GUM Flashcards
1
Q
HIV opportunistic infections
A
- AIDS is the advanced stage of HIV, where cART has not stopped the spread of infection. AIDS is defined as evidence of an AIDS defining illness, alongside a CD4 count of less than 200.
- Pneumocystis jirovecii pneumonia/PCP: If CD4 <200
-> breathlessness, dry cough - Pulmonary TB
-> Fever, night sweats, haemoptysis, productive cough - Candidasis
-> whitish coating on tongue, oral mucosa, sore throat - Cryptococcal meningitis: If CD4 <100
-> fever, NS, photophobia, raised ICP - Cytomegalovirus retinitis: If CD4<50
-> any visual sx - pizza pie fundus, floaters, defects - Cerebral toxoplasmosis: If CD4<50
- Kaposi sarcoma
-> cancer - purple patches on the skin
2
Q
What are the features of primary HIV infection
A
- Classically, patients present with fever and lymphadenopathy.
- Other common features are a maculopapular rash, mucosal, myalgia, arthralgia and fatigue.
- In severe cases encephalopathy
3
Q
Dx of HIV
A
- The gold standard is a serum HIV enzyme-linked immunosorbent assay (ELISA) - HIV antibody and HIV antigen
- Additional tests should include a HIV viral load, full blood count, lymphocyte subset panel including CD4 count
4
Q
Mx of HIV
A
- All pts should be offered combination antiretroviral therapy (cART), regardless of CD4 count.
- If a pt is thought to have been exposed to HIV, they can take PEP, if administered within 72 hrs.
5
Q
Px of genital herpes
A
- Ulcers on genitals -> PAINFUL + ITHCY
- Dysuria, Discharge
- Lymphadenopathy
- +/- fever, headache, neuropathic tingling
6
Q
Dx and Mx of genital herpes
A
- Swab and NAAT
- Aciclovir for 5 days
7
Q
Px of syphillis
A
- Primary: PAINLESS singular genital ulcer (= chancre) at site of contact, NON TENDER local lymphadenopathy
- Secondary: fever, rash on palms/soles/trunk, painless + warty lesions on genitalia
- Tertiary: granulomatous lesions of skin and bones, AORTIC ANEURYSMS, NEUROSYHPILLIS (tabes dorsalis)
- Congenital triad: Interstital keratitis (inflammation of cornea), sensorineural deafness, hutchinsons teeth (blunted upper incisor teeth), saddle nose
-> eyes, ears, nose, teeth
8
Q
Dx + Mx of syphillis
A
- Ab testing to T.pallidum bacteria
- IM benzathine benzylpenicillin
9
Q
BV Px, Dx and Tx
A
- Thin, white-grey, fishy, >4.5 pH discharge
- Dx: Vaginal swab - microscopy -> clue cells
- Tx:
Asym: No tx
Metronidazole for 5-7 days (avoid alcohol)
10
Q
Vaginal candidiasis/thrush Px, Dx, Mx
A
- RF: diabetes, immunosuppression, broad-spectrum abx. Can occur in non-sexually active people
- Itchy, dysuria, dyspareunia
- Thick, white, ‘curdy/cottage cheese’ non-odorous, <4.5 pH
- Dx: Vaginal swab - microscopy + pH
- Tx:
Antifungal e.g. oral fluconazole single dose (1st). Clotrimazole cream
11
Q
Chlamydia Px, Dx, Mx
A
- Often asyx - but dysuria, pelvic pain, dyspareunia
- Purulent thick white/green/yellow discharge, abnormal bleeding
- Dx: Vaginal swab - microscopy, culture, sensitivities. NAAT.
- Tx: Doxycycline
12
Q
Gonorrhoea Px, Dx, Mx
A
- Dysuria, pelvic pain
- Yellow-green, odourless, purulent discharge
- NAAT - RNA/DNAVaginal swab - culture + sensitivities.
- Tx: IM ceftriaxone
13
Q
Trichomonas Px, Dx, Mx
A
Px: itching, dysuria, dyspareunia
- Yellow, green, fishy discharge
Ix: Strawberry CervixVaginal swab
Tx: Metronidazole
14
Q
What is lymphogranuloma venereum
A
- strain of chlamydia bacteria
- Sx: painless genital ulcer, TENDER inguinal lymphadenopathy, rectal pain/discharge, fever
- Mx: doxycycline
15
Q
What is Chancroid
A
- Infection of genital skin caused by haemophilus ducreyi. HIGH INCIDENCE IN TROPICAL AREAS.
- Sx: PAINFUL genital lesion which may bleed on contact, lymphadenopathy
- Tx: Ceftriaxone, Azithromycin or Ciproflaxcin
