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Urgent Care Guide > GU 2 > Flashcards

GU 2 Flashcards

1
Q

PID

A

complication of lower genital tract infections affecting upper female genital tract (uterus, fallopian tubes, ovaries, pelvic structures)

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2
Q

complication of lower genital tract infections affecting upper female genital tract (uterus, fallopian tubes, ovaries, pelvic structures)

A

PID

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3
Q

STI - may c/o
8

A
  1. genital lesions
  2. vaginal/urethral discharge
  3. vaginal itching/irritation
  4. dysuria
  5. pelvic pain (females)
  6. testicular or perineal pain (males)
  7. pharyngitis
  8. conjunctivitis
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4
Q

PID - may c/o
2

A
  1. pelvic tenderness
  2. vaginal discharge
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5
Q

PID - speculum and bimanual PE findings may include
5

A
  1. cervical motion tenderness
  2. adnexal tenderness
  3. uterine compression tenderness
  4. RUQ tenderness on abd exam (Fitz-Hugh-Curtis syndrome or perihepatitis
  5. peritonitis
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6
Q

PID - fever

A

not usually present

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7
Q

STI - PE findings may include (male)
2

A
  1. testicular pain (orchitis)
  2. pain w/ palpation of the epididmysis or perineum (epididymitis or prostatitis)
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8
Q

STI - vesicles

A

HSV

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9
Q

STI - painless ulceration

A

Chancre in primary syphilis

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10
Q

STI - painful ulceration

A

Chancroid -highly contagious yet curable sexually transmitted disease (STD) caused by the bacteria Haemophilus ducreyi

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11
Q

STI - verrucous lesions

A

genital warts

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12
Q

STI - umbilicated papules

A

Molluscum contagiosum -viral skin infection that can be considered a sexually transmitted infection (STI) in adults. It’s characterized by small, smooth, round, pearly bumps with a central core

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13
Q

PID/STI - in females, first img/test

A

pregnancy test

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14
Q

chlamydia and gonorrhea test (if available) - male/female

A

men - first catch urine or urethral swab
women - endocervical swab (req if sending cx for gonorrhea), or vaginal swab, or first catch urine (NAAT)

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15
Q

male urethral swab instructions -

A

clean urethral opening, insert swab 2/3” into urethra and turn 10 times in one direction, pull out

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16
Q

chlamydia test in women
2

A
  1. urine in cup
  2. but more sensitive test is vaginal swab - insert into vaginal canal and swab insides
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17
Q

gonorrhea test in women

A

urine or vaginal swab - same as chlamydia

18
Q

what STIs can be tested in blood

A

genital herpes,
HIV,
syphilis
hepatitis B
chlamydia (but not preferred bc it’s not as accurate)

19
Q

what STIs can be tested in urine sample
3

A

chlamydia
gonorrhea
trichomoniasis

20
Q

what STIs can be tested w/ a swab
5

A

chlamydia
gonorrhea
trich
herpes if lesions present
HPV - pap smear

21
Q

trichomoniasis test - women, men

A

women - vaginal, endocervical or urine specimen
male - urethral swab, urine sediment, or semen

22
Q

syphilis test

A

non-treponemal test (RPR or VDRL), also known as a screening test, is a blood test that detects antibodies that are not specific to the bacteria that causes syphilis

23
Q

syphilis - reactive non treponemal test

A

supports dx but does not confirm - need subsequent test

24
Q

syphilis - non reactive non treponemal test

A

does not definitvely r/o syphilis

25
Q

herpes simplex virus test
1

A

viral culture

26
Q

order urgent US for pain where
2

A
  1. unilateral pelvic pain in the setting of PID - concern for tubo ovarian abscess
  2. testicular pain when dx is unclear
27
Q

gonorrhea tx from CDC

A

Ceftriaxone 500 mg* IM in a single dose for persons weighing <150 kg

If chlamydial infection has not been excluded, treat for chlamydia with doxycycline 100 mg orally 2 times/day for 7 days.

  • For persons weighing ≥150 kg, 1 g ceftriaxone should be administered.
28
Q

gonorrhea tx education
3

A
  1. symptoms usually start to improve within a few days but can take up to two weeks
  2. all partners in the last 60 days should be treated
  3. need f/u testing to ensure clearance in three months - try to schedule at initial visit
29
Q

chlamydia tx from CDC
3

A

1st line - Doxycycline 100 mg orally 2 times/day for 7 days

alternatives include -
Azithromycin 1 g orally in a single dose
OR
Levofloxacin 500 mg orally once daily for 7 days

30
Q

trich tx CDC - female/male

A

female - Metronidazole 500 mg 2 times/day for 7 days

male - Metronidazole 2 g orally in a single dose

31
Q

does partner need to be treated for chlamydia

A

yes, in the last 60 days

32
Q

does partner need to be treated for trich

A

yes, in the last 60 days

33
Q

trich, gonorrhea, chlamydia - when can you resume sex

A

7 days after sx resolve

34
Q

syphilis tx

A

benzathine penicillin G 2.4 million units IM once

35
Q

genital warts tx

A

imiquimod cream 5% apply to lesions 3 x week at bedtime up to 16 weeks

36
Q

genital herpes tx

A

acyclovir 400 mg PO q8h for 7-10 days

37
Q

PID - empirically treat if

A

CMT present, uterine or adnexal tenderness present

38
Q

PID tx

A

ceftriaxone 500 mg IM once + doxy 100 mg PO BID for 14 days

39
Q

what are reportable STIs in the U.S.
5

A
  1. HIV
  2. syphilis
  3. chancroid
  4. chlamydia
  5. gonorrhea
40
Q

which need f/u in three months

A

HIV
syphilis
chlamydia
gonorrhea
chancroid??

41
Q

STI - consider what partner therapy

A

expedited partner therapy EPT

42
Q

PID/STI - when to refer to ER
4

A
  1. uncertain dx and additional img needed - 10-25% of those thought to have PID actually have appendicitis
  2. s/sx of severe illness
  3. PID w/ concurrent pregnancy
  4. concern for tubo-ovarian abscess

Urgent Care Guide (38 decks)

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