13. STIs / Women's Health Flashcards
8 Bacterial STIs
- Chlamydia
- Gonorrhea
- Syphillis
- Chancroid
- Lymphogranuloma Venerum
- Genital Mycoplasms
- Group B Strep
5 Viral STIs
- HIV
- HSV I and II
- Cytomegalovirus
- Hepatitis B and C
- HPV
Protazoal STI (1)
• Trichomoniasis
Parasitic STIs (2)
- Pediculosis
* Scabies
Chlamydia: Causal organism
Chlamydia trachomatis
Chlamydia: Symptoms (4)
Rarely symptomatic, but may report: • Mucopurulent Discharge • Postcoital bleeding • Dysuria • Bartholin's Abcess
Chlamydia Diagnosis (2)
Urine or swab
Chlamydia: Treatment
Azithromycin
Gonorrhea: Symptoms (4)
Rarely symptomatic in women, but may complain of: • Purulent discharge • Dyspareunia • Dysuria • Bartholin's Abcess
Dyspareunia (def)
Painful intercourse)
Dysuria (def)
Painful urination
Gonorrhea: Symptoms
Ceftriaxone
Pelvic Inflammatory Disease: Cause
Complication on untreated GC, CT or other organism
Pelvic Inflammatory Disease: Risk factors (5)
- Young age
- Multiple partners
- History of STIs
- STI at time of IUD placement
- Douching
Minimum criteria for PID dx (3)
- Lower abdominal pain
- Bilateral adnexal tenderness
- Cervical motion tenderness
PID can result in… (3)
- Ectopic pregnancy
- Infertility
- Chronic Pelvic Pain
Syphilis: Timing of primary, secondary, tertiary
Primary: 10-90 days after infection
Secondary: After primary sxs
Tertiary: After 1-20 years of latency
Syphilis Birth defects (3)
- Deafness
- Bone deformities
- Neurological impairment
Primary Syphilis: Symptoms (3)
- Chancre
- Inguinal lymphadenopathy
- Can pass from mother to baby
Secondary Syphilis Symptoms (5)
- Palmar and plantar rash (not itchy)
- Condyloma Lata (genital warts)
- General malaise
- Fever
- Headache
Tertiary Symptoms (4)
- Neurologic
- Cardiovascular
- Musculoskeletal
- Multi-organ system complications
Syphilis Screen
Non-treponemal-antibody tests
(non-specific blood tests)
VDRL and RPR
Syphilis Diagnostic Test
to administer if screen is positive
Trepenomal Tests: FTA - ABS
Syphilis Treatment
Penicillin
Human papilloma Virus: Most common causal organisms (2)
HPV 6 & 11
HPV Diagnosis (2)
- Visual inspection
* PAP smear
HPV treatment (3)
- No cure
- Episodic treatment by topical podofilox
- Comfort measures
Comfort measures for HPV and HSV
- Oatmeal Bath
- Cotton Underwear
- Loose fitting clothing
- Keep lesions dry (HSV)
Symptoms of HSV: Initial episode (5)
- Multiple breakouts
- Fever
- Chills
- Malaise
- Vulvar edema
Symptoms of HSV: Recurrent episodes (2)
- Localized, prodromal tingling
* Painful, recurrent ulcers
Diagnosis of HSV (2)
- Culture: Swab of lesion (must pop blister to test)
* HSV PCR = Blood test
Sensitivity of HSV Blood test
80-90% effective
Treatment for HSV (3)
____CLOVIRs:
- Acyclovir
- Famcyclovir
- Valcyclovir
3 primary routes of transmission: HIV/ AIDS
1) Sexual
2) Parenteral (blood-borne)
3) Perinatal
HIV: Diagnostic Testing Recommendations
Diagnostic testing for all women 13-64
HIV Screen
Elisa Enzyme Immunoassay or Rapid Test
HIV Diagnosis (Confirmation)
Western Blot or Immuno-fluorescence assay
Antenatal treatment / obstetric risk reduction can reduce HIV transmission how much?
So that transmission rates are less than 2%
Trichomoniasis symptoms (6)
May be asymptomatic, or: • Yellow-green, frothy malodorous discharge • Inflammation of the vulva and vagina • Irritation • Pruritis • Dysuria • Dyspareunia
Trichomoniasis diagnosis
- “Strawberry cervix”
* MAY be identified on pap smear
Trichomoniasis treatment
Systemic Metrodazole (Flagyl)
Bacterial vaginosis: Symptoms
- Profuse gray / white discharge
* Fishy odor
BV Diagnosis
- Culture: Add KOH, whiff test
* Clue cells on slide
What are clue cells
(epithelial cells slough off, bacterial cells attach to them – cells are packed together)
BV Treatment
Metronidazole
Candidiasis Symptoms
• Cottage cheese discharge
(Severe: clear discharge because other dc is so thick it doesn’t come out
Candidiasis diagnosis
• Swab, slide, add KOH - wetmount: See PSUDOHYPHAE (yeast buds)
Candidiasis tx (4)
- Topical antifungals
- Oral difucan
- Comfort measures
- Hygiene
