RNC INFECTIOUS DISEASES QUESTIONS AND ANSWERS | 100% RATED CORRECT | 2025-2026
LATEST UPDATE 100% VERIFIED
Presentation of HIV Signs and symptoms are rare in the neonatal period but may be seen in
infancy.
(1) Failure to thrive.
(2) Generalized lymphadenopathy, hepatomegaly, and splenomegaly.
(3) Recurrent mucosal infections.
(4) Systemic bacterial infections
(5) Recurrent candidiasis.
(6) Lymphoid interstitial pneumonitis.
(7) Parotitis, hepatitis, nephropathy, and cardiomyopathy.
(8) Recurrent diarrhea.
(9) Opportunistic infections.
(10) Neurodevelopmental delay.
(11) Malignancies.
Diagnosis of HIV (1) Antibody-based tests.
(a) ELISA.
(b) Western blot.
(c) Indirect immunofluorescence assay.
(2) Viral antigen detection: used to detect HIV antigen, usually the p24 antigen.
,(3) Viral nucleic acid detection: PCR and branched-chain DNA assays are used to diagnose and
monitor disease progression and therapy efficacy.
(4) Viral culture.
(5) Combination of tests (usually PCR and/or viral isolation). A diagnosis can be made in more
than 90% of infants by 2 months of age, and in nearly 100% by 4 months of age (AAP, 2003).
Management of HIV 1) Prompt intervention during bacterial and treatable opportunistic
infections.
(2) Adequate nutrition.
(3) Combination antiretroviral therapy (current treatment recommendations for HIV-infected
children can be found at www.aidsinfo.nih.gov). The Working Group on Pediatric HIV Infection
for the Aids Education and Training Centers (AETC) has current updates of the medication
recommendations for infants less than 12 months of age. Treatment recommendations for
initial therapy have been revised, based on current clinical trial and pharmacokinetic data.
Several complete regimens are strongly recommended for initial therapy (Table 32-2).
Several protease inhibitor (PI)- and nonnucleoside reverse transcriptase inhibitor (NNRTI)-based
regimens are listed as "alternative recommendations," as is one triple nucleoside reverse
transcriptase inhibitor (NRTI) regimen. The guidelines also include discussion of regimens and
individual drugs that are "not recommended" or that have "insufficient data to recommend."
(Included in the latter category are the newer antiretrovirals tenofovir, emtricitabine,
atazanavir, and enfuvirtide [www.aidsetc.org].)
,Prenatal Prophylaxis HIV (a) Zidovudine (ZDU), 200 mg by mouth three times per day, or 300
mg two times per day, initiated at 14 to 34 weeks of gestation and continued throughout the
pregnancy.
(b) Intrapartum loading dose of ZDU is 2 mg/kg IV over 1 hour, followed by continuous infusion
of 1 mg/kg/hour until delivery.
(c) Neonatal administration is 2 mg/kg/dose by mouth every 6 hours for 6 weeks, beginning at
8 to 12 hours of age (Taketomo et al., 2002).
Prevention of HIV (a) Cesarean delivery has not been shown to prevent transmission of HIV
to the infant.
(b) Breastfeeding concerns (AAP, 2003). (i) Transmission of HIV infection to infants from
breastfeeding occurs at rates of 27% to 40% in women with primary infection postpartum
(Palasanthiran et al., 1993).
(ii) Women who are known to be HIV infected should be advised not to breastfeed (AAP, 2003).
Isolation precautions HIV Standard Precautions should be strictly followed.
Toxoplasmosis 1. Caused by intracellular protozoan parasite, Toxoplasma gondii, which is an
important human pathogen.
2. Maternally acquired from consumption of poorly cooked meat or by exposure to infected cat
feces. Only women who become acutely infected during pregnancy can give birth to a newborn
infant with congenital toxoplasmosis. Estimated incidence of acute maternal infection in
pregnancy is 1.1 in 1000 (Sever et al., 1988).
3. Congenitally acquired disease in the newborn infant by vertical transmission. Approximate
neonatal incidence is 0.1 to 1 in 1000 live births.
, 4. Manifestations may include maculopapular rash, hepatomegaly, splenomegaly, jaundice,
and thrombocytopenia.
5. CNS involvement includes microcephaly or hydrocephalus accompanied by convulsions;
cerebral calcifications may be seen on radiographs.
6. Sequelae include mental retardation, learning disabilities, impaired vision, and blindness.
7. Toxoplasmosis may be asymptomatic at birth but may be manifested as intellectual
impairment in late infancy or childhood.
8. Diagnosis may be made by a number of methods: isolation or histologic demonstration of
the organism, detection of Toxoplasma antigens in tissues and body fluids, detection of
Toxoplasma nucleic acid by PCR, and serologic tests.
9. Treatment consists of pyrimethamine, trisulfapyrimidines, and a folic acid supplement to
prevent bone marrow suppression.
10. Isolation procedures consist of Standard Precautions.
Cause, transmission and Presentation of Syphilis 1. Cause: T. pallidum, a thin, motile
spirochete.
2. Transmission: through sexual contact or by maternal-fetal transmission.
3. Presentation.
a. Sometimes asymptomatic.
b. Petechiae.
c. Skin lesions: copper-colored maculopapular rash that is most severe on the hands and feet
and appears at 1 to 3 weeks of age, with subsequent desquamation. Lesions present at birth
may be bullous.
d. Hepatosplenomegaly.
