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MI Internal Medicine and Infectious Disease > Genital Tract Infections > Flashcards

Genital Tract Infections Flashcards

1
Q

What are the 2 most common viral STIs?

A
  1. HPV

2. HSV

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2
Q

What are the symptoms of Urethritis in men?

A
  1. Dysuria

2. Discharge from the penis

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3
Q

What are symptoms of Urethritis/cervicitis in women?

A
  1. Vaginal discharge
  2. Abnormal vaginal bleeding or spotting
  3. Dyspareunia
  4. Dysuria
  5. Could be asymptomatic
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4
Q

Which pathogens can cause Urethritis/cervicitis?

A
  1. Chlamydia

2. Gonorrhea

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5
Q

What comprises a relevant Hx for genital tract infections?

A
  1. New partners?
  2. Multiple partners?
  3. High-risk partners?
  4. Type of exposure: men, women, both?
  5. Anal, vaginal, oral?
  6. Frequency of condom use
  7. Past STIs
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6
Q

What methods are available for the Dx of STIs?

A
  1. Clinical
  2. Microscopy (Gram stain)
  3. Culture
  4. Ag detection
  5. NAAT
  6. Serology
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7
Q

Dx method for Gonorrhea and Chlamydia

A
  1. NAAT - can be done on urine

2. Can also do Gram stain and culture

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8
Q

Tx for Gonorrhea

A
  1. Increasing resistance

2. Cefixime or IM Ceftriaxone + azithromycin

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9
Q

Tx for Chlamydia

A
  1. Doxycycline or azithromycin
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10
Q

What else is involved in the Tx of STIs besides drugs?

A
  1. Reportable infection?
  2. Partner notification
  3. Counselling
  4. Test for other STIs
  5. Check vaccination status for Hep B and HPV
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11
Q

<p>

| What is PID?</p>

A

<p>

| PID = Pelvic Inflammatory Disease Infection of the female upper genital tract (endometrium, Fallopian tubes)</p>

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12
Q

What causes PUD?

A
  1. Polymicrobial infection (STI + endogenous flora)
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13
Q

What are the S/S’s of PUD?

A
  1. Abdominal pain
  2. Fever
  3. Lower abdominal tenderness
  4. Cervical motion tenderness
  5. Adnexal tenderness
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14
Q

What is the Tx for PUD?

A

Antibiotics to cover STI + endogenous flora

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15
Q

What complications arise from scarring due to PUD?

A
  1. Infertility
  2. Ectopic pregnancy
  3. Chronic pelvic pain
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16
Q

What elements are involved in the Dx of PUD?

A
  1. Clinical
  2. Test for Gonorrhea/Chlamydia
  3. Imaging
  4. Possible OR
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17
Q

What are characteristics of Genital Ulcer Disease (GUD)?

A
  1. Ulcers, erosive, vesicular

2. Lymphadenopathy

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18
Q

What causes GUD?

A
  1. HERPES SIMPLEX VIRUS (HSV-1 or HSV-2)

2. Syphilis - less common (Treponema pallidum)

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19
Q

Presentation of primary HSV infection (genitals)

A
  1. May be asymptomatic
  2. Painful vesiculo-ulcerative lesions
  3. Fever
  4. Tender lymphadenopathy
20
Q

What is an atypical presentation of primary HSV infection (genital)?

A
  1. Urethritis/cervicitis

2. Aseptic meningitis

21
Q

Where does HSV go during latency (genital)?

A

Sacral sensory ganglion

22
Q

What are some characteristics of recurrent genital HSV infections?

A
  1. Prodromal symptoms (burning, itching, tingling)
  2. Not as bad as primary episode
  3. Become less frequent and less severe over time
23
Q

How do you Dx HSV?

A
  1. Viral swab for HSV PCR
24
Q

What is the Tx for HSV infection?

A
  1. Valacyclovir
  2. Famiciclovir
  3. Acyclovir
25
Q

What is characteristic of primary syphilis?

A

Painless chancres

26
Q

How do you Dx Syphilis?

A
  1. Serology (RPR or VDRL)

2. Can take fluid from chancre for staining or PCR

27
Q

What is the Tx for Syphilis?

A

IM benzathine penicillin

28
Q

What are 3 causes of vaginal discharge?

A
  1. Bacterial vaginosis
  2. Vulvovaginal candidiasis
  3. Trichomonas
29
Q

Bacterial vaginosis is the most common cause of vaginal discharge, what is it a result of?

A

Overgrowth of genital tract organisms

30
Q

What is Trichomonas?

A
  1. Vaginal discharge caused by the protozoan Trichomonas vaginalis
  2. This is an STI
31
Q

What diagnostics can be done for vaginal discharge?

A
  1. Vaginal swab
  2. Gram stain
  3. ELISA for trichomonas Ag
32
Q

Tx for Vulvovaginal candidiasis

A
  1. OTC antifungal cream
  2. Fluconazole PO
  3. Eliminate risk factors (i.e. antibiotics)
33
Q

Tx for Trichomonas

A
  1. Tx pt and partners with Metronidazole
34
Q

When and how should you Tx Bacterial Vaginosis?

A
  1. Tx if symptomatic and/or pregnant
  2. Use Metronidazole or Clindamycin (PO or topical)
  3. Don’t Tx partners
35
Q

What causes Prostatitis?

A
  1. Gram -ve bacilli (i.e. E. coli)

2. Not usually an STI

36
Q

How to Dx Prostatitis

A
  1. Clinical - Hx and tender/mushy prostate on exam
  2. Urine microscopy (WBCs)
  3. Urine culture
  4. Blood culture
37
Q

Tx for Prostatitis

A
  1. Antibiotics that cover Gram -ve bacilli (cipro, TMP-SMX)

2. Tx for 4-6 weeks

38
Q

Clinical presentation of Prostatitis

A
  1. Fever
  2. Chills
  3. Dysuria
  4. Pelvic pain
39
Q

What should you screen all pregnant women for?

A
  1. HIV
  2. Hep B
  3. Chlamydia
  4. Gonorrhea
  5. Syphilis
40
Q

What 2 things does HPV cause?

A
  1. Warts

2. Cancer

41
Q

What HPV strains cause anogenital warts (AKA Condyloma acuminata)?

A

HPV 6 and 11

42
Q

Which HPV strains cause cervical cancer?

A

HPV 16 and 18

43
Q

What are the 2 HPV vaccine available?

A
  1. Gardasil - (quadravalent) against 6, 11, 16, and 18

2. Cervarix - (bivalent) against 16, 18

44
Q

How can you Dx HPV?

A
  1. Pap tests

2. HPV DNA

45
Q

What is the Tx for HPV?

A
  1. Ablation for warts/pre-cancer

2. Test for other STIs

46
Q

What are the 2 most common bacterial STIs?

A
  1. Chlamydia

2. Gonorrhea

MI Internal Medicine and Infectious Disease (35 decks)

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