DV/STIs Flashcards by Alice Richards

what do you think when you see, perihepatitis in the setting of PID

fitz hugh curtis syndrome

How well did you know this?

Not at all

Perfectly

fitz hugh curtis syndrome causes inflammation in the liver __

and __ surfaces

of the anterior __

capsule

perineal

RUQ

How well did you know this?

Not at all

Perfectly

fitz hug curtis syndrome causes pain in __ (2)

and referred pain to __

RUQ and pleuritic

right shoulder

How well did you know this?

Not at all

Perfectly

what 2 STIs are associated w. fitz hugh curits syndrome

gonorrhea

chlamydia

How well did you know this?

Not at all

Perfectly

chandelier sign is __,

classically in the setting of __

cervical motion tenderness

PID

How well did you know this?

Not at all

Perfectly

what exam is used to assess for chandelier sign

bimanual exam

How well did you know this?

Not at all

Perfectly

stages of syphilis

early

late

neuro

How well did you know this?

Not at all

Perfectly

stages of early syphilis

primary

secondary

early latent

How well did you know this?

Not at all

Perfectly

single painless chancre at the site of inoculation

regional adenopathy

early syphilis

How well did you know this?

Not at all

Perfectly

systemic illness w. rash, fever, malaise

+/- pharyngitis, hepatitis, condyloma lata, alopecia

early secondary syphilis

How well did you know this?

Not at all

Perfectly

what do you think when you see “money spots”

syphylitic rash on palms and soles of feet

How well did you know this?

Not at all

Perfectly

period when a pt is infected w. treponema pallidum via serology but has no sx w.in first year of infxn

early latent syphilis

How well did you know this?

Not at all

Perfectly

syphilis w. CV sx or gummatous dz

tertiary syphilis

How well did you know this?

Not at all

Perfectly

asymptomatic syphilis that occurs more than one year after initial infxn

late latent syphilis

How well did you know this?

Not at all

Perfectly

t/f: neurosyphilis can occur at any time during course of infxn

How well did you know this?

Not at all

Perfectly

first line tx for early syphilis

penicillin G benzathine 2.4 million units IM one

How well did you know this?

Not at all

Perfectly

first line tx for late syphilis

penicillin G benzathine 2.4 million units once weekly x 3 weeks

How well did you know this?

Not at all

Perfectly

tx for neurosyphilis

aqueous penicillin G 3-4 million units IV q 4 hr for 10-14 days

How well did you know this?

Not at all

Perfectly

what do clue cells on a wet prep make you think

How well did you know this?

Not at all

Perfectly

what do budding hyphae on a wet prep make you think

yeast infxn (candidiasis)

How well did you know this?

Not at all

Perfectly

what do WBC on a wet prep make you think

infxn

sample contamination

How well did you know this?

Not at all

Perfectly

what do RBC on a wet prep make you think

irritation

infxn

trauma

menstruation

sample contamination

How well did you know this?

Not at all

Perfectly

what might you see on a wet prep for chlamydia and gonorrhea

increased WBC

increased platelets

How well did you know this?

Not at all

Perfectly

gonorrhea is often asymptomatic, name 3 sx if not

cervicitis w. mucopurulent d.c

pruritis

dysuria

How well did you know this?

Not at all

Perfectly

preferred dx testing for gonorrhea

NAAT

NAAT testing for gonorrhea is __ in women and __ in men

vaginal swab urine

tx for gonorrhea

ceftriaxone 500 mg IM x 1

why would you add doxy to gonorrhea tx

if chlamydia is not ruled out

what routine combo tx for gonorrhea and chlamydia is NO longer recommended

azithromycin plus ceftriaxone

mc symptom of chlamydia

trick question! mc asymptomatic

if not asymptomatic, 4 sx of chlamydia

cervicitis d.c dysuria abnormal vaginal bleeding

2 sx of chlamydia in men

epididymitis chronic prostatitis

dx testing for chlamydia

NAAT * vaginal swab for women* * urine for men*

tx for chlamydia

doxycycline 100 mg po bid x 7 days

tx for chlamydia in pregnant pt or pt w. doxy contraindication

azithromycin 1 go PO x 1

herpes is divided into

primary infxn recurrent infxn

2 presentations for primary herpes infxn

asymptomatic/mild fever/constitutional sx w. painful genital ulcers

unilateral small vesicular or ulcerative lesions +/- vulvar irritation or fissures

recurrent herpes infxn

5 dx testing options for herpes

viral culture w. fluid from unroofed vesicle PCR direct fluorescent abs Tzanck smear serologic testing

problem w. viral culture

50% sensitivity

what dx test for herpes has low sensitivity and low specificity

Tzank smear

positive Tzanck smear findings

multinucleated giant cells

tx for herpes

symptomatic only: acyclovir or valacyclovir for flare ups/suppressive

mc presentation of BV

asymptomatic

if BV is symptomatic what are 2 sx

thin off-white vaginal d.c fishy odor

fishy odor in BV is worse w. (2)

sex menses

what dx criteria is used for BV

Amsel

what must be available to use Amsel testing

microscopy

what is Amsel criteria

**¾ of the following:** homogenous thin white/gray d.c that coats vaginal walls vaginal pH \> 4.5 (+) whiff-amine test w. 10% KOH clue cells on saline mount

for Amsel criteria, clue cells must be at least \_\_% epithelial cells

tx for BV

metronidazole OR clindamycin

t/f: for BV, metronidazole and clindamycin can be oral or topical

what do you think when you see: cottage cheese like, thick white vaginal d.c, intense and pruritis

candidiasis

candidiasis might also present w. (3)

vulvar burning dysuria dyspareunia

dx testing for candidiasis

wet mount showing budding yeast, hyphae

what makes candidiasis easier to see on wet mount

KOH

tx for candidiasis

oral fluconazole x 1 dose OR topical clotrimazole or miconazole

problem w. oral fluconazole

LOTS of ddi's

what do you think when you see, purulent malodorous, greenish yellow thin vaginal d.c

trichomoniasis

other sx associated w. trichomoniasis

burning dyspareunia pruritis dysuria lower abd pain

what do you think when you see strawberry cervix

trichomoniasis

t/f: trich can be asymptomatic

t/f: asymptomatic trich is mc in women

F! it is mc in men

gs dx test for trich

NAAT

what would a wet mount show for trichomoniasis

motile trichomonads

important to remember when using microscopy for trich dx

do not turn on the microscope light → can kill motile trichmonads

tx for trich

metronidazole or tinidazole x 7 days

t/f: medical professionals in CO are required to report DV

4 criteria for provider if pt declines police involvement for DV

pt must be \> 18 yo must report serious injury (GSW/stab) injuries must be documented as DV must refer pt to advocate or counselor for safe plan

healthcare providers are required to report DV in what 2 pt populations

kids elderly

when are pt's most at risk in a DV relationship

when leaving the relationship