2026/2027
Gmail:
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AHN 548 Exam 1 Questions
with Detailed Verified
Answers
Congenital infections- essentials of dx and typical features Ans: can be
acquired in utero, perinatally and postnatally
-Can be asymptomatic in newborn period
-clinical sx complexes include IUGR, chorioretinitis, cataracts, cholestatic
jaundice, thrombocytopenia, skin rash and brain calcifications
-Dx: PCR, antigen and antibody studies and culture
CMV
(Congenital) Ans: MOST COMMON TRANSMITTED IN UTERO
Sx: hepatosplenomegaly, petechiae, growth restriction, microcephaly, direct
hyperbili, thrombocytopenia, intracranial calcifications and chorioretinitis,
HEARING LOSS
TX: Ganciclovir therapy 6mg/kg IV q12h for 6 weeks for symptomatic neonates
affecting the CNS and prevent hearing loss progression
Rubella
(Congenital) Ans: risk of fetal infection and congenital defects as high as 85%
in mothers infected during 1st trimester.
SX: microcephaly, encephalitis, cardiac defects (PDA and pul art stenosis and
arterial hypoplasia), cataracts, retinopathy, and micropthalmia,
hepatosplenomegaly, thrombocytopenia and deafness
Dx: characteristic clinical illness in mother, inc serum rubella-specific IgM or
culture of pharyngeal secretions
, 2026/2027
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Varicella
(Congenital) Ans: Congenital varicella is rare
Sx: limb hypoplasia, cutaneous scars, microcephaly, cortical atrophy,
chorioretinitis and cataracts
Perinatal caricella --> neonate should receive varicella-zoster immune globulin
or IVIG, or if that's not done --> acyclovir.
Toxoplasmosis
(congenital) Ans: Most infants initially asymptomatic
Sx: mental retardation, visual impairment, learning disabilities, growth
restriction, jaundize, chorioretinitis, sz, hepatosplenomegaly, adenopathy,
cataracts, maculopapular rash, thrombocytopenia, pneumonia
Dx: positive toxoplasma-specific IgA, IgE, or IgM in first 6mo of life
Tx: spiramycin for mom to prevent transmission to fetus. Neonatal tx-
pyrimethamine and sulfadiazine with folinic acid.
Sources: cat feces, ingestion of raw/undercooked meat
Fetal damage most severe in 2-6th month gestation.
Parvovirus B19
(Congenital) Ans: If infected during pregnancy- results in severe anemia,
myocarditis, nonimmune hydrops, or fetal death. If fetus survives, long term
outcome is good.
Congenital syphilis Ans: Active primary and secondary maternal syphilis leads
to transplacental passage to fetus in nearly 100% of cases.
Fetal infection can reult in stillbirth or prematurity.
Sx: mucocutaneous lesions, lymphadenopathy, hepatosplenomegaly, bony
changes, hydrops (newborns often asymptomatic)
Herpes Simplex
, 2026/2027
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(Perinatal) Ans: acquired during transit through infected birth canal
Sx days 5-14: localized (skin, eye, mouth) or disseminated (shock, pneumonia,
hepatitis) disease
Sx days 14-28: CNS- lethargy, fever, sz
Dx: viral cultures from vesicles, PCR
Tx: acyclovir 60mg/kg/d divided q8h- 14days if localized, 21 days if
disseminated or CNS.
Mom needs c/s if active genital disease
If mom has active lesions at delivery, neonate needs eye, oropharynx,
nasopharynx, rectum and blood HSV PCr- if colonized, treatment with
acyclovir x10days (if no active lesions on infant)
Hepatitis B & C
(Perinatal) Ans: Infected at time of birth, intrauterine transmission rare
If mother haspositive HBsAg, then the infant should receive HBIG. and hep B
vaccine asap after birth. If mom not tested before birth, run test after, give
Hep B vaccine within 12hours, and if pos, HBIG too.
Enterovirus infection
(Perinatal) Ans: Pos maternal hx of diarrhea, fever and/or rash.
