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Quiz

L20 Infections (gestational, after)

Gelöschter Nutzer 11 Fragen Aktualisiert am 2 Okt 2019

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  1. 1Maternal Immune system has 2 main roles
    1. Don’t kill the foetus
    • Foetus is ‘[blank_start]foreign[blank_end]’ therefore maternal immune system is [blank_start]modified[blank_end] so that the foreign tissue is not killed
    2. Protect the foetus & newborn
    • Protect foetus from infections in utero ([blank_start]congenital[blank_end] infections)
    • Transfer maternal [blank_start]immunity[blank_end] to newborn
    1. Amodified
    2. Bforeign
    3. Ccongenital
    4. Dimmunity
  2. 2Maternal Immune system
    • Increase in [blank_start]number and activity[blank_end] of cells of the innate immune system, including NK cells
    • Cytokine production modified
    • [blank_start]Less[blank_end] antigen presentation at early stages
    • Increasing [blank_start]estradiol[blank_end] – augments Th2/[blank_start]Ig[blank_end] responses
    • Progesterone has a [blank_start]suppressive[blank_end] effect at later stages on acquired responses
    Result of this…
    • Increased [blank_start]susceptibility to diseases[blank_end] where cellular responses are important
    • Increased [blank_start]severity[blank_end] due to altered physiology in pregnancy eg cardiopulmonary changes
    1. Anumber and activity
    2. BLess
    3. Cestradiol
    4. DIg
    5. Esuppressive
    6. Fsusceptibility to diseases
    7. Gseverity
  3. 3Transfer of maternal immunity
    Newborn has:
    • an [blank_start]underdeveloped[blank_end] immune system - immune system in the foetus is tolerogenic and [blank_start]non-reactive[blank_end], so
    doesn't try to kill mother.
    • is immunologically naïve - no [blank_start]memory[blank_end], every infection is new – will get sick
    • no/underdeveloped microflora

    • Newborn infants and children < 2 are highly [blank_start]susceptible[blank_end] to infection, particularly [blank_start]viral[blank_end] infections.
    • This can result in very serious disease - infections must be taken seriously and treated quickly.

    Maternal [blank_start]IgG[blank_end] can cross the placenta and accounts for the high levels present in the foetus. Baby born at 20 weeks ~ [blank_start]100 mg/dL[blank_end]. Breast milk contains [blank_start]IgA[blank_end] (& leukocytes) - transferred to neonate. Baby can produce only limited amounts of antibody, only [blank_start]IgM[blank_end] for first 6 months. At [blank_start]12[blank_end] months all maternal IgG is gone.
    1. Aunderdeveloped
    2. Bnon-reactive
    3. Cmemory
    4. Dsusceptible
    5. Eviral
    6. FIgG
    7. G100 mg/dL
    8. HIgA
    9. IIgM
    10. J12
  4. 4• GBS (group B streptococcus infection) is the most [blank_start]common[blank_end] infection of neonates, [blank_start]vertical[blank_end] transmission from mum during labor/delivery can occur
    • Infection in neonates – [blank_start]CNS, heart and lung[blank_end] pathology with 20-30% mortality in [blank_start]preterm[blank_end] infants, 2-3% in full-term
    • NZ has gone for a [blank_start]risk-based[blank_end] approach (rather then universal screening)
    • All newborns must be observed for [blank_start]1[blank_end] hour as per MoH guidelines
    • If risk factors for GBS extend to at least [blank_start]24[blank_end] hours
    1. Acommon
    2. Bvertical
    3. CCNS, heart and lung
    4. Dpreterm
    5. Erisk-based
    6. F1
    7. G24
  5. 5TORCH(Z) = Microbes associated with congenital infections.
    T - [blank_start]Toxoplasma gondii[blank_end]
    O - [blank_start]Other; inlcudes chicken pox and HIV[blank_end]
    R - [blank_start]Rubella[blank_end]
    C - [blank_start]Cytomegalovirus (CMV)[blank_end]
    H - [blank_start]HSV-1 and HSV-2[blank_end]
    Z - Zika?
    1. AToxoplasma gondii
    2. BOther; inlcudes chicken pox and HIV
    3. CRubella
    4. DCytomegalovirus (CMV)
    5. EHSV-1 and HSV-2
  6. 6Choose the incorrect statement about Cytomegalovirus (CMV).
    1. APost natal infection is subclinical/mild (low fever, sore throat, swollen lymph nodes) = & virus persists for life
    2. BHigher risk of congenital infection if it's a primary infection of the mother, but there's more cases from reinfections of CMV positive mother
    3. C~90% of congenital infections symptomatic at birth
    4. DSymptoms from congenital infection are jaundice, pneumonia, myocarditis, and it is survivable with supportive care
    5. EPermanent disabilities (hearing loss, visual & intellectual impairment) can
      result from both asymptomatic & symptomatic disease
  7. 7CMV - Treatment
    • 6 months of [blank_start]oral Ganciclovir[blank_end] for newborns with [blank_start]severe[blank_end] symptomatic disease
    • No evidence base for treating [blank_start]older[blank_end] children
    • Requirement for new anti-virals with less [blank_start]toxicity[blank_end]
    1. Aoral Ganciclovir
    2. Bsevere
    3. Colder
    4. Dtoxicity
  8. 8Rubella
    • Togaviridae, enveloped [blank_start]gram positive[blank_end] strand RNA virus, worldwide distribution
    • Transmission - respiratory via [blank_start]droplets[blank_end], fetal (infection rate [blank_start]decreases[blank_end] as pregnancy progresses)
    • Highly [blank_start]contagious[blank_end]
    • Originally thought to be a benign disease until birth defects were linked to disease early in pregnancy

