Obstetrics
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| __% of women are GBS vaginal/rectal colonized | 10-30% (all PG women should be tested at 35-37 weeks)
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| What is the most common cause of neonatal sepsis | GBS (Strep agalactiae)
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| GBS bacteruria indicates | Heavy colonization
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| What is something you see in babies born to mothers on AZT for HIV | Lower WBC counts & macrocytic anemia (will resolve over time)
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| Chronic intrauterine infection is responsible for __% of IUGR pregnancies | 5-10
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| What is the most commonly identified pathogen responsible for IUGR | CMV
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| What is the most common protozoan, acquired by eating raw meat, that is responsible for IUGR | Toxoplasma gondii
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| Bacterial infections occur commonly in PG & frequently are implicated in PTD; but they are not commonly assoc w/IUGR; exception to this rule is chronic infx with: | Listeria monocytogenes
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| What is the clinical picture of an infant born to a mother infected with chronic listeria monocytogenes | Critically ill, encephalitis, pneumonitis, myocarditis, hepatosplenomegaly, jaundice, and petechiae
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| Early GBS = | 1st 6 days of life; 75% of cases; in utero or during birth; RFs: PTL, PROM, PPROM
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| Late GBS = | After 1st week of life; nosocomial or CA
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| BV adverse outcomes | PTD/LBW; intraamniotic or placental infxn (ID & Rx did not improve outcomes); USPSTF: no routine screen; tx sx
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| If PG pt pos for HBSAg: | check acute/chronic (HBcAb,LFT); test partner, if neg, vax
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| Hep E antigen = | increased risk of infectivity (vertical trans in maternal chronic Hep B)
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| Hep B vertical transmission: tx | Recombivax, HBIg to neonate after delivery (90% effective); mom can breastfeed after tx
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| Most common effects of rubella transmission | Heart, eye, ear; risks are GA dependent
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| Acyclovir is Category: | C
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| VZV: perinatal exposure: tx | VZIg perinatally (5 days before - 2 days after delivery); acyclovir for maternal VZV
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| Which vax can be given during PG? | Hep B, flu, tetanus (Tdap); DO NOT GIVE VZV or Rubella (live)
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| If active herpetic lesions/prodromal sxs: | deliver by C-section (60% fetal mortality in vaginal delivery, 50% transmission). PPx PO acyclovir after 36 weeks
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| Cystitis tx in PG | Ceph, nitrofurantoin, or sulfa x7-10 days
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| Pyelonephritis tx in PG | Admit, IV Abx (ceph or PCN + AG). Tocolytic tx to halt contractions if preterm labor. Repeat cx for TOC
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| If positive for Herpes: | C-section only if active lesions on vulva / vagina / cervix at time of labor
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| Tx if positive for gonorrhea | CTX 125mg IM or Cipro 500mg PO. All neonates receive eye drops (erythro or tetracycline)
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| Surveillance in HIV+ women who are PG | Viral load and CD4+ counts monthly
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| Chorioamnionitis bugs | Bacteroides, Prevotella. E coli. Anaerobic streptococci. GBS.
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| Endometritis clinical features | Usually presents on day 2-7 post partum. Usually polymicrobial. High fever, chills, purulent / foul lochia
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| Persistent fever, high WBC. Ruled out UTI, endometritis, Dx may be: | septic pelvic vein thrombophlebitis
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