Sx: appears in first 2 weeks- fever, lethargy, irritability, diarrhea and/or rash.
Can p/w meningoencephalitis, myocarditis, hepatitis, pneumonia, shock and
DIC
Dx: PCR
TX: no identified therapy, good prognosis except those with hepatitis,
myocarditis or disseminated dz
HIV infection
(Perinatal) Ans: Can be acquired in utero at time of delivery or via breast milk
, 2026/2027
Gmail:
27
Known mothers with HIV should be treated with zidovudine therapy as early
as 14weeks gestation. Infant for first 6 weeks of life beginning within 12hours.
Best prevention combination: c/s, zidovudine and avoidance of breastfeeding.
Unknown mothers- prophylaxis with 2-3 rx.
Infants asymptomatic, test HIV DNA PCR at 48hrs, 2weeks, 1-2 months, and
2-4 months.
Vitamkin K deficiency bleeding in newborn Ans: Frequently exclusively
breastfed, otherwise clinically well infant
Bleeding from mucous membranes, GI tract, skin or internal (intracranial)
Prolonged PT normal PTT normal fibrinogen and platelet count
Clotting factor deficiency (II, VII, IX, and X).
DDx: DIC and hepatic failure
Tx: 1mg vitamin K SC or IV. avoid IM if pt is actively bleeding
Thrombocytopenia Ans: Generalized petechiae; oozing at cord or puncture
sites
Thrombocytopenia (platelets usually <50,000/ml)
In an otherwise well infant, suspect isoimmune thrombocytopenia- mother's
iGG antibody leads to platelet destruction- may need to treat with IVIG to
mom or infant.
Tx: transfuse platelets (10ml/kg increases platelet count by 70,000/ml), in
preterm infants at r/f IVH, transfuse for counts <40-50,000.
Anemia Ans: HcT < 40% at term birth
Acute blood loss- signs of hypovolemia, normal reticulocyte count
Chronic blood loss- pallor without hypovolemia, elevated reticulocyte count
Hemolytic anemia- accompanied by excessive hyperbilirubinemia
Gmail:
27
AHN 548 Exam 1 Questions
with Detailed Verified
Answers
Congenital infections- essentials of dx and typical features Ans: can be
acquired in utero, perinatally and postnatally
-Can be asymptomatic in newborn period
-clinical sx complexes include IUGR, chorioretinitis, cataracts, cholestatic
jaundice, thrombocytopenia, skin rash and brain calcifications
-Dx: PCR, antigen and antibody studies and culture
CMV
(Congenital) Ans: MOST COMMON TRANSMITTED IN UTERO
Sx: hepatosplenomegaly, petechiae, growth restriction, microcephaly, direct
hyperbili, thrombocytopenia, intracranial calcifications and chorioretinitis,
HEARING LOSS
TX: Ganciclovir therapy 6mg/kg IV q12h for 6 weeks for symptomatic neonates
affecting the CNS and prevent hearing loss progression
Rubella
(Congenital) Ans: risk of fetal infection and congenital defects as high as 85%
in mothers infected during 1st trimester.
SX: microcephaly, encephalitis, cardiac defects (PDA and pul art stenosis and
arterial hypoplasia), cataracts, retinopathy, and micropthalmia,
hepatosplenomegaly, thrombocytopenia and deafness
Dx: characteristic clinical illness in mother, inc serum rubella-specific IgM or
culture of pharyngeal secretions
, 2026/2027
Gmail:
27
Varicella
(Congenital) Ans: Congenital varicella is rare
Sx: limb hypoplasia, cutaneous scars, microcephaly, cortical atrophy,
chorioretinitis and cataracts
Perinatal caricella --> neonate should receive varicella-zoster immune globulin
or IVIG, or if that's not done --> acyclovir.
Toxoplasmosis
(congenital) Ans: Most infants initially asymptomatic
Sx: mental retardation, visual impairment, learning disabilities, growth
restriction, jaundize, chorioretinitis, sz, hepatosplenomegaly, adenopathy,
cataracts, maculopapular rash, thrombocytopenia, pneumonia
Dx: positive toxoplasma-specific IgA, IgE, or IgM in first 6mo of life
Tx: spiramycin for mom to prevent transmission to fetus. Neonatal tx-
pyrimethamine and sulfadiazine with folinic acid.
