytopenia, pneumonia
Dx: positive toxoplasma-specific IgA, IgE, or IgM in first 6mo
of life
Tx: spiramycin for mom to prevent transmission to fetus.
Neonatal tx- pyrimethamine and sulfadiazine with folinic acid.
Sources: cat feces, ingestion of raw/undercooked meat
Fetal damage most severe in 2-6th month gestation.
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Parvovirus B19
(Congenital) Answer: If infected during pregnancy- results in
severe anemia, myocarditis, nonimmune hydrops, or fetal
death. If fetus survives, long term outcome is good.
Congenital syphilis Answer: Active primary and secondary
maternal syphilis leads to transplacental passage to fetus in
nearly 100% of cases.
Fetal infection can reult in stillbirth or prematurity.
Sx: mucocutaneous lesions, lymphadenopathy,
hepatosplenomegaly, bony changes, hydrops (newborns often
asymptomatic)
Herpes Simplex
(Perinatal) Answer: acquired during transit through infected
birth canal
Sx days 5-14: localized (skin, eye, mouth) or disseminated
(shock, pneumonia, hepatitis) disease
Sx days 14-28: CNS- lethargy, fever, sz
Dx: viral cultures from vesicles, PCR
Tx: acyclovir 60mg/kg/d divided q8h- 14days if localized, 21
days if disseminated or CNS.
Mom needs c/s if active genital disease
If mom has active lesions at delivery, neonate needs eye,
oropharynx, nasopharynx, rectum and blood HSV PCr- if
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colonized, treatment with acyclovir x10days (if no active
lesions on infant)
Hepatitis B & C
(Perinatal) Answer: Infected at time of birth, intrauterine
transmission rare
If mother haspositive HBsAg, then the infant should receive
HBIG. and hep B vaccine asap after birth. If mom not tested
before birth, run test after, give Hep B vaccine within 12hours,
and if pos, HBIG too.
Enterovirus infection
(Perinatal) Answer: Pos maternal hx of diarrhea, fever and/or
rash.
Sx: appears in first 2 weeks- fever, lethargy, irritability,
diarrhea and/or rash. Can p/w meningoencephalitis,
myocarditis, hepatitis, pneumonia, shock and DIC
Dx: PCR
TX: no identified therapy, good prognosis except those with
hepatitis, myocarditis or disseminated dz
HIV infection
(Perinatal) Answer: Can be acquired in utero at time of
delivery or via breast milk
Known mothers with HIV should be treated with zidovudine
therapy as early as 14weeks gestation. Infant for first 6 weeks
of life beginning within 12hours.
AHN 548 Exam 1 Questions with
Detailed Verified Answers
Congenital infections- essentials of dx and typical features
Answer: can be acquired in utero, perinatally and postnatally
-Can be asymptomatic in newborn period
-clinical sx complexes include IUGR, chorioretinitis, cataracts,
cholestatic jaundice, thrombocytopenia, skin rash and brain
calcifications
-Dx: PCR, antigen and antibody studies and culture
CMV
(Congenital) Answer: MOST COMMON TRANSMITTED IN
UTERO
Sx: hepatosplenomegaly, petechiae, growth restriction,
microcephaly, direct hyperbili, thrombocytopenia, intracranial
calcifications and chorioretinitis, HEARING LOSS
TX: Ganciclovir therapy 6mg/kg IV q12h for 6 weeks for
symptomatic neonates affecting the CNS and prevent hearing
loss progression
Rubella
(Congenital) Answer: risk of fetal infection and congenital
defects as high as 85% in mothers infected during 1st
trimester.
, Page | 2
SX: microcephaly, encephalitis, cardiac defects (PDA and pul
art stenosis and arterial hypoplasia), cataracts, retinopathy,
and micropthalmia, hepatosplenomegaly, thrombocytopenia
and deafness
Dx: characteristic clinical illness in mother, inc serum rubella-
specific IgM or culture of pharyngeal secretions
Varicella
(Congenital) Answer: Congenital varicella is rare
Sx: limb hypoplasia, cutaneous scars, microcephaly, cortical
atrophy, chorioretinitis and cataracts
Perinatal caricella --> neonate should receive varicella-zoster
immune globulin or IVIG, or if that's not done --> acyclovir.
Toxoplasmosis
(congenital) Answer: Most infants initially asymptomatic
Sx: mental retardation, visual impairment, learning disabilities,
growth restriction, jaundize, chorioretinitis, sz,
hepatosplenomegaly, adenopathy, cataracts, maculopapular
rash, thrombocytopenia, pneumonia
Dx: positive toxoplasma-specific IgA, IgE, or IgM in first 6mo
of life
Tx: spiramycin for mom to prevent transmission to fetus.
Neonatal tx- pyrimethamine and sulfadiazine with folinic acid.
Sources: cat feces, ingestion of raw/undercooked meat
Fetal damage most severe in 2-6th month gestation.
, Page | 3
Parvovirus B19
(Congenital) Answer: If infected during pregnancy- results in
severe anemia, myocarditis, nonimmune hydrops, or fetal
death. If fetus survives, long term outcome is good.
Congenital syphilis Answer: Active primary and secondary
maternal syphilis leads to transplacental passage to fetus in
nearly 100% of cases.
Fetal infection can reult in stillbirth or prematurity.
Sx: mucocutaneous lesions, lymphadenopathy,
hepatosplenomegaly, bony changes, hydrops (newborns often
asymptomatic)
Herpes Simplex
(Perinatal) Answer: acquired during transit through infected
birth canal
Sx days 5-14: localized (skin, eye, mouth) or disseminated
(shock, pneumonia, hepatitis) disease
Sx days 14-28: CNS- lethargy, fever, sz
Dx: viral cultures from vesicles, PCR
Tx: acyclovir 60mg/kg/d divided q8h- 14days if localized, 21
days if disseminated or CNS.
Mom needs c/s if active genital disease
If mom has active lesions at delivery, neonate needs eye,
oropharynx, nasopharynx, rectum and blood HSV PCr- if
, Page | 4
colonized, treatment with acyclovir x10days (if no active
lesions on infant)
Hepatitis B & C
(Perinatal) Answer: Infected at time of birth, intrauterine
transmission rare
If mother haspositive HBsAg, then the infant should receive
HBIG. and hep B vaccine asap after birth. If mom not tested
before birth, run test after, give Hep B vaccine within 12hours,
and if pos, HBIG too.
Enterovirus infection
(Perinatal) Answer: Pos maternal hx of diarrhea, fever and/or
rash.
Sx: appears in first 2 weeks- fever, lethargy, irritability,
diarrhea and/or rash. Can p/w meningoencephalitis,
myocarditis, hepatitis, pneumonia, shock and DIC
Dx: PCR
TX: no identified therapy, good prognosis except those with
hepatitis, myocarditis or disseminated dz
HIV infection
(Perinatal) Answer: Can be acquired in utero at time of
delivery or via breast milk
Known mothers with HIV should be treated with zidovudine
therapy as early as 14weeks gestation. Infant for first 6 weeks
of life beginning within 12hours.
