Model Answers Microbiology Written examinations 2007 - RCPA

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NA 2. Sensitive and specific reliable assay available Limited probably to detection of discordant partners in pregnancy HSV positive male and HSV negative female at risk of primary HSV infection in pregnancy Risk when primary infection occurring at delivery – 50% 3. Availability of a safe effective intervention strategy if detected Practice safe sex at time from 36 weeks 4. Occurs at a frequency that has a cost benefit for the screening ? Parvovirus Detect potential foetal infection and damage Not teratogenic Foetal hydrops – intrauterine transfusion 1. Sensitive and specific reliable assay available IgM – IgG – Immune status Recent infection ? recent infection, susceptible, immune Repeat in 2-4 weeks after exposure or if symptoms occur 2. Availability of a safe effective intervention strategy if detected Foetal hydrops – intrauterine transfusion Ultrasound 3. Occurs at a frequency that has a cost benefit for the screening Diagnosis of infection following contact or illness with rash during pregnancy Common non notifiable infection
Question 1, Marker 2 What is the role of antenatal serology in modern medical practice and why? Role to allow intervention Opportunity to terminate pregnancy/counsel re possible outcomes of pregnancy Prevent transmission Prevent infection/sequelae of infection if transmission occurs Allow early therapeutic intervention/monitoring of infant Opportunistic screening of women who are presenting to health care workers Discussion points: Screening vs symptomatic Universal vs targeted Cost effective Timing of screening eg preconception/early „booking‟ bloods ~ 12 weeks +/- later in pregnancy Australia If no useful intervention or cost/benefit not favourable then screening not recommended. Confirmatory testing – may involve further cost, anxiety, procedures eg amniocentesis, foetal blood sampling – risks to pregnancy Hepatitis B surface antigen – passive and active immunisation at birth prevents > 95% transmission Rubella IgG – if non immune vaccinate post partum
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Model Answers Microbiology Written examinations 2007 - RCPA

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