5. MTB Step 3 - Sexually Transmitted Diseases Flashcards
URETHRITIS
What are (2) Symptoms of Urethritis and which one of those Symptoms MUST be present for a Clinical Diagnosis?
- Urethral Discharge - MUST be present for Clinical Diagnosis
- Dysuria - frequency, urgency, burning.
*Discharge w/o dysuria is still Urethritis*
**Dysuria w/o discharge is not necessarily urethritis; may just have cystitis (eg, UTI)**
URETHRITIS
What are (2) Methods for diagnosing Urethritis?
-
Urethral Swab for:
- Gram Stain
- WBC count
- Culture
- DNA probe
-
Nucleic Acid Amplification Test (NAAT):
- Comparable to PCR
- Can be done on urine sample in a MAN
URETHRITIS
Which 2-Drug Combination is the First-Line Therapy for Urethritis?
Ceftriaxone (IM) + Azithromycin (Single Dose)
**may use Doxycycline (for a week) instead of Azithromycin (single dose), EXCEPT in pregnant women (only Ceftriaxone + Azithromycin for pregnant women)**
URETHRITIS
What are (3) Signs/Symptoms of Disseminated Urethritis?
- Polyarticular Disease
- Petechial Rash
- Tenosynovitis
URETHRITIS
In a patient who develops Recurrent Episodes of Gonorrhea, what Disorder should you test them for?
Terminal Complement Deficiency
**Predisposes patient to recurrent episodes of ANY form of Neisseria infection**
CERVICITIS
What is the Clinical Presentation of Cervicitis?
Cervical Discharge
CERVICITIS
What are (2) Methods for diagnosing Cervicitis?
-
Cervical Swab for:
- Gram Stain
- WBC count
- Culture
- DNA probe
-
Nucleic Acid Amplification Test (NAAT):
- Comparable to PCR
- Can be done on Self-administered Blind Vaginal Swab in a WOMAN
CERVICITIS
Which 2-Drug Combination is the First-Line Therapy for Cervicitis?
Ceftriaxone (IM) + Azithromycin (Single Dose)
*may use Doxycycline (for a week) instead of Azithromycin (single dose), EXCEPT in pregnant women (only Ceftriaxone + Azithromycin for pregnant women)*
**Same Tx as Urethritis**
PELVIC INFLAMMATORY DISEASE (PID)
What are (4) Clinical Manifestations of PID?
- Lower Abdominal Pain
- Tenderness
- Fever
- Cervical Motion Tenderness
**+/- dysuria, +/- vaginal discharge**
PELVIC INFLAMMATORY DISEASE (PID)
- What is the Best INITIAL Diagnostic Test for PID?
- What is the NEXT Best Step in Management?
- What is the Most ACCURATE Diagnostic Test for PID?
- Best INITIAL Test = Pregnancy Test (to exclude ectopic pregnancy)
- NEXT Best Step = Cervical Culture & DNA probe
- Most ACCURATE Test = Laparoscopy (only done for Recurrent or Persistent PID despite therapy or for cases in which the diagnosis is not clear)
**Leukocytosis is a measure of Severity**
PELVIC INFLAMMATORY DISEASE (PID)
Which (2) Medications do you give for OUTPATIENT Treatment of PID?
Ceftriaxone (IM) and Doxycycline (PO)
PELVIC INFLAMMATORY DISEASE (PID)
Which (4) Medications do you give for INPATIENT Treatment of PID?
Cefoxitin (IV) or Cefotetan and Doxycycline and +/- Metronidazole
PELVIC INFLAMMATORY DISEASE (PID)
Which (2) Medications do you give for PID in a patient with a Penicillin Allergy?
Clindamycin and Gentamicin
PELVIC INFLAMMATORY DISEASE (PID)
What is the Mechanism of Infertility and Ectopic Pregnancy in PID?
The fallopian tubes become scarred and narrowed. Sperm cannot travel in to fertilize the egg. Fertilized eggs get caught and implant in the wrong place-all from loss of ciliary action, fibrosis, and occlusion.
EPIDIDYMO-ORCHITIS
What are (2) Signs/Symptoms of Epididymo-Orchitis?
- Painful & Tender Testicle
- NORMAL position of Testicle in Scrotum
**testicular torsion presents with elevated testicle in abnormal transverse position and absence of cremasteric reflex on affected side**
