Williams Chapter 64 ID

Providing passive immunity to the fetus, what<br />immunoglobulin is transferred across the placenta?

• IgA
• IgE
• IgG
• IgM

What is the most common perinatal infection in the developed world?

• Toxoplasmosis
• Cytomegalovirus
• Varicella-zoster virus
• Human parvovirus B19

Which of the following statements about cytomegalovirus (CMV) is true?

• Pregnancy increases the severity of maternal CMV infection
• Women who become infected with CMV during<br />pregnancy are at the greatest risk of having an<br />infected fetus.
• Anti-CMV IgG antibodies render a woman<br />immune and thus safe from recurrence, reinfection, or reactivation.
• Women of higher income groups are more likely<br />to be immune than women of lower socioeconomic backgrounds

A 30-year-old G1P0 presents at 18 weeks’ gestation. Her primary physician decided to send testing<br />for cytomegalovirus (CMV) because the patient<br />reported a mononucleosis-like illness a month<br />before. The testing revealed CMV IgG positive and<br />CMV IgM positive. The patient is very concerned<br />that her illness was primary CMV, and this baby<br />will be affected. What is the best next step in your<br />management?

• Amniocentesis
• CMV IgG avidity testing
• Periumbilical blood sampling
• No further evaluation is warranted

When there are abnormal sonographic findings and<br />positive findings in fetal blood or amnionic fluid,<br />what is the risk of symptomatic congenital CMV<br />infection?

• 0.25
• 0.5
• 0.75
• 1

What is the best accepted way to prevent maternal<br />primary cytomegalovirus (CMV) infection?

• Vaccination
• Hand washing
• Prophylaxis with valacyclovir
• CMV-specific hyperimmune globulin treatments<br />for women at risk for primary infection

Which of the following statements about varicella<br />pneumonia in pregnancy is false?

• Maternal mortality rates are 1–2%.
• Only 2–5% of pregnant woman infected with<br />varicella develop pneumonia.
• Having fewer than 100 cutaneous lesions is a risk<br />factor for varicella pneumonia
• Symptoms of varicella pneumonia usually appear<br />3–5 days into the illness course.

A 29-year-old G2P1 presents at 19 weeks’ gestation.<br />She reports a 2-day history of fever, runny nose, and<br />myalgias. She now has a pruritic rash. A photograph<br />is provided below. What is the most likely diagnosis?

• Mumps
• Varicella
• Influenza
• Toxoplasmosis

Which of the following statements about the infection shown in the photograph below is true?

• It is painless
• It is more contagious than primary varicella
• Congenital varicella syndrome rarely develops
• It is more frequent and more severe in pregnancy

A 27-year-old multigravida presents at 6 weeks’ gestation complaining of fever and a pruritic rash. You<br />diagnose her with varicella-zoster virus (VZV). Three<br />of your other pregnant patients were in the office<br />waiting room at the same time as the sick patient,<br />and you are concerned that they may have been<br />exposed. Two of them report a history of having<br />had varicella in childhood. One reports no history of<br />either vaccination or natural infection. What should<br />your management plan be for that patient?

• Vaccination now
• VZV serological testing followed by vaccination if<br />seronegative
• VZV serological testing followed by varicellazoster immune globulin if seronegative
• VZV serological testing followed by varicellazoster immune globulin and vaccination if<br />seronegative