GYN- Lower GU Infections

Question 1

dysuria, urinary freq/urgency, suprapubic tenderness

Answer 1

UTI

Question 2

1, 2, 3 bugs that cause UTI

Answer 2

Ecoli > S. saprophyticus > enterococcus

Question 3

2 complications of UTI

Answer 3

urosepsis (septic shock), ARDS

Question 4

Treatment for UTI

Answer 4

Not pregnant = Bactrim(TMP SMX) or Cipro
Pregnant = nitrofurantoin
upper UTI/pyleo = IV cephlasporin + admit

Question 5

How to Dx, what bug, and Tx:

thick, white curd like d/c, itching, satellite lesions, no odor +

Answer 5

Candidasis (C albicans)

Dx budding yeast + pseudohyphae on KOH prep

Tx fluconazole (diflucan)

Question 6

what is diff between 1/1, 2/2, 3/3 syphyillis, what bug, and Tx:

Answer 6

1/1: painless chancer + inguinal LAD
2/2: palmar/plantar rash, fever, condyloma lata, enlarged LNs
3/3: neurosyphilis (tabes dorsalis = loss of position, vibration, discriminatory touch (dorsal columns) , CV syphillis (aoritis w/ aortic aneurysm), gummas

Treponema palliudum

Dx RPR, VDRL confirm with FTA-Abs

Tx pen G

Question 7

How to Dx, what bug, and Tx:

recurrent, painful oral/genital vesicles that can rupture

Answer 7

HSV 1/2

Dx Tzanck smear (multinucleated giant cells) or viral Cx

Tx: ACV/VACV

• *Tzanck cells (multinucleated giant cells) are found in:
• Herpes simplex
• Varicella and herpes zoster
• Pemphigus vulgaris
• Cytomegalovirus

Question 8

How to Dx, what bug, and Tx:

painful chancre + inguinal LAD

Answer 8

Chancroid (Haemophilus ducreyi)

Dx: school of fish on gram stain

Rx: azythromycin or ceftriaxone

Question 9

what is diff btwn 1/1, 2/2, 3/3 lymphogranuloma venerium (LGV)

Bug, Dx, Tx

Answer 9

1/1 transient, painless ulcer
2/2 painful LAD
3/3 anogenital syndrome (proctocolitis, rectal stricture, rectovaginal fistula, elephantitis)

Bug: Chlamydia trachomatis L1-L3 serotypes

Dx: PE or complement fixation

Tx: doxycycline

Question 10

genital warts - Bug, Dx, Tx

Answer 10

HPV 6/11 = Chondyloma Accuminata

Dx PE

Tx removal

Question 11

bus, Dx, Tx

domed papule with umbilicated stump

Answer 11

Moluscum Contagiosum Virus (pox family)

Dx PE, Tx removal

Question 12

itching, irritation, vesicles, burrows

Answer 12

scabies vs pediculosis

sarcoptes scabi vs phuthirus pubis

Dx: PE Tx: permethrin cream

Question 13

thin homogenous discharge with fishy odor

Answer 13

bacterial vaginosis

gardnella vaginalis

Dx clue cells on wet prep

Tx metronidazole

Question 14

Green gray frothy discharge, odor, strawberry d/c

Answer 14

Trichomonas vaginallis

Dx: mobile trichomonads on wet prep

Tx metronidazole

Question 15

cervicitis, PID, TOA< bartholin abcess

Answer 15

Gohnorrhea

Tx ceftriaxzone (+azythromycin)

Question 16

cervicitis, PID, TOA, usually asmx

Answer 16

chlamydia

Tx azythromycin (+ceftriaxone)

Question 17

MC bacterial STD

Answer 17

chlamydia

Question 18

what is jarisch-herxheimer rxn

Answer 18

acute febrile rxn s/p treatment for syphillis tx (MC seen with 2/2 syphillis), due to dead spirochetes –> exotoxin release