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20 Cards in this Set
- Front
- Back
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1. Tx of asymptomatic UTI in pregnancy?
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a. Because most UTIs are caused by E. coli, initial tx of asymptomatic bacteriuria is usually with one of the following:
1. amoxicillin 2. nitrofurantoin (Macrodantin) 3. TMP/SMX (Bactrim) 4. Cephalexin. |
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2. Tx of symptomatic UTIs and cystitis in pregnancy?
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a. Same as above w/adjustment of meds based on culture-sensitivity.
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3. Phenazopyridine (Pyridium)?
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a. Concentrates in urine and acts as a local anaesthetic to reduce the pain.
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4. Tx of pyelonephritis in preg (has complications of septic shock and ARDS)?
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a. Aggressive tx with:
i. IV hydration ii. IV abx: cephalosporins (cefazolin, cefotetan, or ceftriaxone), or ampicillin and gentamicin b. Tx until pts is asymptomatic for 24-48 hours. Then transition to oral abx. |
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5. Risk of bacterial vaginosis in pregnancy?
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a. Preterm premature rupture of membranes
b. Preterm delivery c. Puerperal infections. |
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6. Common sx of bacterial vaginosis?
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a. Malodorous discharge or vaginal irritation ( may be asymptomatic).
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7. Diagnosis of bacterial vaginosis?
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a. 3 of following findings:
1. Presence of thin, white, homogenous discharge coating the vaginal walls. 2. An amine odour noted w/addition of 10% KOH (whiff test) 3. pH of >4.5 4. Presence of clue cells on microscopic exam. |
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8. Gold standard for diagnosis of bacterial vaginosis?
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a. Gram’s stain w/exam of bacteria in the vaginal discharge.
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9. 3 Common bacterial vaginosis organisms?
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1. Gardnerella vaginosis
2. Bacteroides 3. Mycoplasma hominis |
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10. Tx of choice for bacterial vaginosis in pregnancy?
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a. Oral metronidazole (Flagyl)
b. Oral clindamycin may also be used. |
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11. What 3 conditions does Group B strep commonly cause in pregnancy?
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a. UTIs
b. Chorioamnionitis c. Endometritis |
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12. GBS in baby?
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a. Major pathogen in neonatal sepsis.
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13. What is used in pts w/GBS when rash allergies to ampicillin?
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a. Cefazolin.
b. If allergic to pcn, Clindamycin is a common alternative. |
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14. When is GBS performed?
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a. 35-37 weeks gestation by culture of vagina and rectum.
b. Subsequently tx’d w/IV Pen G in labour or ampicillin (easier to dose). |
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15. Chorioamnionitis?
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a. Infection of the membranes and amniotic fluid surrounding the fetus.
b. Frequently associated w/preterm and prolonged rupture of membranes but can also occur w/o ROM. c. It is the most common precursor of neonatal sepsis |
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16. Common signs of Chorioamnionitis?!?!
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a. Fever
b. Elevated maternal WBC count c. Uterine tenderness d. Fetal tachycardia |
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17. Gold standard for diagnosis of chorioamnionitis?
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a. Culture of amniotic fluid, which can be obtained via amniocentesis.
b. Most sensitive screening test for chorioamnionitis appears to be IL-6 levels in the amniotic fluid that rise prior to change in many other screening tests. |
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18. Tx of chorioamnionitis?
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a. IV abx:
i. Broad spectrum (2nd or 3rd gen ceph) or ii. Ampicillin and gentamicin. |
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19. Recommended mode of delivery if HSV lesions are present?
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a. Cesarean
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20. Risk of HSV infection spreading to neonate (worst when it is a primary infection in mother)?
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a. Viral sepsis
b. Pneumonia c. Herpes encephalitis. |
