JAAPA CME Post-Test August 2025
Cytomegalovirus: Maternal and Neonatal Infection Prevention and Management
Cytomegalovirus (CMV) is the most common congenital infection in the United States and a leading cause of nongenetic sensorineural hearing loss (SNHL). This activity reviews
the epidemiology and diagnosis of CMV infection, with an emphasis on the effects of congenital infection on fetal and neonatal health. Recognition of early signs of infection and prompt testing in the neonate are imperative to prevent or decrease the severity of long-term sequelae, including SNHL. This activity also highlights the importance of congenital CMV screening and audiology follow-up in infants, and it provides an overview of specialty interventions, possible treatment, related education, and prevention in women of reproductive age.
Learning Objectives
At the conclusion of this activity, participants should be able to:- Identify clinical signs and risk factors of cCMV in newborns that warrant diagnostic testing, including the timing and type of recommended testing
- Describe the appropriate use of targeted CMV screening in newborns and differentiate it from universal screening approaches currently under investigation
- Summarize current guidelines for the management of infants with confirmed cCMV including criteria for antiviral therapy, recommended hearing follow-up schedules, and multidisciplinary care needs
- Apply evidence-based strategies to counsel pregnant patients and caregivers on effective hygiene practices to reduce the risks of infection and transmission
Using Point-of-Care Ultrasound to Assess Volume Status
Determining volume status at the bedside is an essential skill clinicians must possess. Unfortunately, traditional bedside
assessments, including measuring vital signs, obtaining a history, and performing a physical examination, are often unreliable and limited by patient body habitus. Point-of-care ultrasound (POCUS) is a valuable and accurate adjunct to aid in determination of a patient’s volume status. POCUS of the lungs, heart, inferior vena cava, and internal jugular vein can add valuable data for clinicians when determining volume status. Specifically, lung ultrasound is more accurate than physical examination and chest radiography in detecting pulmonary edema and pleural effusions; cardiac POCUS allows for qualitative estimations of left ventricle and right ventricle function and can confirm the presence or absence of clinically significant pericardial effusions; and POCUS of the inferior vena cava and internal jugular vein can estimate right atrial pressure, and in the appropriate clinical context, help to determine intravascular volume status.
Learning Objectives
At the conclusion of this activity, participants should be able to:- Describe the utility of POCUS in the evaluation of volume status
- Understand which POCUS examination types are necessary for evaluating a patient’s volume status
- Discuss limitations of POCUS in evaluating a patient’s volume status
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