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Men's Health > Day 3 > Flashcards

Day 3 Flashcards

1
Q

You are visualizing a patient with a cauliflower like lesion on his penis and are trying to decide; what is it? How do you treat this?

A

A condyloma acuminata indicative of HPV, treat w/ podofilox .5% solution or gel (Condylox)

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2
Q

What is the dosing regimen for Podofilox gel when prescribing for a pt with HPV…

A

3 days on/4 days off can do up to 4 cycles.

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3
Q

How do most infections of HPV present?

A

Asx; but warts are most common sign…

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4
Q

What are some complications of HSV that you want to be cautious for…

A

blindness especially if there is a vesicle on the nose…

aseptic meningitis, herpes encephalitis, radicular pain, constitutional sx, painful lesions.

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5
Q

How would u go about working up to DX HSV once suspected..

A

Viral Culture (Gold standard)

  • PCR in the CSF
  • Western Blot/ELISA more common to check partners as opposed to acute sx.
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6
Q

Which test was previously used to dx HSV but no longer is reliable?

A

Tzanck Smear..

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7
Q

What is your tx for HSV

A

Acyclovir 800 mg PO TID 7-10 days.

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8
Q

What’s an alternate to acyclovir

A

Vancyclovir only requires BID dosing, but is more expensive.

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9
Q

Whats a benefit of using the Fanicyclovir for episodic suppressive therapy…

A

Only requires 1 day dosing..

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10
Q

What are benefits to treating HSV suppressive therapy?

A
  1. reduces outbreaks
  2. reduces viral shedding
  3. reduces risk of infxn partner
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11
Q

How do you tx Chlamydia?

A 
Azithromycin PO 1g x1 dose 
Ceftriaxone IM (gonorrhea)
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12
Q

How do you distinguish chlamydia from gonorrhea?

A

Discharge will be watery. mucoid in chlamydia vs. pururlent/yellow/creamy in gonorrhea

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13
Q

How else do u dx Chlamydia?

A

Historically the gold standard was culture… nowadays ppl use Nucleic Acid Amplication Test (NAAT) b/c it covers both C/G

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14
Q

What is the time frame for when u want to test a pt’s partner for a + C/G

A

< 60 days or their last sex partner if greater than 60 days…

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15
Q

What could be some sx consistent with disseminated gonoccocal infxn (DGI)

A
  1. skin lesions
  2. arthralgia/arthritis
  3. tenosynovitis
  4. hepatitis
  5. myocarditis
  6. endocarditis
    7 meningitis
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16
Q

How would u dx gonorrhea?

A

Culture as gold standard, but nowadays the NAAT w/ a “dirty” urine sample…

17
Q

How would u describe a “dirty” urine sample for the NAAT test to dx C/G

A

-must not have urinated for 2 hours and catch the 1st 20cc’s

18
Q

how do u tx gonorrhea?

A

Ceftriaxone 250mg IM x1
PLUS
Azithromycin 1g PO x1

19
Q

What do u want to educate ur patient about sex after u prescribe abx?

A

No sex in 7 days or until sx are gone!!

20
Q

How do u dx trichomonas

A

greyish-green dx and possible dysuria; wet mount, culture to confirm.

21
Q

How do u tx a trichomonas pt?

A

metronidazole 2g PO x 1

22
Q

What pt education do u want to provide after prescribing metronidazole?

A

No ETOH for 24 hrs

23
Q

How does the nitrite dipstick change over time and why?

A

due to air exposure, it can cause 1/3 false-+ in a wk. and 3/4 false + in 2 wks…

24
Q

How do u a treat a male w/ sx of frequency and urgency suggesting a cystitis?

A

Bactrim or FQ x 7 days

25
Q

In men < 50 y/o what is the most common urologic dx in men

A

acute bacterial prostatitis.

26
Q

How does tx differ btw acute and chronic b. prostatitis

A

4-6 wks Bactrim/FQ for acute

6wks-3 to 4 mnths chronic…

27
Q

whats the most common pathogen causing epididymitis/orchitis in men < 35

A

G/C vs.. in child or older men =e.coli

28
Q

how do u tx epididymitis/orchitis

A

Doxycyline < 50 x 14days

FQ > 50 y/o

29
Q

What are the keys to differentiate Granuloma Inguinale from other dz

A

occurs in India, New Guinea, etc and initially presents w/ painless ulcer that later becomes painful

30
Q

What’s the hallmark finding to diagnose?

A

Donovan bodies on bx…

31
Q

how do u tx granuloma inguinale

A

doxy or Batrim 3-4wks.

32
Q

what are the differentiating findings of lymphogranuloma venereum

A

occurs in asia, Caribbean, Africa… presents as painless ulcers; bubo’s may develop that are painful..

33
Q

How do u Dx and tx lympogranuloma venereum

A

culture, doxy 100mg PO BID x 21 days

34
Q

how does a chancroid differ

A

also occurs in asia, Africa, and Caribbean bu vesiculopustular lesions are painful..

35
Q

how do u dx chancroid?

A

clinical dx, r/o syphilis & HSV

36
Q

How do u tx chancroid?

A

Cetriaxone 250mg IM x 1 dose OR

Azithromycin 1 g PO x 1 dose

37
Q

what’s the pathogen causing molluscum contagiosum

A

pox virus

38
Q

How do u tx molluscum contagiosum

A

Imiquimod (Aldara) 5% QD before bed 3x/wk for 1-3 months.

Men's Health (3 decks)

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