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80 Cards in this Set
- Front
- Back
What type of virus is CMV? |
beta herpes virus |
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CMV method of transmission? |
saliva urine breastmilk sexual contact vertical transmission at birth blood transfusion |
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what to do if patient is CMV positive? (eg IgM positive, IgG positive) |
repeat test in 2-4 weeks, to check if - rise in IgG - change of negative to positive IgG |
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how long can you have a positive IgM for CMV infection? |
2-3 years |
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how to check fetus for CMV infection |
amniocentnesis - 45% accurate if <20 weeks - 90% accurate if >20 weeks: do viral load |
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does a positive CMV IgM indicate the degree that the baby will be affected? |
no |
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what symptoms does the baby have if they get congenital CMV infection? |
1. hepatomegaly 2. poly or oligohydramnios 3. microcephaly 4. IUGR 5. pseudomeconium ileus 6. increased fluid: hydrocephalus, ascites, pleural / pericardial effusion, 7. intracranial calcifications |
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risk of transmission of primary CMV infection to the fetus? |
50% - 10% are symptomatic |
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risk of transmission of reactivation of CMV infection to the fetus? |
<1% |
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what percentage of adults / children infected with rubella will be symptomatic? |
50% |
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rubella route of transmission? |
droplet & contact with nasopharyngeal secretions |
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risk of baby being affected if mother infected with rubella in first 10 weeks? |
90% |
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features of congenital rubella syndrome |
1. CNS 2. Eyes 3. sensorineural deafness 4. cardiac abnormalities 5. IUGR 6. inflammatory lesions (brain, bone, liver, lungs) |
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risk to baby if mother reinfected with rubella during pregnancy? |
<10% |
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risk of rubella transmission to baby if >20weeks when maternal primary infection? |
30% but almost no risk of congenital defects |
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when to give rubella vaccine to non-immune woman if she's pregnant? |
give postpartum |
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how long is a baby with congenital rubella infection infectious for? |
1 year after birth (unless nasopharyngeal or urine cultures negative after 3 months) |
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Is EBV infection during pregnancy dangerous to the baby? |
unclear - may lead to premature birth & low for birth weight baby |
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what is the risk of transmission of EBV from mother to baby? |
low, even if mother symptomatic |
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how is EBV transmitted? |
saliva |
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which vaccines are contraindicated in pregnancy (2)? |
live ones - varicella - MMR |
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which vaccines should be given in pregnancy and when (2)? |
1. influenze - early as possible 2. pertussis - around 30 weeks / third trimester |
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how is toxo transmitted? |
1. eating raw / uncooked meat 2. not washing hands after handling: - raw meat - dirt that may be contaminated with cat feces - cat litter very rare through direct cat contact |
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what type of bug is toxo? |
toxoplasmosis gondii - a parasite once infected it remains latent until reactivated if very immunosuppressed |
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is a baby at risk if mother has latent toxo infection? |
no |
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what is the risk of transmission of toxo from mother to fetus in primary maternal infection? |
first trimester: 15% second trimester: 40% third trimester: 75% |
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what is the risk of the baby having defects if they get toxo in utero? |
first trimester: 80% second trimester: 25% third trimester: 10% |
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how do you treat toxo? |
spiramycin or atovaquone or aciclovir |
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what serology in the mother shows possible active infection with toxo, and what further serology will confirm it is primary infection? |
IgM & IgG positive additional: repeat IgM & IgG still positive, positive IgA, low IgG avidity (need to re-check as IgM can be positive for months to years) |
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what are the features of varicella zoster syndrome (6)? |
1. skin scarring 2. eye abnormalities 3. limb abnormalities 4. intellectual disability 5. preterm birth, low birth weight & mortality 6. poor sphincter control |
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method of VZV transmission? |
1. droplets (respiratory) 2. contact with fluid from vesicle |
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when is VZV infection contagious? |
48 prior to rash until all lesions are crusted over |
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what to do if a non-immune pregnant woman is exposed to VZV? |
1. Zoster Immunoglobulin if <96hr since exposure 2. aciclovir if >96hr since exposure & in second half of pregnancy or immunocompromised |
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what to do if a woman has primary VZV infection in pregnancy? what is the main risk to the mother? |
give aciclovir if <24 of rash starting, otherwise nothing
risk of VZV pneumonia (10% risk) |
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risk of VZV transmission from mother to fetus? |
20 - 30% |
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period of maximum risk of VZV fetal syndrome if mother infected during pregnancy? what is this risk? |
12 - 28 weeks 1.4% (0.5% when <12 weeks, negligible risk after 28 weeks) |
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when to give Zoster Immunoglobulin to a baby whose mother had VZV? |
if mother developed VZV from 7 days prior to 28 days after birth (otherwise just monitor baby) |
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can babies breastfeed if mother has had / develops VZV? |
