Infections in pregnancy | Baamboozle - Baamboozle

clinical presentation and history of listeriosis

woman with nonspecific flu-like symptoms who ate uncooked lunch meats (or hot dogs, non pasteurized milk products)

Transmitted in breastmilk (2) - there are more, but these two are the mayor guys.

HIV, CMV

Pt. education on Rifampin (odd fact)

discolors urine orange

Patients on Isoniazid should take this supplement to avoid deficiency.

Vit B6

Criteria for GBS prophylaxis in current pregnancy

Previous infant with GBS disease, +GBS bacteriuria or Swab, unknown GBS AND either <37 wks, SROM >18 hrs, temp >100.4F

fetal risks of Parovirus B19

Fetal anemia and hydrops

Bacterial infections from this module (2)

Listeriosis, GBS

sexually transmitted infections from this module (3)

HIV, zika, CMV

Incubation period for varicella compared to flu.

2 weeks vs 2-4 days.

Which fetus has the highest risk of congenital rubella syndrome? A. 8 weeks B. 22 weeks C. 36 weeks

A.

Which infection starts with lymphadenopathy in the postauricular, deep cervical and suboccipital chains?

Rubella

Route of transmission of rubella: A. Droplets B. Feces C. Fomites D. Blood E. Air

A.

Treatment of TB in pregnancy

Isoniazid, Rifampin, Ethambutol

When would we treat latent TB in pregnant woman?

If she develops active disease (symptoms) or is immunocompromised (HIV..)

Fetal risks of TB

Fetal loss Low birthweight Congenital TB (extremely rare in US)

maternal risks of TB (2)

Preeclampsia Hemorrhage

The most common and most easily preventable cause of poor birth outcomes in the world

Malaria

explain the mechanism of why someone with malaria has a higher risk of PPH?

Anemia = less efficient uterine ctx = PP hemorrhage

Which infection causes severe anemia and thrombocytopenia?

Malaria

Signs indicating complicated malaria (5)

Dizziness Breathlessness/difficulty breathing Sleepy/drowsy Confusion/coma Sometimes fits, jaundice, severe dehydration

Fetal complications of 5th disease/ Parovirus B19

Fetal anemia - non immune hydrops, heart failure Rare: direct infection of fetal myocardium 11% fetal loss for infections < 20 wks

Flu treatment in pregnancy

A and B: Zanamivir and Oseltamivir (P.Cat. C) Start within 24-36 hrs symptom onset A: Amantidine and Rimantidine (P. Cat. C) Antibiotics to prevent secondary

HIV transmission to baby

vertical or breastmilk

Do all HIV+ women have to deliver by C/S?

Only if high viral load.

How can we detect neonatal HIV infection?

polymerase chain reaction

Which tests would we run during prenatal care of a HIV positive patient?

HIV RNA viral load, CD4 count in 1st and 2nd trimester TORCH, STD screen in 1st and 3rd trimester Pap smear twice (eight weeks apart) Watch for PTL

When would we give VZIG to the newborn?

If mom develops varicella during last 7 days of pregnancy or the first 14 days after delivery

Clinical presentation of varicella syndrome in newborn

Skin scarring in dermatomal distribution Limb hypoplasia and/or paresis Low birth weight Less common: microcephaly, neurologic deficits, eye defects

symptomas of varicella pneumonia

develops 2-5 days after onset of rash (sx: cough, dyspnea, pleurisy, and hemoptysis)

Treatment for varicella pneumonia

Acyclovir

Who should VZIG be offered to?

seronegative pregnant woman with a significant contact.

fetal complications of CMV infection (6)

1. micro-& hydrocephaly 2. chorioretinitis 3. cerebral calcification 4. mental retardation 5. heart block 6. petechiae

Spiramycin is treatment for which infection: A. Varicella B. Listeriosis C. Toxoplasmosis D. CMV

C.

which infection is caused by a parasite? A. Listeriosis B. Rubella C. Hepatitis B D. Toxoplasmosis

D. Toxoplasmosis

which infections are caused by a parasite? (2)

Toxoplasmosis, malaria

Fetal risks of Toxoplasmosis

chorioretinitis, hydrocephaly or microcephaly, cerebral calcification