Buxton - 11/19 - Causes Of Perinatal Infection

Front 1

Routes of CMV infection in neonatal period

Back 1

In utero (1%)
Breast milk
Blood/organs

Front 2

Periods of highest risk of CMV acquisition

Back 2

neonatal
after puberty

Front 3

What % of neonates with congenital CMV are asymptomatic at birth?

Back 3

90%

Front 4

CMV symptoms at birth include

Back 4

low birth weight
petechiae
hepatosplenomegaly
microcephaly
deafness
jaundice
Chorioretinitis

Front 5

15% develop late-onset manifestations of CMV including

Back 5

deafness
others

Front 6

Most likely person to pass CMV onto infant who manifests at birth

Back 6

Higher income groups

Front 7

Worst case scenario of CMV is

Back 7

Woman with primary infection during pregnancy (higher risk of symptomatic birth)

Front 8

Diagnosis of CMV is done by

Back 8

Virus isolation from urine
Anti-CMV IgM
CMV antigen detection
Histopathology or cytology

Front 9

Antivirals used in the tx of CMV in ADULTS include

Back 9

Ganciclovir
Foscarnet
Cidofovir

(not licensed for infant use)

Front 10

Antiviral used in the prevention of late onset hearing loss in congenitally infected infants

Back 10

gancyclovir

Front 11

Histologic finding of CMV includes

Back 11

"Owl's eye" with nucleus and internuclear inclusion body

Front 12

Reactivation of latent CMV is prevented by

Back 12

Nothing

Front 13

Treatment indicate for use in pregnant women with active CMV

Back 13

Gancyclovir

Front 14

What must be monitored for when treating pregnant women with gancyclovir for CMV?

Back 14

Hydrops fetalis after 20 wk gestation

Front 15

Most serious cause of neonatal herpes

Back 15

Primary infection of mother with active genital lesions

Front 16

Manifestations of Neonatal Herpes

Back 16

Skin, eye and mouth involvement
Encephalitis
Disseminated disease
Sequalae
Neurologic
Ocular

Front 17

Least serious type of neonatal herpes infection

Back 17

Skin, eye, and mouth

Front 18

Most serious type of neonatal herpes infection with higher rate of mortality

Back 18

Encephalitis
Disseminated disease

Front 19

Treatment of neonatal herpes

Back 19

IV acyclovir

Front 20

Dx of neonatal herpes is made by

Back 20

Symptoms presenting w/i 1-3 wks post-partum
viral isolation
conjunctiva
throat
urine

Front 21

Main determinant of mother-to-child transmission of HIV

Back 21

Mother's viral load

Front 22

Main presenting cause of neonatal herpes is

Back 22

septic infant

Front 23

Suspected neonatal herpes in the absence of lesions may be dx by

Back 23

urinalysis with high index of suspicion

Front 24

Clinical symptoms/signs of HIV in neonates

Back 24

Failure to thrive
Generalized lymphadenopathy
Hepatosplenomegaly
Recurrent thrush
PCP
Recurrent bacterial infections
Neurodevelopmental problems

Front 25

Differences b/t HIV in infants and adults

Back 25

Incubation period shorter**
Disease progresses faster**
Both cellular and humoral immunity affected
Infants more likely to develop some illnesses, less likely to develop others

Front 26

Diagnosis of HIV in neonates is accomplished with

Back 26

PCR

Front 27

Tx of neonatal HIV

Back 27

anti-retrovirals
Antibiotics (for opport inf)
IVIG

Front 28

Prevention of HIV transmission durin labor is done by what 4 steps?

Back 28

HIV test

anti-retrovirals for mother

IV zidovudine during labor
Tx infant with

anti-retrovirals for 6 weeks and monitor for evidence of infection

Front 29

To prevent Hep B transmission during labor, what should ALL pregnant women receive?

Back 29

HBSaG screening with each pregnancy

Front 30

Infants born to HepB-infected mothers should be tx with what?

Back 30

HBIG (Hep B Immune Globulin) and vaccine within 12 hrs

Front 31

Danger of neonates acquiring Hep B

Back 31

90% chance of having a CHRONIC INFECTION

Front 32

Babies NOT born to Hep-B infected mothers should receive what?

Back 32

Only the vaccine

Front 33

Presentation of HPV-B19 infection in neonates

Back 33

Hydrops Fetalis

Front 34

Presentation of HPV-B19 infection in kids

Back 34

facial rash

Front 35

Presentation of HPV-B19 infection in adults

Back 35

Rash, arthralgia

Front 36

Presentation of HPV-B19 infection in pt with hemolytic anemia

Back 36

rash, aplastic anemia

Front 37

Pathogenesis of HPV-B19 in fetus

Back 37

Transplacental infection of fetal liver (leading to hydrops fetalis)with 10% chance of death

Front 38

Dx of HPV-B19

Back 38

anti-viral IgM

Front 39

Prevention of HPV-B19

Back 39

Awareness of fetal risk
Washing hands

Front 40

Population who gets Rubella virus

Back 40

immigrants
Poor
Unvaccinated (people with stupid religious ideas)

Front 41

Clinical presentation of Rubella in adults/kids

Back 41

Low-grade fever
lymphadenopathy
arthralgia

Front 42

unusual clinical manifestations of rubella in adults/kids

Back 42

encephalitis
thrombocytopenia
purpura

Front 43

Clinical manifestation of Rubella in fetus

Back 43

spontaneous abortion
skin rash
fetal anomalgies
late-onset complications

Front 44

Characteristic skin rash of fetal Rubella infection

Back 44

Petechiae
purpura
“blue berry muffin lesions”

Front 45

Fetal anomalies characteristic of fetal Rubella infection

Back 45

Cataracts
Heart defects
Deafness

Front 46

Primary late-onset complication of fetal Rubella infection

Back 46

deafness

Front 47

clinical manifestations of each disease are primarily used for what?

Back 47

Indication of risk to fetus