7 - STIs Flashcards
A positive “whiff” test is associated with what type of condition?
- bacterial vaginosis
What first line medical treatment of genital warts?
Trichloroacetic acid (TCA)
What phase of syphilis is this?
You see a maculo-papular rash on palms, condyloma latum and systemic symptoms. The onset is around 6 months after primary and lasts about 2-6 weeks.
- Secondary syphilis
What phase of syphilis is this?
Multiple systems are affected. You see gumma on the skin. Tabes Dorsalis, Argyl-Robertson pupil, blindness, paresis.
Tertiary syphilis
A patient presents with a cc of intense pruritus and a low-grade fever and malaise. What is the diagnoses?
- Pubic Louse “crabs”
What is the outpatient antibiotic treatment for PID?
- Ceftriaxone 250 mg IM
- AND Doxycycline x 14d
What is the cause of bacterial vaginosis?
- lack of hydrogen peroxide producing lactobacilli results in an increase in pH (>4.5)
What phase of syphilis is this?
You see painless ulcer with raised edges, almost always single. Highly infectious. It lasts about 3-6 weeks.
- Primary syphilis
A patient presents with a cc of intense pruritus that worsens at night. On physical exam you notice a papular rash with linear burrows. What is the diagnoses?
- Scabies
Genital warts is more common in what population?
immunocompromised
A “strawberry red” cervix is consistent with this infection.
trichomoniasis
What are the the treatment options for chlamydia?
- Azithromycin 1g PO x 1d
- OR Doxycycline 100 mg PO x 7d
(also prescribe to partner = EPT)
How are chlamydia and gonorrhea diagnosed?
Nucleic Acid Amplification Test (NAAT)
How is candidiasis (yeast) treated?
- Fluconazole 150 mg PO x 1
* other vaginal creams also available
What virus causes genital herpes?
HSV-1 or HSV-2
A patient presents for a regular check-up. She has no symptoms. When performing the pelvic exam you see mucopurulent discharge. What do you suspect the diagnosis could be?
- chlamydia
* asymptomatic*
What is usually the main treatment for molluscum contagiosum?
- nothing, allow to regress
The hallmark sign of this diagnosis is papular, centrally umbilicated lesions.
molluscum contagiosum
A 24 yo female presents to the clinic complaining of a thin discharge and a “fishy” odor. On physical exam you notice a milky vaginal discharge. What do you suspect the diagnoses is?
- bacterial vaginosis
What is the treatment for primary initial HSV infection?
- antivirals and topical lidocaine
What is the first line treatment for syphilis?
Penicillin G
What is the first line treatment for gonorrhea?
- Ceftriaxone 500 mg IM x 1d
- AND Azithromycin unless chlamydia excluded
How is trichomoniasis treated?
- metronidazole PO
How is bacterial vaginosis treated?
- metronidazole or clindamycin
What is the inpatient antibiotic treatment for PID?
- Cefotetan IV
- OR Cefoxitin IV
- AND Doxycycline PO/IV 14d
(treat until 24 hr after clinical improvement)
What is the diagnostic criteria that has to be met for PID?
- sexually active + < 25 yo
- AND history of STI OR multiple sex partners
- AND tenderness on pelvic exam
- AND no other etiology can be found
The CDC recommends annual screening of all sexually active women < _____ yo.
< 25 yo
What is argyll robertson pupil?
- pupils that accomodates but does not react to light
A patient presents with vaginal itching and burning. She states last time she had intercourse with her partner it was very painful. On physical exam you notice a thick white discharge that looks like “cottage cheese”. What do you suspect the diagnoses is?
Candidiasis (yeast)
What is tabes dorsalis?
- loss of propioception, vibration, and fine touch d/t demyelination of the dorsal columns
What is the treatment for both scabies or pubic louse?
- permethrin cream (Nix)
A patient presents with vaginal itching, burning, and dysuria. On physical exam you notice a frothy, white or grey discharge. What do you suspect the diagnoses is?
Trichomoniasis
What is the sequelae of chlamydia or gonorrhea that we try to prevent?
pelvic inflammatory disease
A patient presents with PHARYNGITIS. She has no other notable symptoms. When performing the pelvic exam you see mucopurulent discharge. What do you suspect the diagnosis could be?
- Gonorrhea
