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ENRP Exam 1 > Gynecologic Infections Part 2 > Flashcards

Gynecologic Infections Part 2 Flashcards

1
Q

Symptoms of cervicitis?

A
  • purulent/mucopurulent discharge
  • Intermenstrual or post sex bleeding
  • +/- dysuria
  • dyspareunia, vulvovaginal irritiation
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2
Q

Possible pathogens for cervicitis?

A
  • Chlamydia and Gonorrhea are most common
  • Trichomonas
  • Mycoplasma genitalium
  • HSV
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3
Q

N. gonorrhea describe the micro, growth, and virulence factors.

A
  • Facultative anaerobic intracellar gram - diplococcus
  • Grows on thayer martin chocolate agar
  • Pili for adherence, IgA1 protease, Opa proteins
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4
Q

C. trachomatis micro?

A
  • Gram - tiny obligate intracellular bacteria
  • Often doesn’t appear on gram stain because it is so small, so PCR is usually for diagnosis of chlamydia
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5
Q

Mycoplasm genitalium micro?

A
  • bacteria without cell walls
  • mycoplasma bacteria are smallest free living bacteria
  • cause of non gonoccal urethritis
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6
Q

How do you treat gonorrhea and chlamydia?

A
  • IM Ceftriaxone and oral Azithromycin
    • if allergic to azithromycin use doxycycline
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7
Q

What family of abx do the following fall under:

  • ceftriaxone
  • azithromycin
  • doxycycline
A
  • Ceftriaxone: 3rd gen cephalosporin
  • Azithromycin: macrolide
  • Doxycycline: tetracycline
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8
Q

How does Ceftriaxone work?

A

Inhibits cell wall synthesis

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9
Q

Azithromycin MOA and AE’s? What type of bacteria is it used on?

A
  • 50s ribosome inhibitor
  • GI upset and abd. pain
  • Bacteria lacking cell walls such as mycoplasma, legionella and chlamydia and some anaerobes
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10
Q

Ceftriaxone (IM) pharmacokinetics and AE’s?

A
  • IM penetrates CSF
  • assoc. with acalculous cholestasis and bilirubin displacement from albumin
    • use caution with neonates and avoid in jaundiced ones
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11
Q

How does Doxycycline work, pregnancy use?

A
  • 30s ribiosome inhibitor
  • Teratogenic
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12
Q

Chandelier sign?

A

Cervical motion tenderness

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13
Q

Key features of PID? Initial work up?

A
  • fever
  • lower abdominal or pelvic pain
  • significant cervical motion tenderness
  • Same workup as cervicitis but +/- pelvic US
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14
Q

Most common cause of PID?

A

N. gonorrhea and C.trachomatis

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15
Q

Where does PID begin and spread to?

A
  • begins in vulva or vagina and spreas up through genital tract
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16
Q

What is considered a late stage of PID and how does it present?

A
  • Tubo-ovarian abscess
  • presents with adnexal mass, fever, increased WBC’s, abdominal pelvic pain
17
Q

Waht is Fitz-Hugh CUrtis syndrome?

A
  • Peritoneal inflammation/perihepatitis with sudden onset of sevefre abdominal pain, +/- fever, N/V
  • can occur when tubo-ovarian abscess infection from PID spreads beyond ovary
18
Q

What are the long term effects of PID?

A

Infertility, ectopic pregnancy

19
Q

What are the complications in infants from gonorrhea and chlamydia?

A
  • Both cause conjunctivitis via vertical transmission, this can lead to blindness
  • presents with swelling of eye surface membranes erythema and discharge
20
Q

In a patient with PID what would necessitate an inpatient treatment?

A
  • high fever and severe pain with N/V
  • complications such as pelvic or tubo-ovarian abscess
  • Need for surgery
  • Pregnancy
21
Q

Outpatient PID treatment?

A
  • Ceftriaxone and Doxycycline
    • if complicated (abscess or recent gynecologic instrumentation) consider adding metronidazole
22
Q

Inpatient PID treatment?

A
  • Doxycycline plus Cefoxitin or Cefotetan
23
Q

Inpatient PID treatment in a pregnant patient?

A
  • Clindamycin and Gentamicin
24
Q

Cefoxitin and Cefotetan MOA and class?

A
  • 2nd gen Cephalosporins, Beta lactams
  • Inhibit cell wall synthesis
    *
25
Q

What are 2 main advantages of Cefoxitin and Cefotetan to penicillins?

A
  • More resistant to beta lactamases
  • New R group adds chemcial versatility for future dev of new abx
26
Q

AE’s of Cefoxitin and Cefotetan (2nd Gen Cephaosporins)

A
  • GI issues
  • Neurotoxicity
  • Nephrotoxicity
  • Hepatic enzyme abnormalities
  • Hematologic issues
27
Q

Spectrum for 2nd gen cephalosporins?

A
  • less activity for Gram + compared to first gens
  • Covers Neisseria gonorrhea
28
Q

Gentamycin MOA and class?

A
  • Inhibtis 30s subunit
  • Aminoglycoside
29
Q

What bacterira are resistant to Gentamicin and why?

A
  • Anaerobic bacteria are resistant bc transport of gentamicin into bacteria is oxygen dependent
30
Q

Pharmacokineteics of Gentamicin

A

Ecreted unchanged in keidney so reduce dose if patient has renal impairments

31
Q

AE Gentamicin?

A
  • Nephrotoxicity
  • Ototoxicity (usu. irreversible)
  • Complete neuromuscular blockade (BBW) very rare

ENRP Exam 1 (7 decks)

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