Genitourinary Flashcards
1
Q
What is 1st line treatment of BV ?
A
Metronidazole
2
Q
What is treatment for chlamydia?
A
Doxycycline
3
Q
What is treatment for gonorrhea ?
A
Ceftriaxone
4
Q
What cell are characteristic in BV?
A
Clue cells (stippled vaginal epithelial)
5
Q
What’s a complication in HIV patients that can cause breathlessness?
A
Pneumocystitis jivroveci pneumonia
6
Q
How in labs i.e. what stain can identify fungus that causes pneumocystis jivroveci?
A
Silver stain
7
Q
What organism does India ink stain identify?
A
Cryptococcus
8
Q
What type of meningitis is an AIDs defining illness?
A
Cryptococcal meningitis
9
Q
What is classic presentation for cryptococcal meningitis?
A
Blurred vision
Bilateral papilledema
Confusion
CT head will be normal
10
Q
What’s the name of the single painless ulcer in syphilis?
A
Chancre
11
Q
What type of bacteria is gonorrhoea?
A
Gram negative diplococci
12
Q
What is first line treatment for trichomoniasis (strawberry cervix)?
A
Metronidazole
13
Q
When can sex be resumed with hsv genital lesions?
A
Once lesions are gone
14
Q
How many cigarettes smoked is a contraindication for COCP?
A
Over 35 a day
15
Q
How long is the pill not effective for when first taken?
A
7 days
16
Q
How is fitz-hugh-curtis characterised?
A
Hepatitis and liver adhesions, can cause RUQ pain and shoulder tip pain : can be due to gonorrhea or chlamydia
17
Q
What is prescribed prophylactically to prevent further episodes of PCP in HIV patients with CD4 below 200?
A
Co-trimoxaloe - continued until immune function improves - i.e. CD4 above 200 for a while
18
Q
What’s a good CD4 count?
A
Anything above 500
19
Q
What’s treatment for secondary syphilis?
A
IM benzathine benzylpenicillin
20
Q
Which infection is caused by a flagellated protozoan parasite?
A
Trichomoniasis
21
Q
What are the features of PID?
A
Fever
Lower abdo pain
Deep dyspareunia
Cervical excitation
Pain on movement of cervix
22
Q
What is treatment of PID?
A
IM ceftriaxone, oral doxycycline + metronidazole
23
Q
What is oral treatment for thrush?
A
Fluconazole
24
Q
How is outbreak of HSV managed?
A
Oral aciclovir
25
Which type of pessary do you use in thrush?
Clotrimazole
26
Why is COCP a risk factor for thrush?
The oestrogen in the pill can alter the vaginal environment making it more conductive for fungal growth
27
If patient is pen allergic and has gonorrhea what should be given? Because remember the cross similarity of cefotaxime and penicillin's
IM gentamicin and oral azithromycin
28
Missing more than one pill means?
Barrier method or abstinence is needed for a week
29
When would a pill free week be skipped?
If the missed pills are from the last week of the pack
30
Which pill week prevents ovulation and therefore if missed would need emergency contraception?
The first week
31
Which bacteria most commonly causes BV?
Gardnerella vaginalis
32
If patients vomit within 3 hours of taking COCP or within 2 hours of taking progesterone only pill then what?
Take another pill straight away
33
If COCP pills are missed in week 3 then what?
Finish current pack and start next pack immediately
34
Which condition can cause painless genital ulcer and painful inguinal nodes?
Lymphogranuloma venereum - caused by a strain of chlamydia
35
What is first line treatment for pneumocystitis pneumonia? with and without an oxygen of 8 or less?
Without oxygen less than 8 is co-triomxazole
When oxygen is 8 or less than C--Trimoxazole and steroids.
36
What's treatment of chlamydia in breastfeeding women?
Oral azithromycin and doxycycline is contraindicated
37
Which herpes causes kaposi's sarcoma?
HHV-8
38
Which HPV causes genital warts?
HPV 6
39
When does latent syphilis occur?
Absence of any symptoms and occurs after primary and secondary stages
40
What are the potential side effects of co-trimoxazole?
Stevens-johnson syndrome
Drug induced Lupus
Agranulocytosis
Toxic epidermal necrolysis
41
How long after UPSI can ella one be taken?
Up to 120 hours so five days
42
How long within can levonelle be used after UPSI as emergency contraception?
Within 3 days
43
What is a complication of untreated or recurrent urethritis?
Urethral stricture - can lead to scarring and narrowing of the urethra
44
Which tests are used for diagnostic of gonorrhoea and chlamydia?
NAAT
45
How would molluscum vs. HSV genital bumps present differently?
Molluscum: dome shaped flesh coloured or pink papule with a central indentation
HSV: painful fluid filled blisters- no central indentation
46
How long can IUD last for?
5-10 years
47
What is a chancroid?
Bacterial STI - erythematous papule forms at site of inoculation: deep ulcer with soft , irregular border and friable base
48
How can BV affect a pregnancy?
Can cause preterm rupture of membranes and premature labour
49
Which pessary is treatment in women with recurrent candida infections?
Nystatin pessary
50
What's the difference between chancroid and lymphogranuloma venereum?
Lymphogranuloma venereum: Painless ulcer and tender inguinal lymph nodes
Chancroid: PAINFUL ulcer + tender inguinal lymph nodes
51
What is chancroid caused by?
Bacterium haemophilus ducreyi
52
Which patients is oral fluconazole contraindicated in?
