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PoM II - Final Exam > 05. GYN Infections > Flashcards

05. GYN Infections Flashcards

1
Q

Which strains of HPV are targeted in Gardasil?

A

16, 18, 6, 11

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2
Q

Which strains of HPV are known to increase risk of cervical cancer?

A

16, 18

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3
Q

Which strains of HPV are known to cause most cases of genital warts?

A

6, 11

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4
Q

How can HSV be diagnosed in a patient with exposure but no outbreak?

A

Antibody tests

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5
Q

What symptoms will a patient experience during the prodrome phase of an HSV outbreak?

A

Tingling/itching of skin in region where lesion(s) will appear

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6
Q

How long does a primary HSV infection generally take to heal?

A

7-14 days

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7
Q

How long does viral shedding continue after a primary HSV infection?

A

2-3wks

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8
Q

What is the preferred tx for HSV?

A

Acyclovir (cheapest) or Valacyclovir (easiest BID dosing)

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9
Q

What are the preferred topical treatments for tinea?

A

Clotrimazole; miconazole; Ketoconazole

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10
Q

What organisms cause tinea?

A

Trichophyton rubrum; Epidermophyton floccosum

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11
Q

What oral treatments can be used for severe or unresponsive cases of tinea?

A

Itraconzole; Griseofulvin

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12
Q

What condition is associated with intense burning, pruritus, and erythema of the vaginal region with associated thick, curdy discharge?

A

Vaginal candidiasis

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13
Q

When diagnosising vaginal candidiasis, what characteristic should be observed on a wet mount?

A

Pseudohyphae

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14
Q

Are oral or topical therapies preferred for tx of vaginal candidiasis in a pregnant patient?

A

Topical

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15
Q

If a “strawberry cervix” and diffuse, malodorous, yellow-green d/c are observed during a specular exam, what STD should be suspected?

A

Trichomonas vaginalis

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16
Q

What treatments are effective for Trichomonas infections?

A

Systemic - Metronidazole or Tinidazole; Intravaginal NOT effective

17
Q

A patient comes to clinic complaining of vaginal discharge that is thick and milky and smells “fishy”. What is your leading differential diagnosis based on the patient’s description?

A

Bacterial vaginosis

18
Q

Is bacterial vaginosis an STD?

A

This is is a change in the balance of bacteria normally present in the vagina. It is NOT an STD, but it is considered a “sexually-associated infection”.

19
Q

What are indicative lab findings of bacterial vaginosis?

A

Clue cells (>20%) on microscopic eval of d/c; fishy odor during “whiff test”; vaginal pH >4.5

20
Q

What oral treatment is used for BV?

A

Metronidazole x 7 d

21
Q

What topical treatment is used for BV?

A

Clindamycin crm 2% QHS x 7d

22
Q

What STD causes target-shaped lesions on palms and soles?

A

Secondary syphilis

23
Q

What is the first line treatment for syphilis?

A

Benzathine PCN G 2.4 million units IM (not the same as Strep tx)

24
Q

What treatment can be used to treat syphilis in pts allergic to PCN?

A

Doxycycline BID x 28 d

25
Q

How can a chancroid be differntiated from a chancre d/t primary syphilis?

A

Chancroid infxn is painful. Primary syphilis chancre is painLESS.

26
Q

What is cervicitis?

A

Inflammation and infection of endocervical cells. MCC = GC & chlamydia.

27
Q

S/Sx of cervicitis

A

Often asymptomatic. Mucopurulent cervicitis/vaginal d/c. DYSURIA THAT MAY BE CONFUSED WITH UTI. POSTCOITAL BLEEDING D/T FRIABLE CERVIX. Suspect CHL when sterile pyuria with UTI symptoms present

28
Q

Tx of cervicitis

A

Presumptive tx for women

29
Q

PID

A

Pelvic inflammatory disease. Inflammation of the upper female genital tract. Often d/t GC and/or CHL

30
Q

Minimum criteria for Empiric Tx of PID

A

Pelvic/lower abdominal pain, AND Cervical motion tenderness or Uterine tenderness or Adnexal tenderness

31
Q

Definitive Dx of PID

A

Transvag U/S, or MRI, or Laparoscopy showing endometritis

32
Q

Tx of PID

A

Cefoxitin + Doxy +/- Metronidazole

33
Q

Fitz-Hugh-Curtis Syndrome

A

PID accompanied by RUQ pain resulting from inflammation of peritoneum around the LIVER. Laparoscopy reveals thins adhesions “violin strings” in abdomen d/t chronic inflammation.

34
Q

Complications of PID

A

Tubo-ovarian abscess (TOA); Adhesions, scarring, chronic pain; Infertility

35
Q

What genital tract infection results primarily from IUD placement?

A

Actinomycosis (d/t Actinomyces israelii)

36
Q

Tx of Actinomycosis

A

PCN & surgical drainage

37
Q

Tx of Genital TB

A

RIPE regimen x 24-36 mo

38
Q

CDC Criteria for TSS

A

Temp >38.9 C/102.2 F
Diffuse rash, intense erythroderma, blanching “boiled lobster”, with subsequent desquamation, esp. of palms & soles
Involvement of 3 or more organ systems

PoM II - Final Exam (12 decks)

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