GYN infections (5 stars esp STDs) Flashcards
Clue cells
Bacterial vaginosis (Gardnerella vaginalis)
Greenish frothy vaginal discharge
Trichomonas
Pseudohyphae + budding yeast on KOH prep
Candida albicans
Strawberry cervix + foul smelling vaginal discharge
Trichomonas
Fishy odor of KOH prep
Bacterial vaginosis (Gardnerella vaginalis)
“Cottage-cheese” thick, white vaginal discharge
Candida albicans
Vaginal pH >4.5 (high)
Bacterial vaginosis or Trichomonas
Motile organisms on KOH prep
Trichomonas
Treatment bacterial vaginosis
Metronidazole
Treatment trichomonas vaginalis
Metronidazole + sexual partner
Treatment candida vaginitis
Topical -azole or oral fluconazole
Generalized macular rash + fever + hypotension + desquamation of palms and soles
Toxic shock syndrome
Treatment TSS
Clindamycin or penicillinase-resistant B-lactam + vancomycin for MRSA
UTI or cervicitis + no organisms on gram stain/culture
Chlamydia (intracellular)
Thayer-Martin culture
Neisseria gonorrhea
MC reportable STD
Chlamydia
Treatment chlamydia or gonorrhea
Treat for both
C - Azithromycin (or doxycycline)
G - Ceftriaxone
Lower abdominal pain w/i days of menses + cervical motion tenderness (chandelier sign) + adnexal tenderness
PID
PID + RUQ tenderness
Fitz-Hugh-Curtis (liver involvement)
MCC PID
Gonorrhea or chlamydia
E coli, bacteroides, strep
Labs for syphilis
Treponema spirochete visualized on dark-field microscopy
VDRL or RPR (screening)
FTA-ABS or MHA-TP (treponemal specific) for confirmation
Cannot be cultured
Primary syphilis
Painless chancre (ulcer), heals spontaneously w/i 9 weeks
Secondary syphilis
Fever, HA, malaise, lymphadenopathy
Maculopapular rash on palms and soles
Papules on mucus membranes, genitals (condyloma lata)
Resolves spontaneously
Tertiary syphilis
After latent period of 1-30 years
Gummas of skin, bone, liver
Tabes dorsalis (loss of 2-pt discrimination and proprioception, shooting pains), paresthesias
Argyll-Robertson pupil (small, does not contract to light, contracts to accommodation)
Tree-bark aortitis (ascending aorta aneurysms) and AV insufficiency
Treatment PID
Empiric antibiotics til culture returns
Treatment syphilis
Penicillin G
HPV types
1-4: skin warts
6, 11: genital warts
16, 18: cervical cancer
16: anal, penile, vulvar, head and neck cancer associations
Cauliflower-like warts on genital region
HPV
Treatment HPV warts
Podyphyllin, trichloracetic acid, topical 5-FU, a-IFN
Injection, cryotherapy, laser therapy, excision
Small papule -> painful ulcer w/ gray base and possible bubo formation (inguinal swelling)
Chancroid (Haemophilus ducreyi)
Treatment chancroid
Ceftriaxone or azithromycin
Malaise, fever, HA + papule -> painless ulcer + unilateral inguinal bubos, can have fistulas, abscess esp if anal
Lymphogranuloma venereum (L1-3 chlamydia serotypes)
Treatment LGV
Doxycycline
Papule -> painless ulcer w/ beefy red base, irregular borders, easy bleeding w/ Donovan bodies (intracellular gram negative rods) on Giemsa stain of lesion
Granuloma inguinale (Klebsiella granulomatis)
Treatment granuloma inguinale
Doxycycline
Genital ulcers (painful/painless)
Some Girls Love Licorice but Fellows Hate Candy Syphilis, Granuloma inguinale, Lymphogranuloma venereum = painLess
painFul
Herpes
Chancroid
