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UWS Q9 > GU Suvery Exam 2 Part 2 > Flashcards

GU Suvery Exam 2 Part 2 Flashcards

1
Q

What are 4 causative agent for prostatitis?

A
  1. E coli
  2. Klebsiella
  3. NG
  4. CT
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2
Q

what is an anoscopic?

A

specimen collection for HSV, NG, CT, syphilis

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3
Q

What is another name for condyloma accuminata?

A

HPV

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4
Q

what are 4 main ways HPV infection can present?

A
  1. visible genital warts
  2. subclinical infection
  3. oropharyngeal infection
  4. anal infection
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5
Q

describe the genital warts assoc w/ HPV?

A
  • raised/flat; single/multiple; small/large; cauliflower-like
  • most often painless; can cause itching, irritation, bleeding
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6
Q

are genital warts most often painless?

A

yes

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7
Q

what is the subclinical infection of HPV implicated in

A

Implicated in the risk for some vaginal, vulvar, anal and penile squamous cell cancers

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8
Q

HPV and anal infection increases the risk for which cancer by 2/100k year?

A

anal cancer

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9
Q

what is the increase risk for MSM for anal cancer and HPV?

A

20xs increased

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10
Q

what is the most common sx for anal infection of HPV?

A

• m/c sx genital warts
 Anal d/c, bleeding, itching, pain, pressure or lesionsiv
 Grayish hyperpigmented patches of HGAIN

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11
Q

what are the CDC goals of tx for HPV?

A
  1. remove visible warts
  2. tx annoying sx
  3. EDUCATE SAFER SEX
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12
Q

Visible HPV Treatment Options?

A
  • Cryotherapy (liquid nitrogen)
  • Podofilox/podophylin
  • Trichloracetic acid (TCA)
  • Electrocautery
  • Laser therapy
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13
Q

how is subclinical HPV infections generally diagnosed?

A
  • Most often diagnosed on Pap smear

* Monitor for precancerous changes

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14
Q

4 DDX for genital ulcer dz?

A
  • # 1 Herpes simplex virus
  • # 2 Syphilis
  • # 3 Chancroid (Haemophilus ducreyi)
  • # 4 Lymphogranuloma venereum (LGV)-CT
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15
Q

Do condoms prevent spread of HSV 1 & 2?

A

condoms do not necessarily prevent infection

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16
Q

When does most HSV spread?

A

asx viral shedding spreads most HSV (usually before a breakout)

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17
Q

What are the 3 distinct syndromes of HSV?

A
  1. primary herpes
  2. first episode non-primary herpes
  3. recurrent herpes
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18
Q

describe primary herpes

A

the first infection with either HSV 1 or 2

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19
Q

describe first episode non-primary herpes?

A

initial genital infection in a patient who has already experienced infection with the other HSV type

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20
Q

describe recurrent herpes?

A

reactivation with either virus type

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21
Q

What is the most severe and longest duration sx form?

A

genital HSV: primary herpes

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22
Q

What is the classic progression of genital HSV?

A
  1. erythematous papule
  2. vesicle
  3. pustule
  4. ulceration (most painful-increased with moisture)
  5. encrustation
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23
Q

what are some systemic sx of genital herpes?

A

fever, malaise, arthralgia, headache

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24
Q

What is the average time from sexual contact to onset of sx and lesions of genital HSV?

A

4 days, range is 2-20 days

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25
Q

who transmits most of the HSV infections?

A

persons w/o sxs

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26
Q

what are prodromal sxs for HSV?

A

local paresthesias, itching, pain

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27
Q

What are some triggers for HSV breakouts?

A

stress, fatigue, intercourse, menstrauation, diet/lifestyle, menopause

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28
Q

what is the lab dx for HSV?

A

viral culture

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29
Q

what test can be done if only in pustular stage for HSV?

A

tzank smear, antigen detection tests

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30
Q

what is herpes on the hand called?

A

whitlow

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31
Q

HSV of the eye can cause?

A

keratitis (inflammed cornea- usually unilateral)
blepharitis
keratoconjunctivitis

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32
Q

goals of HSV treatment?

A
  • Prevent acquisition of other STI’s, transmission of HSV, and reinocculation
  • Reduce pain
  • Reduce severity and duration of outbreaks
  • Reduce reoccurrence rate
  • LOWER VIRAL SHEDDING
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33
Q

what is the organism for syphilis?

A

spirochete

  1. treponema pallidum
  2. blood born pathogen
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34
Q

Where can syphilis infect?

A

capable of infecting almost any organ and system

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35
Q

what is the syphilis progression?

A

•A syphilis infection can spread through the bloodstream to all parts of the body

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36
Q

how does syphilis spread in the body?

A

via bloodstream

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37
Q

How many stages are there in the syphilis progression?

A

4 stages if not treated, usually extends over many years to the point of affecting behavior

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38
Q

what can the last stage of syphilis cause?

