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Endo-Repro Extras > Gynecologic and Pregnancy Related Infections Part 3 > Flashcards

Gynecologic and Pregnancy Related Infections Part 3 Flashcards

1
Q

What is the herpes virus?

A
  • DNA virus

- Lifelong persistent infection

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2
Q

What is the usual site of involvement of the herpes virus?

A
  • HSV I: orofacial

- HSV II: genital

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3
Q

What is the treatment of herpes?

A
  • Acyclovir
  • Famciclovir
  • Valacyclovir
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4
Q

When is treatment of herpes most effective?

A
  • If started within 72 hours
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5
Q

What is the MOA of acyclovir?

A
  • Inhibits herpes virus DNA polymerase competitively

- Gets incorporated in viral DNA and stops lengthening of DNA strands

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6
Q

How does acyclovir resistance develop?

A
  • Decreased or absent production of viral thymidine kinase

- Prevents acyclovir from reaching the activated triphosphate state

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7
Q

What is seen in primary syphillis?

A
  • Painless chancre that develops 3-6 weeks after contact
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8
Q

What is seen in secondary syphillis?

A
  • Condyloma lata; macular red rash on palms and soles
  • Patchy hair loss
  • Lymphadenopathy
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9
Q

What is seen in tertiary syphillis?

A
  • Gummatous lesions of skin and bone
  • Thoracic aortic aneurysm
  • Tabes dorsalis –> involvement of posterior columns and dorsal roots
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10
Q

When does syphilis become tertiary?

A
  • 6 years after secondary infection
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11
Q

What is tabes dorsalis in tertiary syphillis?

A
  • Decreased coordination
  • Loss of pain and temp sensation
  • Diminished proprioception and vibratory sensation
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12
Q

What is the cause of syphillis?

A
  • Spirochete –> treponema pallidum

- Looks like corkscrew organism on silver stain

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13
Q

What is seen histologically in syphillis?

A
  • Lymphoplasmacytic infiltrate
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14
Q

What can be used to diagnose syphillis?

A
  • Non-treponemal tests –> VDRL, RPR
  • Treponemal tests –> FTA-ABS
  • Direct specimen –> PCR
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15
Q

What is the general treatment for primary, secondary or early latent syphilis?

A
  • Benzathine penicillin or Doxycycline
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16
Q

What is the general treatment for neurosyphilis?

A
  • Aqueous crystalline penicillin G
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17
Q

What is the spectrum for benzathine penicillin?

A
  • Gram pos bacteria

- Gram neg bacteria

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18
Q

What is the MOA of beta lactam antibiotics?

A
  • Inhibition of bacterial wall synthesis
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19
Q

What is a chancroid? Association?

A
  • Multiple painful ulcers usually 1-2 cm

- Associated with inguinal lymphadenopathy

20
Q

What is the main cause of chancroids?

A
  • Haemophilus ducreyi
21
Q

What are some treatment options of chancroids?

A
  • Azithromycin
  • Ceftriaxone
  • Ciprofloxacin
  • Erythromycin
22
Q

What is lymphogranuloma venereum?

A
  • A single, painless genital ulcer

- Heals within few days

23
Q

What happens weeks after a lymphogranuloma venereum?

A
  • Buboes develops

- A painful unilateral inguinal lymphadenopathy

24
Q

What is the main cause of lymphogranuloma venereum?

A
  • Chlamydia trachomatis L1, L2, L3
25
Q

What is the treatment for lymphogranuloma venereum?

A
  • Doxycycline

- Azithromycin or Erythromycin if pregnant

26
Q

What is a granuloma inguinale?

A
  • Painless, slowly enlarging, highly vascular, beefy red nodules/ulcers
27
Q

Does granuloma inguinale usually produce lymphadenopathy?

A
  • No
28
Q

What is the main cause of granuloma inguinale?

A
  • Klebsiella granulomatosis
29
Q

What is seen with Klebsiella granulomatosis?

A
  • Donovan bodies
30
Q

What is the treatment for granuloma inguinale?

A
  • Azithromycin
31
Q

What is seen in TSS?

A
  • Rapid onset fever
  • Diffuse macular rash involving palms and feet
  • Desquamation of rash after a week or two
  • Hypotension
  • Multiorgan involvement
32
Q

What organism causes TSS?

A
  • S. aureus –> Coag pos, catalase pos
33
Q

What toxin causes TSS?

A
  • TSST-1 which crosslinks T cells and macrophages producing a bunch of cytokines
34
Q

What is the treatment of TSS?

A
  • Removal of foreign body
  • Supportive care for shock
  • Empiric antibodies until culture results
35
Q

What drug is used for MRSA?

A
  • Vancomycin
36
Q

What is the MOA of vancomycin?

A
  • Inhibits bacterial wall synthesis
37
Q

What is tazobactam?

A
  • Beta lactamase inhibitor

- Used in conjunction with beta lactam antibiotics

38
Q

What is the combo piperacillin/tazobactam used for?

A
  • P. aeruginosa

- PID

39
Q

What is the MOA of cefepime?

A
  • 4th gen cephalosporin
40
Q

What is the spectrum for cefepime?

A
  • P. aeruginosa
  • S. aureus
  • Multiple drug resistant S. pneumoniae

** Front line agent when infection Enterobacteriaceae

41
Q

What is the MOA of meropenem?

A
  • IV beta lactam
42
Q

What are some serious side effects of meropenem?

A
  • C diff infection
  • Seizures
  • Allergic reactions
43
Q

What is imipenem/cilastatin?

A
  • Carbapenem

- Not active against MRSA

44
Q

What degrades imipenem?

A
  • Renal enzyme dehydropeptidase 1 (DHP1)
45
Q

Why is imipenem combined with cilastatin?

A
  • To prevent inactivation by DHP1

Endo-Repro Extras (5 decks)

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