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2020 phase 3a newer > GUM > Flashcards

GUM Flashcards

1
Q

what are the symptoms of trichomonas?

A 
green frothy discharge
vulvovaginitis
strawberry cervix 
high pH>4.5
in men, urethritis
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2
Q

how is trichomonas investigated?

A

direct microscopy and culture

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3
Q

how is trichomonas treated?

A

metronidazole oral stat 2g or 5-7 days

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4
Q

what pathogen causes trichomonas?

A

flagellated protozoan

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5
Q

what bacteria causes gonorrhoea?

A

neisseria gonorrhoeae

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6
Q

where can gonorrhoea infect?

A

GU
pharynx
rectum

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7
Q

what are the symptoms of gonorrhoea?

A

in women, discharge
in men, discharge and dysuria and scrotal pain
if pharynx, rectum, asymptomatic

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8
Q

how long is gonorrhoea incubation period?

A

2-5 days

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9
Q

why is it possible to be reinfected with gonorrhoea?

A

variability in type 4 pili and Opa proteins

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10
Q

what are the complications of gonorrhoea?

A

urethral stricture
epididymitis and salpingitis
reactive arthritis

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11
Q

what is the triad of disseminated gonorrhoea

A
  • arthritis
  • dermatitis
  • tenosynovitis
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12
Q

how is gonorrhoea treated?

A

ceftriaxone IM

if not, oral cefixime and azithromycin

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13
Q

what sti can cause endocarditis?

A

gonorrhoea

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14
Q

when should genital herpes be treated?

A

within 5 days of symptom onset acyclovir

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15
Q

how should pregnant women with genital herpes be treated?

A

elective c section at term if herpes after 28 weeks

women with recurrent herpes: transmission is low, suppressive therapy

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16
Q

how long is syphilis incubation period

A

9-90 days

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17
Q

what are the features of primary syphilis?

A

chancre

non-painful lymphadenopathy

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18
Q

when is secondary syphilis?

A

6-10 weeks

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19
Q

what are the symptoms of secondary syphilis?

A 
fever
lymphadenopathy
macpap rash on trunks, palms, soles 
buccal snail track ulcers
condylomata lata
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20
Q

what are the tertiary features of syphilis?

A 
ascending aortic aneurysms
gummas
tabes dorsalis
general paralysis of the insane 
argyl-robinson pupil
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21
Q

what are the features of congenital syphilis?

A 
blunted teeth, mulberry molars
keratitis
rhagades (lines on mouth)
deafness
saber shins
saddle nose
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22
Q

what organism causes syphilis?

A

treponema pallidum `

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23
Q

what tests can be used for syphilis

A

cardiolipin

treponemal specific antibody tests

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24
Q

what are the cardiolipin syphilis tests?

A

VDRL

RPR - 1 in 2 is better than 1 in 8 (only needs diluting 2x)

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25
Q

What are the treponemal specific antibody tests?

A

TPHA

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26
Q

following treatment with syphilis, which tests are positive and which are negative

A

VDRL becomes negative

TPHA remains positive

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27
Q

how is syphilis treated?

A

IM benpen stat

28
Q

what does eia look for in syphilis?

A

IgM

29
Q

when would eia be negative?

A

no infection or reinfection

30
Q

which viruses cause genital warts

A

HPV 6 and 11

31
Q

how are genital warts managed?

A

if keratinised and solitary, cryotherapy

if not, podophyllotoxin or imiquimod cream?

32
Q

how is hiv assessed/

A

HIV antibody and HIV antigen test

p24 antigen

33
Q

how is hiv treated?

A

cART

34
Q

what type of birth in hiv?

A

if >50 - c-section

if <50 - vaginal

35
Q

what treatment for baby in hiv?

A

zidovudine if mum has low viral load
cART if mum has high
avoid breastfeeding

36
Q

how is jarisch herxeimer treated>

A

admit and treat

following treatment of syphilis - rigors etx

37
Q

how do you manage absent cremasteric reflex/

A

surgery (could be torsion?)

38
Q

what causes lymphogranuloma venereum?

A

chlamydia - diagnose with pcr of ulcers

painful lymph nodes

treated with azithromycin

39
Q

what are the upssi guidelines?

A 
understands professional advice
persuade to tell parents
sexual intercourse anyway
suffer mental health
interests (best)
40
Q

is bv vaginal or endocervical?

A

vaginal

infective, but not STI

41
Q

how is bv managed in preg?

A

metronidazole for 5-7 days

same treatment in pregnancy

42
Q

what increases risk of thrush?

A

glycosuria (dm and preg)
high oestrogen (COCP)
too much cleaning
abx?

43
Q

what is oral treatment of thrush

A

fluconazole po

contraindicated in pregnancy

44
Q

how does thrush look on microscopy?

A

pseudohyphae on KOH prep

45
Q

which sti is flagellated protozoa?

A

trichomonas

46
Q

how is trichomonas investigaed?

A

vulvovaginal NAAT
Swab posterior fornix
shows mo0tile trophozites
pH >4.5

47
Q

how is trichomonas treated

A

po metronidazole for 5-7 days
or po metronidazole 2g stat
treat sexual partners

48
Q

when is stat dose of metronidazole contraindicated in?

A

men

1st trimester preg

49
Q

how is chlamydia tested for?

A

vulvovaginal NAAT

50
Q

chlamydia treatment

A

doxycycline 7 days
azithromycin 1g stat

abstain for 7 days

51
Q

how does PID present?

A 
lower bilateral abdo pain 
abnormal purulent discharge
deep dyspareunia
IMB/PCB
dysuria
cervical motion tenderness
fever
52
Q

what causes pid?

A

chlamydia
gonorrhoea
pelvic surgery

ifection and inflammaton
of uterus ovaries peritoneum tubes

53
Q

how is PID investigated

A

vvs NAAT: chlamydia, gonorrhoea, and trichomonas
endocervical swab for gonorrhoea culture
bloods for hiv and syphilis
high vaginal swab - bv, tv, candida

54
Q

how is PID treated?

A

ceftriaxone - gonorrhoea
doxycycline - chlamydia
metronidazole - trichomonas

55
Q

what is tabes dorsalis?

A

loss of vibration and proprioception

56
Q

what is tertiary syphilis?

A

aortic aneurysm
tabes dorsalis
severe ulceration of skin (gummas)

57
Q

what is secondary syphilis?

A

rash on trunks palms soles
influenza
systemic vasculitis

58
Q

when to test post hiv exposure and post-exposure prophylaxis?

A

test at 12 weeks

59
Q

how to test for HIV?

A

HIV antibody test - positive 4-6 weeks

p24 antigen test - from 1-4 weeks

60
Q

what is involved in the antibody test?

A

elisa and western blot to confirm

61
Q

if negative hiv antibody test at 4 weeks, when to offer a second test?

A

12 weeks

62
Q

person with meningitis

encapsulated organisms visible by India ink.

A

Cryptococcus neoformans

63
Q

most common cause of diarrhoea in patients with HIV

A

Cryptosporidium

64
Q

how is cerebral toxoplasmosis treated?

A

sulfadiazine and pyrimethamine

65
Q

what are the side effects of zidovudine?

A

peripheral neuropathy

2020 phase 3a newer (11 decks)

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