AHN 548 EXAM WITH WELL DETAILED QUESTION &
ANSWERS PERFECTLY A+ GRADED WITH RATIONALE
NEW UPDATE
Congenital infections- essentials of dx and typical features CORRECT 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) CORRECT 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) CORRECT ANSWER>>>>risk of fetal infection and congenital defects as
high as 85% in mothers infected during 1st trimester.
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) CORRECT 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) CORRECT 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.
Parvovirus B19
(Congenital) CORRECT 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 CORRECT 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) CORRECT 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 colonized, treatment with acyclovir x10days (if no active lesions on infant)
Hepatitis B & C
(Perinatal) CORRECT 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) CORRECT ANSWER>>>>Pos maternal hx of diarrhea, fever and/or rash.
ANSWERS PERFECTLY A+ GRADED WITH RATIONALE
NEW UPDATE
Congenital infections- essentials of dx and typical features CORRECT 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) CORRECT 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) CORRECT ANSWER>>>>risk of fetal infection and congenital defects as
high as 85% in mothers infected during 1st trimester.
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) CORRECT 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) CORRECT 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.
Parvovirus B19
(Congenital) CORRECT 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 CORRECT 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) CORRECT 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 colonized, treatment with acyclovir x10days (if no active lesions on infant)
Hepatitis B & C
(Perinatal) CORRECT 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) CORRECT ANSWER>>>>Pos maternal hx of diarrhea, fever and/or rash.
