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Women's Health > cervicitis > Flashcards

cervicitis Flashcards

1
Q

Gonorrhea in neonates can lead to?

A

Ophthalmia neonatorum (gonococcal conjunctivitis) which can lead to blindness.

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2
Q

What is the treatment for Gonorrhea ?

A

ceftriaxone 500 mg IM <150 kg (300 lb)
ceftriaxone 1000 mg IM ≥ 150 kg (300 lb)

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3
Q

What surfaces afftected by gonorrhea?

A

Any mucocutaneous surface: oral, urethral, vaginal, cervical, and anal

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4
Q

Persistent Pharynigitis (sore throat) should make you consider a diagnosis of ?

A

Gonorrhea

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5
Q

most common curable sexually transmitted infection in the United States

A

Gram-negative obligate, nonmotile intracellular bacteria known as Chlamydia trachomatis

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6
Q

second most common sexually transmitted infection in the US

A

Gram-negative diplococci bacteria Neisseria gonorrhoeae.

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7
Q

What are the serotypes that cause lymphogranuloma ?

A

Chla,ydia trachomatis L1. L2 & L3

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8
Q

What is lymphogranuloma venerum ?

A

Ulcerative sexually transmitted infection of the genital area caused by chlamydia trachomatis

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9
Q

What are the 3 stages of lymphogranuloma venerum?

A

Primary stage: Short lived PAINLESS genital ulcer at inoculation site.

Secondary stage: 2-6 weeks later-> PAINFUL unilateral or bilateral inguinal/ femoral lymphadenopathy (also called buboes).
——–>proctocolitis can develop.

Late stage with strictures, fibrosis, and fistulae of the anogenital area.

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10
Q

What is the 1st stage of lymphogranuloma venerum?

A

Short lived PAINLESS genital ulcer at inoculation site

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11
Q

What is the 2nd stage of lymphogranuloma venerum?

A

2-6 weeks later: PAINFUL unilateral or bilateral inguinal/ femoral lymphadenopathy (also called buboes).

——–> Proctocolitis can develop: rectal discharge, anal pain, pain with defecation, rectal bleeding, tenesmus

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12
Q

What is the 3rd stage of lymphogranuloma venerum?

A

Late stage: Necrosis and rupture of the lymph nodes—–>strictures, fibrosis, and fistulae of the anogenital area.

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13
Q

How is lymphogranuloma venerum treated?

A

all nonpregnant patients is doxycycline 100 mg oral twice daily for 21 days.

azithromycin or erythromycin for pregnant people

I&D of Buboes to avoid rupture or sinus tract formation.

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14
Q

What are some complications of gonorrhea and chlamydia ?

A

Pelvic inflammatory disease
Infertility
Chronic pelvic pain

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15
Q

How are pregnant patients diagnosed with chlamydia treated?

A

Azithromycin 1000 mg PO x1

NEVER GIVE DOXYCYCLINE TO A PREGNANT PERSON!!!!

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16
Q

How are non-pregnant people diagnosed with chlamydia treated?

A

Doxycycline 100 mg BID x7 days

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17
Q

What should a pregnant person with chlamydia obtain a test of cure?

A

In 4 weeks. & retest in 3 months.

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18
Q

In men chlamydia can also cause?

A

Epididymitis = unilateral pain & swelling of scrotum.

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19
Q

Signs of chlamydial infection in newborns may include

A

Fever, cough, wheezing, and crackles (in pneumonia)

Conjunctival erythema, mucoid discharge, or periorbital swelling (in conjunctivitis), often bilateral

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20
Q

Ceftriaxone is safe to use in pregnant people diagnosed with gonorrhea. T/F

A

T

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21
Q

a 22-year-old patient presents with a complaint of painful blisters on the vulva and vaginal introitus. She admits to a prodrome of burning, tingling, and pruritus before the appearance of lesions. Upon examination, you note vesicles on an erythematous base.

A

Herpes Simplex Virus 2

22
Q

Herpes Simplex Virus: what is?

A

Enveloped double-stranded DNA viruses that affect the skin and mucous membranes

23
Q

What is the genital presentation of Herpes simplex

A

Prodromal burning, tingling or itching before lesions

Multiple grouped vesicles on an erythematous base

Painful inguinal lymphadenopathy.

24
Q

How should a pregnant women with a hx of herpes and desires vaginal birth be treated?

A

Antiviral therapy at 36 wks - delivery

If outbreak is present at the time of delivery = C-section

25
Q

What is the diagnosis of HSV?