Sources: cat feces, ingestion of raw/undercooked meat
Fetal damage most severe in 2-6th month gestation.
Parvovirus B19
(Congenital) Ans: If infected during pregnancy- results in severe anemia,
myocarditis, nonimmune hydrops, or fetal death. If fetus survives, long term
outcome is good.
Congenital syphilis Ans: Active primary and secondary maternal syphilis leads
to transplacental passage to fetus in nearly 100% of cases.
Fetal infection can reult in stillbirth or prematurity.
Sx: mucocutaneous lesions, lymphadenopathy, hepatosplenomegaly, bony
changes, hydrops (newborns often asymptomatic)
Herpes Simplex
, 2026/2027
Gmail:
27
(Perinatal) Ans: acquired during transit through infected birth canal
Sx days 5-14: localized (skin, eye, mouth) or disseminated (shock, pneumonia,
hepatitis) disease
Sx days 14-28: CNS- lethargy, fever, sz
Dx: viral cultures from vesicles, PCR
Tx: acyclovir 60mg/kg/d divided q8h- 14days if localized, 21 days if
disseminated or CNS.
Mom needs c/s if active genital disease
If mom has active lesions at delivery, neonate needs eye, oropharynx,
nasopharynx, rectum and blood HSV PCr- if colonized, treatment with
acyclovir x10days (if no active lesions on infant)
Hepatitis B & C
(Perinatal) Ans: Infected at time of birth, intrauterine transmission rare
If mother haspositive HBsAg, then the infant should receive HBIG. and hep B
vaccine asap after birth. If mom not tested before birth, run test after, give
Hep B vaccine within 12hours, and if pos, HBIG too.
Enterovirus infection
(Perinatal) Ans: Pos maternal hx of diarrhea, fever and/or rash.
Sx: appears in first 2 weeks- fever, lethargy, irritability, diarrhea and/or rash.
Can p/w meningoencephalitis, myocarditis, hepatitis, pneumonia, shock and
DIC
Dx: PCR
TX: no identified therapy, good prognosis except those with hepatitis,
myocarditis or disseminated dz
HIV infection
(Perinatal) Ans: Can be acquired in utero at time of delivery or via breast milk
, 2026/2027
Gmail:
27
Known mothers with HIV should be treated with zidovudine therapy as early
as 14weeks gestation. Infant for first 6 weeks of life beginning within 12hours.
Best prevention combination: c/s, zidovudine and avoidance of breastfeeding.
Unknown mothers- prophylaxis with 2-3 rx.
Infants asymptomatic, test HIV DNA PCR at 48hrs, 2weeks, 1-2 months, and
2-4 months.
Vitamkin K deficiency bleeding in newborn Ans: Frequently exclusively
breastfed, otherwise clinically well infant
Bleeding from mucous membranes, GI tract, skin or internal (intracranial)
Prolonged PT normal PTT normal fibrinogen and platelet count
Clotting factor deficiency (II, VII, IX, and X).
DDx: DIC and hepatic failure
Tx: 1mg vitamin K SC or IV. avoid IM if pt is actively bleeding
Thrombocytopenia Ans: Generalized petechiae; oozing at cord or puncture
sites
Thrombocytopenia (platelets usually <50,000/ml)
In an otherwise well infant, suspect isoimmune thrombocytopenia- mother's
iGG antibody leads to platelet destruction- may need to treat with IVIG to
mom or infant.
Tx: transfuse platelets (10ml/kg increases platelet count by 70,000/ml), in
preterm infants at r/f IVH, transfuse for counts <40-50,000.
Anemia Ans: HcT < 40% at term birth
Acute blood loss- signs of hypovolemia, normal reticulocyte count
Chronic blood loss- pallor without hypovolemia, elevated reticulocyte count
Hemolytic anemia- accompanied by excessive hyperbilirubinemia
