Gyne/Urology/STIs

Question 1

What do you see in Primary and Secondary Syphillis? Tertiary?

Answer 1

Primary: painless chancre +/- painless bilat iguinal LN
Secondary: Rash 5-8 weeks after chancre. on ddx rash palms/soles. Constitutional sx
Tertiary: Neuro syphilis. Is the ‘great imitator’ so can present as anything.

Question 2

Condyloma Lata is pathnmonic for what?

How does it differ from Condyloma acuminata?

Answer 2

Secondary syphillis

Both are painless but lata is more flat topped. Condyloma accuminata are genital warts.

Question 3

What are 3 complications of Herpes infection?

Answer 3

Recurrance
Meningitis
Encephalitis
Transverse Myelitis
Hepatitis
Pneumonitis
Disseminated infection

Question 4

DDx Penile Ulcer

Answer 4

Syphilis
Herpes Simplex
Chancroid
Lymphogranuloma venereum
Bechet's syndrome
Neoplasm
Lichen Planus

Question 5

Which HPV types are transmitted sexually and cause genital warts? (there are 6)

Answer 5

types 6, 11, 16, 18, 31, and 35 are transmitted sexually and cause anogenital warts, also called genital warts

90% are caused by 6,11 - covered by HPV vaccine
16,18 - assc with cervical cancer

Question 6

What is the most common STI?

Answer 6

Chlamydia

Question 7

What is the Treatment for Gonorrhea (STI)

Answer 7

Cefixime 800 mg PO x1 or 250 mg IM ceftriaxone

Also treat for Chlamydia also with Azithromycin 1gPO x1 or Doxy x 7 days

Question 8

What is the treatment for Chlamydia? (STI, pt presents with urethritis)

Answer 8

1 g Azithromycin PO x 1

Question 9

DDX vaginitis

Answer 9

STI's
Gonorrhea
Chlamydia
Non-gonococal urethritis
Bacterial vaginosis
Trichomonas
Candida
Contact vaginitis

Question 10

DDX cervicitis

Answer 10

Gonorrhea
Chlamydia
HSV
Trichamonas
Mucopurulent cervicitis (tx on spec for GC)

Question 11

Vaginal discharge: fishy odor, thin, pH >4.5, Clue cells on microscopy.
What is the Dx?

Answer 11

Bacterial vaginosis

Question 12

Vaginal discharge: thin discharge, foul smelling, pH 5-6, flagellated protozoae on microscopy.
Dx?

Answer 12

Trichomonas

Question 13

What is the treatment for Trichomonas?

Answer 13

Flagyl 500 BID x 7 days

Avoid sex x 7 days

Question 14

What is the treatment for BV?

Answer 14

Flagyl x 7 days

Question 15

What is the treatment for PID?

Answer 15

Tx GC, BV
Ceftriaxone 250 mg IM and
Doxy 100 mg BID x 14 days
+/- Flagyl 500 mg BID x 14 days if concern for BV, Trich

Question 16

DDX scrotal pain

Answer 16

Testicular torsion
Epididymitis
Torsion of appendix of testis
Orchitis
Iguina Hernia