Gynecologic and Pregnancy Related Infections Part 2 Flashcards

1
Q

What kind of organism is N. gonorrhea?

A
  • Gram neg diplococcus
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2
Q

What agar grows N. gonorrhea?

A
  • Thayer martin chocolate agar
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3
Q

What is the virulence factor of N. gonorrhea?

A
  • Pili for adherance
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4
Q

What is needed often for the diagnosis of N. gonorrhea?

A
  • PCR since it does not stain with Gram stain
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5
Q

What is mycoplasma genitalium?

A
  • Bacterial without cell walls

- Cause of non-gonococcal urethritis

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6
Q

What is the empirical treatment of Gonorrhea and chlamydia?

A
  • Ceftriaxone – IM
  • Azithromycin – PO
  • Doxycycline
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7
Q

What is the MOA of ceftiraxone?

A
  • Penetrates CSF with a long half life

- Broad spectrum –> 3rd gen cephalosporin

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8
Q

What is the spectrum for azithromycin?

A
  • Bacteria lacking cell walls and some anaerobes
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9
Q

What is the MOA of azithromycin?

A
  • Binds 50s subunit
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10
Q

What is the MOA of doxycyline?

A
  • Binds 30S subunit
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11
Q

Is doxycycline safe in pregnancy?

A
  • NO
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12
Q

What are the most common causes of PID?

A
  • N. gonorrhea and chlamydia trachomatis
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13
Q

Where does PID begin?

A
  • Vulva or vagina and spreads through the genital tract
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14
Q

What is a bad end result of PID?

A
  • Pyrosalpinx and tubo-ovarian abscess
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15
Q

What is seen in a tubo-ovarian abscess?

A
  • Adnexal mass
  • Fever
  • Increased WBC
  • Abdominal-pelvic pain
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16
Q

What can occur in long term PID?

A
  • Infertility
  • Ectopic pregnancy
  • Intestinal obstruction
17
Q

What is Fitz-Hugh-Curtis syndrome?

A
  • Peritoneal inflammation
  • Sudden onset of severe abdominal pain
  • +/- fever
  • N/V
18
Q

What two STIs can cause neonatal conjunctivitis?

A
  • Gonorrhea – > gonococcal ophthalmia neonatorum

- Chlamydia –> neonatal inclusion conjunctivitis

19
Q

What is the outpatient treatment for PID?

A
  • Ceftriaxone (3rd gen ceph) AND doxycycline (binds 30S)

- Could add metronidazole if serious (DNA breakage)

20
Q

What is the inpatient treatment for PID?

A
  • Doxycycline (30S) PLUS either Cefoxitin OR cefotetan (2nd gen ceph)
  • Clindamycin (bind 50S) AND gentamicin in pregnancy
21
Q

What are some undesirable side effects of 2nd gen cephalosporins?

A
  • GI disturbances
  • Neurotoxicity
  • Nephrotoxicity
  • Hepatic enzyme abnormalities
  • Hematologic problems
22
Q

What is the MOA of gentamicin? Spectrum?

A
  • Binds 30S

- Transport is oxygen dependent (cannot use in anaerobes)

23
Q

What are some undesirable side effects of gentamicin?

A
  • Nephrotoxicity
  • Ototoxicity
  • Complete neuromuscular blockage
24
Q

What is the black box warning with gentamicin?

A
  • Injection is potentially nephrotoxic/neurotoxic