A

heart dz, brain damage, spinal cord damage, blindness and death

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39
Q

what are the 4 stages of syphilis

A
  1. primary
  2. secondary
  3. latent (hidden) stage
  4. tertiary (late) stage
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40
Q

which lesion is associated with primary syphilis?

A

chancre

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41
Q

when does a chancre usually occur?

A

within 3 weeks

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42
Q

is primary syphilis highly contagious?

A

YES

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43
Q

What is a painless ulcer with clean base?

A

Chancre

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44
Q

what do the borders of a chancre look like?

A

firm indurated borders

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45
Q

where can chancre occurs?

A

anywhere on the body

46
Q

What stage is the Great Mimicker?

A

secondary syphilis

47
Q

when does secondary syphilis occur?

A

•2-8 weeks after chancre pts often develop a RASH

48
Q

symptoms that occurs once syphilis has spread through the body?

A

–A fever of usually less than 101 °F(38 °C).
–A sore throat.
–A vague feeling of weakness or discomfort throughout the body.
–Weight loss
–Patchy hair loss, especially eyebrows, eyelashes, & scalp.
–Lymphadenopathy
–Nervous system symptoms of secondary syphilis: neck stiffness, headaches, irritability, paralysis, unequal reflexes, and irregular pupils.

49
Q

Where would a rash of secondary syphilis occur?

A

•Diffuse, macular, papular, combinations
•palms •soles
•Patterned Hair loss

50
Q

what defines the latent stage of syphilis?

A
  • If untreated, an infected person will progress to latent stage
  • After secondary-stage rash goes away, no symptoms = latent period; may be as brief as 1 year or range from 5 to 20 years.
51
Q

Is a person contagious during latent stage of syphilis?

A

•A person is contagious during early part of latent stage & may be contagious even when no symptoms are present.

52
Q

what is the most destructive stage of syphilis?

A

tertiary late stage

53
Q

what are the complication of tertiary late stage syph?

A

–Gummata large sores inside the body or on skin.
–Cardiovascular affects heart & blood vessels.
–Neurosyphilis affects brain or related structures

54
Q

How to dx syphilis?

A 
•Screening antibody testing/VDRL/RPR
–for non-specific ‘reagin’ antibody
–screening test (false positives common)
•More specific / confirmation testing
–flourescent treponemal antibody absorption (FTA- ABS), microhemagglutination test (MHA-TP)
–To confirm screening tests
55
Q

what bacterium is associated with a chancroid?

A

STI caused by H. ducreyi

56
Q

what does H ducreyi cause?

A

chancroids- ulcers on genitals and are associated with inguinal lymphadenitis

57
Q

what can form if a chancroid affects lymph nodes?

A

abscess formation

58
Q

are chancroids painful?

A

yes

59
Q

what causes lymphogranuloma venereum (LGV)?

A

specific strain of chlamydia

60
Q

where is the highest LGV?

A

•incidence is highest among sexually active people living in tropical or subtropical climates

61
Q

what is the first symptom of LGV?

A

small, painless pimple or lesion occurring on penis or vagina. often unnoticed –> lymph nodes

62
Q

another name for crab louse?

A

pediculosis pubis and pthirus pubis

63
Q

How is crab louse transmitted by?

A
  1. sexual contact
  2. shared bedding
  3. shared clothing
64
Q

For how long can untreated crab louse ova can live on fomites?

A

for a month

65
Q

how can you prevent the spread of STIs?

A

– Abstinence
– Limit number of sex partners.
– Use a male or female condom.
– Carefully wash genitals after sexual relations.
– If infection is suspected, avoid any sexual contact and visit local STI clinic, hospital, doctor.
– Notify all sexual contacts immediately so they can obtain examination and treatment.

66
Q

what is the tx of perimenopause determined?

A

Treatment determined by severity of symptoms and impact on QOL

67
Q

what is a marker of perimenopause?

A

rising FSH

68
Q

define menopause?

A

1 year since last spontaneous menstrual period

69
Q

typical are for menopause?

A

around 50 YO

70
Q

what age is premature menopause?

A

<40 YO

71
Q

what is surgical menopause?

A

bilateral oophorectomy

72
Q

in 2015 what % of US women will be menopausal?

A

50%

73
Q

what are menopausal symptoms due to?

A

decreased estrogen

74
Q

Early changes associated with normal menopause estrogen loss?

A

hot flushes (75%), insomnia, irritability, mood changes, low libido, abnormal bleeding

75
Q

Intermediate changes associated with normal menopause estrogen loss?

A

vaginal atrophy, urinary incontinence, skin atrophy, hair thinning, facial hair

76
Q

Late changes associated with normal menopause estrogen loss?

A

Osteoporosis, CAD, Alzheimer’s dementia, colon cancer, age-related macular degeneration, insulin resistance

77
Q

Hot flashes/vasomotor instability?

