EXAM #2: STIs Flashcards
How is syphilis diagnosed?
1) Serology
2) Darkfield microscopy
3) VDRL, RPR
4) Flourescent antibody
How is chancroid diagnosed?
Culture
What increases the risk for chancroid?
1) Developing countries
2) Commerical sex workers
What is the relationship between chancroid and HIV? What are the implications?
- H. duceryi is a cofactor for HIV
- Test for HIV at time of chancroid diagnosis
What is the treatment for chancroid?
Azithromycin or Ceftriaxone
What is the most common STI in women?
HSV
How is HSV diagnosed?
1) Culture
2) PCR
3) Serology
If a patient is positive for HSV on serology (without genital ulcers) can you diagnose them with HSV-1 or HSV-2?
NO
What is primary HSV? How does this relate to pregnancy?
1) Culture positive HSV
2) Antibody negative
*Highest transmission rate in pregnancy
What is nonprimary first episode HSV?
1) Culture positive
2) HSV antibody to opposite serotype
What is recurrent HSV?
Reactivation of HSV with complimentary antibody
What should a woman do that is HSV negative but has a partner that is positive?
Avoid sex in 3rd trimester
What should you do if a patient has prodromal sx. of HSV at time of delivery?
C-section
What is the clinical indication of primary syphilis?
Painless ulcer at site
What are the clinical manifestations of secondary syphilis?
- Rash
- Mucocutaneous
- LAN
What are the clinical manifestations of tertiary syphilis?
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How is syphilis treated?
PCN
What should you do if a patient is pregnant and allergic to PCN with syphilis?
Desensitize
How are pregnant women with syphilis monitored?
Follow titers
What is the most frequently reported STI in the US?
Chlamydia
*Mostly asymptomatic; screen those under 25
What are the sequelae of Chlamydia?
1) PID
2) Ectopic pregnancy
3) Infertility
What is the treatment for Chlamydia?
One time dose of azithromycin
How long should a patient abstain from sex if positive for Chlamydia?
7 days
What are children born to a mother with Chlamyida at risk for?
1) Conjuncitivitis
2) Pneumonia
What is the treatment for gonorrhea?
1) Cefriaxone AND
2) Azithromycin
What is a common cause of septic arthritis in a sexually active young adult?
Gonorrhea
What are the sequelae of neonatal gonorrhea?
Ophthalmia neonatorum
How is PID diagnosed?
1) Pelvic lower abdominal pain with no alt. cause
2) CMT or uterine/adnexal tenderness
What is the definitive diagnosis for PID?
1) Endometrial biopsy
2) TVUS or MRI
3) Laproscopy
What did the PEACH trial show for PID?
No difference in outcomes for inpatient for outpatient
Who requires inpatient care for PID?
1) Unable to exclude surgical diagnosis
2) Pregnant
3) Non-complaint
4) Unable to tolerate PO meds
5) Tubo-ovarian abscess
If you manage a PID patient as an outpatient, what do you need to do?
See the patient back in 72 hours
What causes Granuloma inguinale or Donovanosis?
Klebsiella granulomatis
What type of lesion is seen in Donovanosis?
Painless without lymphadenopathy
How is Donovanosis diagnosed?
Dark-staining Donovan bodies
How is Donovanosis treated?
Doxycycline
What serotypes of HPV cause condyloma?
6 and 11
What serotypes of HPV are associated with cervical dysplasia?
16, 18, 31, 33, and 35
When should you biopsy suspected HPV?
1) Uncertain diagnosis
2) Unresponsive to treatment
3) Immunocompromise
What is the concern of HPV in pregnancy?
Recurrent respiratory papillomatosis
What is the classic presentation of Trichomonas?
Diffuse, malodorus, yellow-green discharge with “strawberry” cervix
How is Trichomonas diagnosed?
Wet mount
How is Tichomonas treated?
Metronidazole
How is Scabies treated?
Permethrin
What causes Molluscum contagiosum?
Poxvirus
What organism most commonly causes cystitis?
E. coli
Proteus mirabilis is 2nd
What UA findings are indicative of cystitis?
1) Leukocyte esterase
2) Nitrite