Pregnant or breastfeeding
53
What does HBsAg mean?
Detected following initial infection
54
What does Anti-HBs mean?
Either cleared infection OR vaccination against hep b
55
What does anti-HBc mean?
Hep b infection is either chronic or resolved
56
If there is negative anti-HBc and positive Anti-HBs what does this mean?
Patient is vaccinated against hep B
57
Is oesophageal candidiasis a AIDS defining illness?
Yes
58
What are pearly penile papules?
Harmless rounded / finger like growths found near head of penis - may also look yellow or pinkish - patient can be reassured and discharged
59
What treatment is used for genital warts that are non keratinsed?
Podophyllotoxin
60
What is an alternative treatment for non-keratinized genital warts other than podophyllotoxin?
Imiquimod
61
What is disseminated gonococcal infection?
Rare complication of gonorrhoeae.
Involving arthritis-dermatitis syndrome and tenosynovitis
There will pain with passive flexion and tenderness along flexor sheath
Commonly affects fingers, wrists, and toes.
62
What is jarisch herxheimer reaction?
Self resolving high fever, heart rate and unwell can be due to IM benzylpeniccilin for a primary syphilis
63
What HIV viral load is appropriate for a vagina delivery ?
Under 50 if greater than 50 then it should be C-section
64
What is infant post-exposure prophylaxis for HIV ?
Zidovudine monotherapy or cART
65
Is breastfeeding safe in HIV?
Only okay if women has low viral load on cART - even so more recommended to formula milk
66
What the gold standard for diagnosis for HIV?
HIV antibody and HIV antigen
67
When can the HIV antibody test detect HIV infection?
21-25 days post infection -it's used as the point of care test
68
What is bronchoalveolar lavage?
diagnostic procedure that involves collecting a fluid sample from the lungs to help diagnose lung conditions
69
What is the gold standard investigation for PCP?
Bronchoalveolar lavage
70
How do anti-epileptics and COCP react?
Anti-epileptics will increase metabolism of COCP due to being enzyme inducers , therefore the COCP becomes less effective
71
What is an appropriate contraception of choice in epileptics?
Contraceptive injection as it does not interact with liver enzymes
72
What is treatment for primary CNS lymphoma (HIV related0
Commence CRT and whole brain irradiation
73
How is Primary CNS lymphoma seen on brain CT?
Single lobulated lesion with single homogenous enhancement
74
Who can receive HIV post-exposure prophylaxis?
Anyone - don't need to have risk factors but they must have a determined HIV status first so that it isn't given to someone who already has HIV
75
What would a smear show for chlamydia?
5 or more polymorphs per high power field with no evidence of gram negative diplococci
76
If doxycycline is contraindicated what is offered?
Azithromycin, ofloxacin, erythromycin
77
What are the most specific signs for primary HIV infection?
Maculopapular rash on upper areas and mucosal ulcers
78
What is treatment for toxoplasmosis?
Sulfadiazine and pyramethamine
79
Which medication needs to be co-prescribed with sulfadiazine and why?
Folate as sulfadiazine can lead to folate deficiency
80
How often does the progesterone injection need to be administered?
Every 3 months
81
What organism is responsible for molluscum?
Poxvirus
82
Except from ovarian cancer why else can ca-125 be raised?
PID
83
How can PID present?
Bilateral abdominal pain
Inter-menstrual bleeding
84
Are HIV patients on long term cART at risk of stroke?
Yes
85
What's the most common cause of fitz-hugh curtis syndrome?
Chlamydia
86
What is mitterlschmerz?
Mic-cycle abdo pain in lower abdomen - subsides within 24-48 hours after onset
87
What is treatment for recurrent thrush?
3 doses of oral fluconazole 150mg to be taken every 3 days. Then 150mg oral fluconazole once a week for 6 months as maintenance
88
Can molluscum cause eye things?
Yes small umbilicated lesions on lid margins but also other stuff around eye
89
What is a trachoma?
Leading cause of blindness worldwide. Particularly endemic in Africa. Damage to cornea occur when eyelid turns inward - entropion
aused by chlamydia
90
What's the normal dose of oral aciclovir for hsv vs in pregnancy?
200mg three times a day normally but in pregnancy due to higher circulating blood volume it's 400mg three times a day
91
Which antiepileptics interact with cocp to induce liver enzymes and which one is safe?
Phenytoin, barbituates, carbamezapine - induce liver enzymes
Levetiracetam - is fine
92
How many years breast cancer free in order to take cocp?
Not within 5 years
93
Is cholestatic jaundice in pregnancy a contraindication for cocp?
Yes
94
What BP measures are contraindications for cocp?
systolic higher than 160 or diastolic higher than 100
95
What is treatment regime with doxycycline for chlamydia?
100mg twice a day for 7 days
96
What does multiple ring enhancing lesions on CT scan suggest in a HIV patient?
Toxoplasmosis
97
What is treatment for CMV retinitis?
IV ganciclovir
98
How does CMV retinitis present?
Rapid painless vision loss
Flashes of light
Retina has pizza slice appearance
Affected section appear to have marked haemorrhages
99
What's the mechanism of action of doxycycline?
Tetracycline antibiotic that blocks translation by binding the bacterial 30s ribosomal subunit
100
What is most definitive option for diagnosing fitz-hugh-curtis syndrome?
Laparoscopy - may reveal adhesions between diaphragm and liver or between liver and anterior abdominal wall
101