LATEST UPDATE 100% VERIFIED
Presentation of HIV Signs and symptoms are rare in the neonatal period but may be seen in
infancy.
(1) Failure to thrive.
(2) Generalized lymphadenopathy, hepatomegaly, and splenomegaly.
(3) Recurrent mucosal infections.
(4) Systemic bacterial infections
(5) Recurrent candidiasis.
(6) Lymphoid interstitial pneumonitis.
(7) Parotitis, hepatitis, nephropathy, and cardiomyopathy.
(8) Recurrent diarrhea.
(9) Opportunistic infections.
(10) Neurodevelopmental delay.
(11) Malignancies.
Diagnosis of HIV (1) Antibody-based tests.
(a) ELISA.
(b) Western blot.
(c) Indirect immunofluorescence assay.
(2) Viral antigen detection: used to detect HIV antigen, usually the p24 antigen.
,(3) Viral nucleic acid detection: PCR and branched-chain DNA assays are used to diagnose and
monitor disease progression and therapy efficacy.
(4) Viral culture.
(5) Combination of tests (usually PCR and/or viral isolation). A diagnosis can be made in more
than 90% of infants by 2 months of age, and in nearly 100% by 4 months of age (AAP, 2003).
Management of HIV 1) Prompt intervention during bacterial and treatable opportunistic
infections.
(2) Adequate nutrition.
(3) Combination antiretroviral therapy (current treatment recommendations for HIV-infected
children can be found at www.aidsinfo.nih.gov). The Working Group on Pediatric HIV Infection
for the Aids Education and Training Centers (AETC) has current updates of the medication
recommendations for infants less than 12 months of age. Treatment recommendations for
initial therapy have been revised, based on current clinical trial and pharmacokinetic data.
Several complete regimens are strongly recommended for initial therapy (Table 32-2).
Several protease inhibitor (PI)- and nonnucleoside reverse transcriptase inhibitor (NNRTI)-based
regimens are listed as "alternative recommendations," as is one triple nucleoside reverse
transcriptase inhibitor (NRTI) regimen. The guidelines also include discussion of regimens and
individual drugs that are "not recommended" or that have "insufficient data to recommend."
(Included in the latter category are the newer antiretrovirals tenofovir, emtricitabine,
atazanavir, and enfuvirtide [www.aidsetc.org].)
,Prenatal Prophylaxis HIV (a) Zidovudine (ZDU), 200 mg by mouth three times per day, or 300
mg two times per day, initiated at 14 to 34 weeks of gestation and continued throughout the
pregnancy.
(b) Intrapartum loading dose of ZDU is 2 mg/kg IV over 1 hour, followed by continuous infusion
of 1 mg/kg/hour until delivery.
(c) Neonatal administration is 2 mg/kg/dose by mouth every 6 hours for 6 weeks, beginning at
8 to 12 hours of age (Taketomo et al., 2002).
Prevention of HIV (a) Cesarean delivery has not been shown to prevent transmission of HIV
to the infant.
(b) Breastfeeding concerns (AAP, 2003). (i) Transmission of HIV infection to infants from
breastfeeding occurs at rates of 27% to 40% in women with primary infection postpartum
(Palasanthiran et al., 1993).
(ii) Women who are known to be HIV infected should be advised not to breastfeed (AAP, 2003).
Isolation precautions HIV Standard Precautions should be strictly followed.
Toxoplasmosis 1. Caused by intracellular protozoan parasite, Toxoplasma gondii, which is an
important human pathogen.
2. Maternally acquired from consumption of poorly cooked meat or by exposure to infected cat
feces. Only women who become acutely infected during pregnancy can give birth to a newborn
infant with congenital toxoplasmosis. Estimated incidence of acute maternal infection in
pregnancy is 1.1 in 1000 (Sever et al., 1988).
3. Congenitally acquired disease in the newborn infant by vertical transmission. Approximate
neonatal incidence is 0.1 to 1 in 1000 live births.
, 4. Manifestations may include maculopapular rash, hepatomegaly, splenomegaly, jaundice,
and thrombocytopenia.
5. CNS involvement includes microcephaly or hydrocephalus accompanied by convulsions;
cerebral calcifications may be seen on radiographs.
6. Sequelae include mental retardation, learning disabilities, impaired vision, and blindness.
7. Toxoplasmosis may be asymptomatic at birth but may be manifested as intellectual
impairment in late infancy or childhood.
8. Diagnosis may be made by a number of methods: isolation or histologic demonstration of
the organism, detection of Toxoplasma antigens in tissues and body fluids, detection of
Toxoplasma nucleic acid by PCR, and serologic tests.
9. Treatment consists of pyrimethamine, trisulfapyrimidines, and a folic acid supplement to
prevent bone marrow suppression.
10. Isolation procedures consist of Standard Precautions.
Cause, transmission and Presentation of Syphilis 1. Cause: T. pallidum, a thin, motile
spirochete.
2. Transmission: through sexual contact or by maternal-fetal transmission.
3. Presentation.
a. Sometimes asymptomatic.
b. Petechiae.
c. Skin lesions: copper-colored maculopapular rash that is most severe on the hands and feet
and appears at 1 to 3 weeks of age, with subsequent desquamation. Lesions present at birth
may be bullous.
d. Hepatosplenomegaly.
