Genital Lesions Flashcards
what is another term for genital warts
condyloma acuminata
what is condylomata acuminata caused by
HPV-DNA virus that multiplies within the nuclei of infected epithelial cells
most common STI
where else can condylomata acuminata present?
intra-oral lesions
peri-anal lesion
prevention of condylomata acuminata
9-valent HPV vaccine (Gardasil 9) protects against cancers
6, 11 prevents genital warts
16, 18 prevents cervical cancer
Tx of genital warts
topicals (don’t memorize) -imiquimod, podofilox , sinecatechins
cryotherapy
surgical options (laser, electrosurgical coagulation, excision)
trichloracetic acid solution
if a genital ulcer is painful, it is likely that it is
HSV, chancroid
what is genital herpes caused by
HSV-2 and HSV-1
chronic viral infection
direct contact transmission
2x risk of HIV infection
What is this a presentation of?
genital herpes
what are clinical features of genital herpes
common, 14% of Canadians aged 14-59 have HSV-2
chronic recurrent infection
cluster of vesicles on reddened background
subsequent episodes are shorter
prodrome
Dx of genital herpes
nucleic acid amplification tests (NAAT) - highly sensitive and rapid
serology can be done but not specific
viral cultures
biopsy
Tx for HSV
prevention
severe: IV acyclovir
non-severe: PO acyclovir, famiciclovir, calciclovir
what bug is this
Treponema pallidum subspecies pallidum
causes syphillis
is syphyllis a reportable STI?
yes
what stages of syphilis is it transmissable?
primary, secondary and early latent infection
describe the primary stage of syphilis
painless chancre, regional lymphadenopathy
heals spontaenously (lasts 3-6 weeks)
describe clinical presentation of secondary syphilis
systemic features (rash, fever, lymphadenopathy, mucus lesions, condyloma lata, alopecia, meningitis, headaches)
can occur at 2-12 weeks following infection
generalized rash
condyloma lata (wart-like lesions)
describe the latent stage of syphilis
asymptomatic
early is less than 1 yr
late if more than 1 yr
what systems do tertiary syphilis target
cardiovascular
gumma (can grow anywhere, soft, non-cancerous growth)
neurosyphilis
skin lesions - nodular, gummata
Dx of syphilis
universal screening in pregnancy
syphilis PCR (molecular detection of T. pallidum from fluid/tissue)
serology (can take up to 12 wk to become positive)
EIA (IgM and IgG)
Tx for syphilis
primary, secondary, early latent: penicillin single dose
late latent, tertiary: penicillin 3 doses
neurophyphilis: 10-14 days penicillin
sexual contacts (90days): penicillin single dose
congenital: crystalline peniccilin G <1mo age, benzathine otherwise