A

Viral culture: Gold

Polymerase chain reaction: more sensitivity and specific

Tzanck prep: multinucleated giant cells

26
Q

What is the tx for HSV

A

Acyclovir (TID)
Valacyclovir (BID)

27
Q

When is viral suppression indicated in pts w HSV?

A

> 6 episodes in 1 year
->valacyclovir 500 mg once daily

28
Q

Where does HSV 2 lie dormant

A

Sacral Ganglia

29
Q

Genital warts is caused by

A

HPV type 6 and 11

30
Q

Which HPV cause cervical cancer ? Which is the most common type?

A

HPV 16 & 18 is the most common type

HPV 31, 33 & 35 also cause cervical cancer

31
Q

Which vaccine protects against HPV causing cervical cancer?

A

HPV 9-valent vaccine

32
Q

What are some treatments for genital warts?

A

Pt applied podophyllin &Topical imiquimod
Clinician: trichloroacetic acid & Cryotherapy with liquid nitrogen

33
Q

Chancroid is caused by the pathogen ?

A

Haemophilus ducreyi: gram neg rod

34
Q

A pt presents with complaints of a cauliflower like lesion on her vulva. What solution can be used to confirm it diagnosis?

A

4% acetic acid applied will turn the area white = positive finding for genital warts.

35
Q

outpatient treatment for pelvic inflammatory disease, Regimen A consists of a single intramuscular dose of ____________ followed by oral antibiotics __________ and _____________ for 14 days.

A

outpatient treatment for pelvic inflammatory disease, Regimen A consists of a single intramuscular dose of ceftriaxone followed by oral antibiotics doxycycline and metronidazole for 14 days.

36
Q

_________________ is a complication of pelvic inflammatory disease depicted by a fluid-filled fallopian tube on ultrasonography.

A

hydrosalpinx

37
Q

_________________________and Neisseria gonorrhoeae are the most common sexually transmitted organisms associated with pelvic inflammatory disease

A

Chlamydia trachomatis

38
Q

Pelvic inflammatory disease can lead to _________________syndrome which is an infection of the liver capsule and “violin string” adhesions of peritoneum to the liver

A

Fitz-Hugh–Curtis syndrome

39
Q

_______________ sign refers to cervical motion tenderness, elicited in patients with pelvic inflammatory disease.

A

Chandelier sign

40
Q

What are some complications of PID?

A

infertility, ectopic pregnancy, tubo-ovarian abscess (adnexal mass), fitz-hugh-curtis syndrome

41
Q

___________ is a feature of tertiary syphilis that is described as a pathological pupil that shows accommodation but does not react to light.

A

Argyll-Robertson pupil

42
Q

_________is the spirochete bacterium that causes syphilis and initially produces small, painless indurated genital lesions.

A

Treponema pallidum

43
Q

The treatment for syphilis is______

A

Penicillin G
-> doxycycline can be used if allergy rxn

44
Q

What is the tx of early syphilis (primary & secondary & early latent syphilis) ?

A

Single dose of intramuscular penicillin

45
Q

What is the tx of late syphilis (latent syphilis & teritary syphilis)?

A

IM penicillin weekly for x3 weeks.

46
Q

What does primary syphilis entail?

A

a single painless genital ulcer at the site of inoculation.
-> smooth base with firm well-demarcated borders
inguinal adenopathy

47
Q

Secondary syphilis entails?

A

Dissemination of syphilis into bloodstream weeks - months after primary.

-> Pink-brown maculopapular rash: starts a trunk and spreads to sole & palms.
->condyloma lata: smooth white painless wart-like lesion.

48
Q

What is amsel criteria? What diagonsis is it associated with ?

A

Amsel is the dx criteria used for BV. Most have 3/4 for a dx.

Homogeneous, thin, white-gray discharge
> 20% clue cells on saline microscopy
Vaginal fluid pH > 4.5
Positive potassium hydroxide whiff test result

49
Q

What are cell cells?

A

Clue cells are vaginal epithelial cells that have a stippled appearance due to coccobacilli that adhere to the edge of the cell.

50
Q

What is the whiff test?

A

Detection of a fishy odor (caused by amines) when vaginal secretions are placed in 10% KOH

51
Q

What are the risk factors for vulvovaginal candidiasis?

A

Oral contraceptive use, recent antibiotic therapy, corticosteroid therapy, pregnancy, poorly controlled DM, and tight-fitting undergarments. Infection with HIV has been associated with an increased incidence of persistent or recurring infections.

52
Q

How is the diagnosis of vulvovaginal candidiasis made?

A

Identification of pseudohyphae in vaginal secretions mixed with 10% KOH confirms the diagnosis. Vaginal pH is normal (<4.5).

Women's Health (12 decks)

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