24/3/22 Flashcards
Coliforms are sensitive to what antibiotic?
Gentamicin
What factors must you consider when changing from IV to oral antibiotics?
Remember oral is optimum if poss
Ability to swallow
Afebrile
Where must you check with cellulitis of the leg and why?
Check between toes for tinea pedis (athletes foot) - potential point of entry
What is “rouleaux” formation on blood film?
Stacking of RBC
How does heparin work?
Increases potency of anti-thrombin
Should you worry if you see swab of pseudomonas aeruginosa from an ulcer?
No - they commonly colonise ulcers and only worry if patient not recovered from antibiotics for staph aureus etc.
More likely to cause problems if diabetic, or esp. deep
Is doxycycline allowed in pregnancy?
No
What antibiotic must patients not drink on?
Why?
Metrinidazole
Can cause N+V, flushing and in severe cases
What is the drug treatment for the following STIs
- Chylamdia
- Bacterial vaginosis
- Gonorrhoea
- Trichomoniasis
- Candida
- PID
- Syphillis
What extra advice would you give for BV and candidia?
Cyhlamdia - doxcycline 100mg BD x1wk Gonorrhoea - ceftriaxone 1g IM Trichomoniasis - metronidazole Candida - clotrimazole pessary and cream Bacterial vaginosis - metronidazole
PID
- Ceftriaxone 1g IM
- Doxycycline 100mg BD x2wk
- Metronidazole 100mg BDx2wk
Wash with just water or completely unperfumed soap
Cotton underwear
Clyamdia doesn’t present with discharge colour change in women. It is normally asymptomatic - if it isn’t how would it present?
In men it can present with what kind of discharge?
Abdo pain
Abnormal bleeding
General change in discharfe
Milky
NAAT swabs are used to test for gonorrhoea and chlamydia - they test for DNA and RNA.
What are charcoal swabs used to test for?
Bacterial vaginosis and trichomoniasis
What STI are clue cells associated with?
BV
What STI is a strawberry cervix (multiple haemorraghes across the cervix which give it the appearance of a strawberry) assoc. with?
Trichomoniasis
What kind of pain in women is characterisitic of GU infection?
Deep dyspareunia - pain on deep vaginal intercourse
What is cervical excitation?
What is it a sign of?
Patient complaining of tenderness when moving cervix from side to side
Sign of pelvic inflammation
- PID
- Ruptured ectopic
What is involved in a standard STI screen if done anywhere in the UK?
NAAT - Gonorrhoea - Chlyamidia Serology - HIV - Syphilis
If wanting to do a speculum and STI screen what should be remembered?
Make sure do NAAT swab before speculum exam or else results not valid
How do you perform a NAAT swab on males and females?
Females - typically self performed vaginal swab
Males - first void urine (like to have held urine for at least an hour)
If a patient has signs and symptoms of upper GU tract infection - which are?
What would you treat for alongside any other infection?
Cervical excitation
Deep dyspareunia
Abdo pain
PID
What is the most common bacterial STI?
Chylamidia
How many days after exposure to chylamdia should you get tested?
14 days
What is a ‘test of cure’?
In what STI is it done?
How long after treatment?
Test to make sure AB worked
Gonorrohea
2wks after ceftriaxone 1g IM
Can neonatal herpes happen in primary and non-primary attacks?
Just primary in 3rd trimester
Give a DD of lymphadenopathy in the neck
Infection
- EB
- Secondary syphilis
- TB
- HIV
Neoplasm
- leukemia
- lymphoma
- metastatic
- thyroid adenocarcinoma
Autoimmune
- SLE
- RA
Patient presents with a genital painless ulcer - what do you suspect?
Primary syphilis
What is the name of the bacteria that causes syphilis?
treponema pallidum
What is the treatment of syphilis - how does it differ for early and late presentation?
What makes it late syphilis?
Late = asymptomatic and had for over 2 years
IM benzathine penicillin - stat for early
Late = weekly dose for 3 weeks
What HPV type is worse - 16 or 18?
16
What is the treatment for HPV warts?
podophyllotoxin
What causes the majority of HPV warts?
HPV 6 and 11
