AHN 548 Exam 1 Questions With 100% Solved
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1. Congenital
can be acquired in utero, perinatally and postnatally
infec- tions-
-Can be asymptomatic in newborn period
essentials of
-clinical sx complexes include IUGR, chorioretinitis, cataracts, cholestatic
dx and typical
jaundice, thrombocytopenia, skin rash and brain calcifications
features
-Dx: PCR, antigen and antibody studies and culture
MOST COMMON TRANSMITTED IN UTERO
2. CMV
Sx: hepatosplenomegaly, petechiae, growth restriction, microcephaly,
(Congenital)
direct hy- perbili, thrombocytopenia, intracranial calcifications and
chorioretinitis, HEARING LOSS
TX: Ganciclovir therapy 6mg/kg IV q12h for 6 weeks for symptomatic
neonates attecting the CNS and prevent hearing loss progression
risk of fetal infection and congenital defects as high as 85% in mothers
3. Rubella infected during 1st trimester.
(Congenita
l) SX: microcephaly, encephalitis, cardiac defects (PDA and pul art stenosis
and arte- rial 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
Congenital varicella is rare
4. Varicella Sx: limb hypoplasia, cutaneous scars, microcephaly, cortical atrophy,
(Congenita chorioretini- tis and cataracts
l)
Perinatal caricella --> neonate should receive varicella-zoster immune
globulin or IVIG, or if that's not done --> acyclovir.
5. Most infants initially asymptomatic
, AHN 548 Exam 1 Questions With 100% Solved
Answers
Toxoplasmosis Sx: mental retardation, visual impairment, learning disabilities, growth restriction,
(congenital) jaundize, chorioretinitis, sz, hepatosplenomegaly, adenopathy, cataracts, mac
lopapular 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.
6. Parvovirus
B19 infected during pregnancy- results in severe anemia, myocarditis, nonimmune
(Congenital) hydrops, or fetal death. If fetus survives, long term outcome is good.
7. Congenit Active primary and secondary maternal syphilis leads to transplacental passage
al to fetus in nearly 100% of cases.
syphilis
Fetal infection can reult in stillbirth or prematurity.
Sx: mucocutaneous lesions, lymphadenopathy, hepatosplenomegaly, bony
changes, hydrops (newborns often asymptomatic)
acquired during transit through infected birth canal
8. Herpes
Simplex Sx days 5-14: localized (skin, eye, mouth) or disseminated (shock, pneumonia,
(Perinatal) 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.
, AHN 548 Exam 1 Questions With 100% Solved
Answers
Mom needs c/s if active genital disease
If mom has active lesions at delivery, neonate needs eye, oropharynx,
nasophar- ynx, rectum and blood HSV PCr- if colonized, treatment with
acyclovir x10days (if no active lesions on infant)
9. Hepatitis B & Infected at time of birth, intrauterine transmission rare
C (Perinatal)
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.
10. Enterovirus infec- Pos maternal hx of diarrhea, fever and/or rash.
tion
(Perinatal) 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
11. HIV
infection Can be acquired in utero at time of delivery or via breast milk
(Perinatal)
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.
Best prevention combination: c/s, zidovudine and avoidance of
breastfeeding. Unknown mothers- prophylaxis with 2-3 rx.
Infants asymptomatic, test HIV DNA PCR at 48hrs, 2weeks, 1-2 months,
, AHN 548 Exam 1 Questions With 100% Solved
Answers
and 2-4 months.
Answers
1. Congenital
can be acquired in utero, perinatally and postnatally
infec- tions-
-Can be asymptomatic in newborn period
essentials of
-clinical sx complexes include IUGR, chorioretinitis, cataracts, cholestatic
dx and typical
jaundice, thrombocytopenia, skin rash and brain calcifications
features
-Dx: PCR, antigen and antibody studies and culture
MOST COMMON TRANSMITTED IN UTERO
2. CMV
Sx: hepatosplenomegaly, petechiae, growth restriction, microcephaly,
(Congenital)
direct hy- perbili, thrombocytopenia, intracranial calcifications and
chorioretinitis, HEARING LOSS
TX: Ganciclovir therapy 6mg/kg IV q12h for 6 weeks for symptomatic
neonates attecting the CNS and prevent hearing loss progression
risk of fetal infection and congenital defects as high as 85% in mothers
3. Rubella infected during 1st trimester.
(Congenita
l) SX: microcephaly, encephalitis, cardiac defects (PDA and pul art stenosis
and arte- rial 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
Congenital varicella is rare
4. Varicella Sx: limb hypoplasia, cutaneous scars, microcephaly, cortical atrophy,
(Congenita chorioretini- tis and cataracts
l)
Perinatal caricella --> neonate should receive varicella-zoster immune
globulin or IVIG, or if that's not done --> acyclovir.
5. Most infants initially asymptomatic
, AHN 548 Exam 1 Questions With 100% Solved
Answers
Toxoplasmosis Sx: mental retardation, visual impairment, learning disabilities, growth restriction,
(congenital) jaundize, chorioretinitis, sz, hepatosplenomegaly, adenopathy, cataracts, mac
lopapular 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.
6. Parvovirus
B19 infected during pregnancy- results in severe anemia, myocarditis, nonimmune
(Congenital) hydrops, or fetal death. If fetus survives, long term outcome is good.
7. Congenit Active primary and secondary maternal syphilis leads to transplacental passage
al to fetus in nearly 100% of cases.
syphilis
Fetal infection can reult in stillbirth or prematurity.
Sx: mucocutaneous lesions, lymphadenopathy, hepatosplenomegaly, bony
changes, hydrops (newborns often asymptomatic)
acquired during transit through infected birth canal
8. Herpes
Simplex Sx days 5-14: localized (skin, eye, mouth) or disseminated (shock, pneumonia,
(Perinatal) 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.
, AHN 548 Exam 1 Questions With 100% Solved
Answers
Mom needs c/s if active genital disease
If mom has active lesions at delivery, neonate needs eye, oropharynx,
nasophar- ynx, rectum and blood HSV PCr- if colonized, treatment with
acyclovir x10days (if no active lesions on infant)
9. Hepatitis B & Infected at time of birth, intrauterine transmission rare
C (Perinatal)
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.
10. Enterovirus infec- Pos maternal hx of diarrhea, fever and/or rash.
tion
(Perinatal) 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
11. HIV
infection Can be acquired in utero at time of delivery or via breast milk
(Perinatal)
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.
Best prevention combination: c/s, zidovudine and avoidance of
breastfeeding. Unknown mothers- prophylaxis with 2-3 rx.
Infants asymptomatic, test HIV DNA PCR at 48hrs, 2weeks, 1-2 months,
, AHN 548 Exam 1 Questions With 100% Solved
Answers
and 2-4 months.