    • Post-natal infection
    - Fever, aching, [blank_start]swollen[blank_end] lymph nodes, cough, [blank_start]sore[blank_end] throat. Self- [blank_start]limiting[blank_end].

    • Congenital infection
    - infection in the first [blank_start]8[blank_end] weeks results in fetal damage in 85% of infants
    - immediate symptoms: cataracts, [blank_start]cardiac[blank_end] abnormalities, deafness
    - delayed symptoms - [blank_start]neurological[blank_end] impairment, [blank_start]behavioural[blank_end] disorders, diabetes

    • Treatment - treat [blank_start]symptoms[blank_end]

    • Prevention - Live vaccine ([blank_start]MMR[blank_end]), 90-97% effective
    1. Agram positive
    2. Bdroplets
    3. Cdecreases
    4. Dcontagious
    5. Eswollen
    6. Fsore
    7. Glimiting
    8. H8
    9. Icardiac
    10. Jneurological
    11. Kbehavioural
    12. LMMR
    13. Msymptoms
  9. 9Varicella-Zoster Virus
    - enveloped ds DNA virus
    - highly [blank_start]contagious[blank_end], airborn [blank_start]transmission[blank_end]
    - 3 diseases - congenital varicella syndrome ([blank_start]neonates[blank_end]), chickenpox ([blank_start]children[blank_end]), shingles (herpes zoster - [blank_start]adults[blank_end])
    - major complication is [blank_start]bacterial infections[blank_end] of rash
    - treatment - lotions to stop [blank_start]itching[blank_end], immunoglobulin or nucleotide analogues for at risk groups

    - congential disease in 1-2 trimester - very [blank_start]rare[blank_end], deformed [blank_start]limbs[blank_end], low birth [blank_start]weight[blank_end], scarring, [blank_start]mental[blank_end] defects.
    - 3 trimester - mother develops rash < [blank_start]4 days[blank_end] before delivery - disseminated & fulminant disease, [blank_start]30[blank_end]% mortality.
    - prevention: vaccine.
    1. Acontagious
    2. Btransmission
    3. Cchildren
    4. Dneonates
    5. Eadults
    6. Fbacterial infections
    7. Gitching
    8. Hrare
    9. Ilimbs
    10. Jweight
    11. Kmental
    12. L4 days
    13. M30
  10. 10Post natal infections - mother:
    • Risk of any infection [blank_start]1–4[blank_end]% after vaginal delivery and [blank_start]10–20[blank_end]% after caesarean section
    • Mild [blank_start]breast[blank_end] infections most common, anti-microbials in 1/3 of cases
    • Infections associated with [blank_start]discontinuation[blank_end] of breast feeding
    1. A1–4
    2. B10–20
    3. Cbreast
    4. Ddiscontinuation

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Beschreibung
Der Nutzer hat seine Fachbereichs-Information gelöscht. Quiz am L20 Infections (gestational, after), erstellt von Gelöschter Nutzer am 02/10/2019.
Autor
Gelöschter Nutzer
Sprache
English
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79
Verlauf
Erstellt am 2 Okt 2019 · aktualisiert am 2 Okt 2019
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