yes |
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can shingles transmit to a baby from a pregnant mother? |
no |
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period of infectivity for syphilis? |
from initial infection to 4 years after non infectious 48 hours after starting ABx |
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body systems affected in tertiary syphilis? |
1. neuro 2. cardiovascular 3. bones & joints 4. liver |
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what bug causes syphilis? |
bacterial sphirochete: triponema pallidum |
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how is syphilis transmitted? |
sexual congenital |
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what three tests are there for syphilis: - screening - confirmation of infection - disease activity |
- treponemal specific enzyme immunoassay -TPPA - RPR |
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how to treat a pregnant woman who has had syphilis for <2 years? |
1. IM benzylpenicillin (if in third trimester, then repeat dose 1 week later) |
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what is the risk of maternal syphilis to the newborn? |
preterm labour / birth miscarriage* / neonatal death / congenital syphilis syndrome
*most common outcomes, esp in mid trimester |
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what is the risk of syphilis transmission to the baby if it is primary, secondary or early latent syphilis? (<2 years since first infected) |
30 - 60% |
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what is the risk of transmission to the baby in late latent syphilis? (>2 years since infection) |
10% |
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what are the features of congenital syphilis? |
1. deafness 2. neurologic impediment 3. bone deformities |
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when to treat a baby for syphilis? |
if the mother hasn't been treated or if she was only treated in the last 4 weeks of the pregnancy |
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what causes slapped cheek syndrome? what other name does it have? |
parvovirus b19 fifth disease |
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what is the main risk of parvovirus in pregnancy? |
anemia (aplastic crisis or chronic anemia) esp if woman has sickle cell disease, thalassemia, or is immunocompromised |
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how is parvovirus transmitted? |
respiratory secretions hand-mouth contact |
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what is the risk of parvovirus transmission from mother to fetus? |
50% |
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what are the risks to the baby of fetus parvovirus infection? |
anemia & myocarditis lead to: fetal hydrops & death (often 5 weeks after maternal infection) |
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what treatment is used for HIV during vaginal birth / after birth for for baby with HIV positive mother? |
zidovudine |
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what to do if a mother is HIV negative but is high risk with a recent exposure? |
re-check in 4 weeks |
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can a mother who is HIV positive breastfeed? |
not recommended |
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risks of malaria during pregnancy? |
anemia (mother & baby) miscarriage premature birth low birthweight |
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what is the risk of Hep C transmission from mother to baby? |
very small esp if undetectable viral load |
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when to do LUCS for Hep C positive woman? |
no indication for this - risk of transmission is the same for LUCS & vaginal birth
do instrumental delivery if possible for difficult delivery |
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can you breastfeed if the mother has Hep C? |
yes, just not if nipples bleeding (small amount of Hep C in breastmilk, but is negligible) |
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what does the results below mean? HCV antibody positive HCV RNA PCR negative |
past exposure NOT immunity |
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what is the risk of HCV transmission from mother to baby? when is this risk highest in the pregnancy? |
5% highest risk is at birth |
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risk of HCV infection progressing to chronic infection? |
75 - 80% |
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what type of birth is recommended for mothers with Hep B? |
no particular recommendations |
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what should be done for every baby with a mother who has Hep B? |
Hep B immunoglobulin at birth Hep B vaccination: at birth, 6-8 weeks, 4months, 6 months |
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transmission method of Hep B? |
secretions: saliva, breast milk, semen, vagina mucous membranes blood |
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risk of transmission for ACUTE Hep B: - in first trimester - in third trimester |
10% 75% |
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Hep B surface antigen shows? |
exposure to Hep B |
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anti-HBc means? |
chronic infection |
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anti-HBs means? |
immune! |
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should women with Hep B breastfeed? |
yes |
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how much is the risk of babies getting Hep B infection reduced by treating babies with Hep B vaccine & Hep B immunoglobulin at birth? |
95% reduction in risk 5% who still get Hep B often have incomplete vaccine schedule or mothers with high viral loads |
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what bug causes listeria? |
bacteria: listeria monocytogenes |
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what is the risk of mother to baby transmission of listeria? |
small |
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what are the risks to the baby if they are infected with listeria? |
very high mortality (miscarriage/ still birth / infant death) ~50% |
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how to test for listeria? |
blood cultures |
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treatment of listeria? |
amoxycillin |
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how can mothers avoid listeria infection? |
wash hands don't eat: - pate / cold meats / cold seafood - raw vegetables (e.g. old salad) - unpasturised milk - soft cheeses eg: eat recently well cooked food |