A

Dysfunction of central thermoregulatory function due to decreasing estrogen  Increased norepinephrine/decreased serotonin  perspiration and vasodilation  sensation of heat starting in chest rising to head

78
Q

PAP screening guidelines?

A

every 3 yr 21-65 y.o. (or up to 5 yrs c HPV testing 30-65 yo) uspstf 2012

79
Q

Screening mammogram guidelines?

A

Biennial screen 50-74 yo

80
Q

Colonoscopy screening?

A

(start @ 50*)
Annual screening with high-sensitivity fecal occult blood testing
Sigmoidoscopy every 5 years, with high-sensitivity fecal occult blood testing every 3 years
Screening colonoscopy every 10 yearsuspstf 2008

81
Q

DEXA guidelines?

A

DEXA (bone density) (start @ 65*)

82
Q

goal of menopause tx?

A
  1. Symptom Relief/ improve quality of life
    hot flashes, night-sweats, insomnia, moods, anxiety, irregular bleeding, vaginal dryness, low libido, etc.
  2. Disease prevention and treatment
    Heart disease
    Osteoporosis
    Insulin resistance & diabetes
    Weight gain
    Alzheimer’s
    Cancer (which increase in 50’s? Breast, ovarian, colorectal, endometrial)
    Macular degeneration
83
Q

levels of intervention for menopause?

A

1-Diet, Exercise, Stress Management
2-Nutritional Supplementation, Acupuncture
3-Botanicals (Chinese or Western)
4-HRT
5-Other pharmaceuticals (SSRI’s, Fosamax, Lipitor)

84
Q

if HRT is used when should it be used?

A

used early menopause

85
Q

ET?

A

estrogen therapy (no uterus)

86
Q

EPT/HRT?

A

estrogen progesterone therapy (uterus)

87
Q

CHD screening increased risk with ?
HDL?
LDL?

A 
HDL <35
LDL>130
pt w/o CHD and <1 risk factor
LDL 100-130
pt w/o CHD but >2 risk factors
*HDL>50
negative risk factor
88
Q

what is procidentia?

A

prolapse or falling down, pelvic prolapse

89
Q

cystocele?

A

protrusion of bladder

90
Q

urethrocele?

A

protrusion of urethra

91
Q

rectocele?

A

rectum protrusion

92
Q

enterocele?

A

intestine protrusion

93
Q

predisposing factors for uterine prolapse?

A

multiparous women, pelvic floor defects d/t childbirth, partial pudendal and perineal neuropathies associated with labor, constipation, menopause, genital atrophy, obesity, smoking

94
Q

what is the #1 sxs of cystocele?

A
  • Incontinence*

- often causes no sx “something is falling out”

95
Q

what is the most common complaint of rectocele?

A

constipation or the need to apply digital pressure in the vagina in order to defecate

96
Q

what are typical sxs of enterocele?

A

typical asxs, can have vaginal pressure and aching discomfort

97
Q

where does the enterocele herniate to?

A

into the rectovaginal septum

98
Q

what is the most common presenting sx for urethrocele?

A

vaginal bleeding

99
Q

what is observed upon examination of an urethrocele?

A

round doughnut-shaped mucosa is obserbed protruding from the urethral opening

100
Q

Main 3 tranmission of HIV?

A
  1. sexual contact
  2. contaiminated blood
  3. donor tissue, mother to child
101
Q

7 body fluids where HIV is detected?

A
  1. Blood
  2. Semen & pre-seminal fluid
  3. Vaginal fluid
  4. Breast milk
  5. Sweat
  6. Saliva
  7. Tears
102
Q

5 bodily fluids that transmit HIV?

A
  1. Blood
  2. Semen & pre-seminal fluid
  3. Vaginal fluid
  4. Breast milk
  5. other body fluids containing blood
103
Q

5 routes of HIV transmission?

A
  1. Vagina
  2. Rectum
  3. Mouth
  4. Urethra
  5. Inside of eyelids
104
Q

who is more likely to get HIV a female negative receiver or giver

A

female receiver

105
Q

What is the screening test for HIV infection

A

ELISA

106
Q

what is the confirmatory test for HIV?

A

Western blot

107
Q

What does the ELISA detect?

A

antibodies

108
Q

What is the 6 months window period

A
  • screening detect antibodies not virus
  • so the drawback of the antibody test is the “window” period: time it takes to produce antibodies after transmission
  • during this period before antibodies are produced, one can be infected with HIV and can infect other, but still test negative on HIV antibody test
109
Q

Can you have HIV and test negative on an antibody test like ELISA?

A

yes, if you are within the 6m window period, newer tech allows detection of lower antibody levels, can ID them between 3-5 weeks in most individuals

110
Q

what is AIDS?

A

CD4+/T4 cells <200 cu mm

or onset of HIV-associated dz

UWS Q9 (3 decks)

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