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Clin Med part II > ID - sexually transmitted infections > Flashcards

ID - sexually transmitted infections Flashcards

1
Q

Which stage of syphilis is infectious?

Which is not infectious?

A

EARLY stage is INFECTIOUS!

LATE stage is not infectious

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2
Q

In which stage of syphilis are there high numbers of spirochetes in the lesions?
In which stage are there low numbers of spirochetes in the lesions?

A

EARLY stage = abundant spirochetes

Late stage = lesions contain few demonstrable spirochetes

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3
Q

What are the primary lesions of syphilis?

A

chancre (at infection site) & regional lymphadenopathy

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4
Q

What are the secondary lesions of syphilis?

A

skin: nonpruritic macular, papular, pustular or follicular (NOT vesicular). Palms & soles common

mucous membranes: highly infectious mucous patches

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5
Q

What is the timeline of untreated syphilis?

A
  1. sexual exposure to partner with syphilis
  2. 3-4 weeks later: an initial small erosion that quickly becomes a painless superficial ulcer (at site of inoculation); also, enlargement of regional lymph nodes
  3. a few weeks to 6 months later: distant skin & mucosal lesions; condyloma lata
  4. Then, a LATENT stage, may last a few months to a lifetime: no physical signs; positive serologic tests for syphilis
  5. Late/tertiary syphilis: gummatous lesions (anywhere, but skin & bone common); CVD, ocular problems, respiratory problems, GI problems
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6
Q

What is the specific secondary lesion of syphilis?

A

CONDYLOMA LATA

fused, weeping papules of skin/mucous membranes, sometimes mistaken for genital warts

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7
Q

Which phase does neurosyphilis occur in?

A

Neurosyphilis can occur AT ANY TIME

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8
Q

What is the treatment for syphilis?

A

PENICILLIN, PENICILLIN, PENICILLIN

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9
Q

What organism causes syphilis?

A

Treponema pallidum, a spirochete

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10
Q

What organism causes gonorrhea?

A

Neisseria gonorrhoeae, a gram-negative diplococcus

Likes to live in polymorphonuclear cells

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11
Q

What organism causes genital herpes?

A

HSV-2

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12
Q

What lab tests do you do for herpes?

A

Tzanck smear (large multinucleated cells)
PCR
Direct fluorescent antibody test

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13
Q

Where do genital herpes lesions occur?

A

penile shaft, labia, perianal, buttocks

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14
Q

What organism causes granuloma inguinale?

A

Calymmatobacterium (Donovania) granulomatis (CURRENT)

Klebsiella granulomatis (lecturer)

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15
Q

What is the pathognomonic cell of granuloma inguinale?

A

Large, contains intracytoplasmic cysts filled with bodies (Donovan bodies) that stain deeply with Wright stain

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16
Q

How is granuloma inguinale treated?

A

doxycycline
azithromycin
ciprofloxacin

17
Q

Name 2 STIs with PAINFUL ulcers.

A 
genital herpes (HSV-2)
chancroid (H. ducreyi)
18
Q

Name 2 STIs with PAINLESS ulcers.

A 
syphilis (T. pallidum)
granuloma inguinale (C. or K. granulomatis)
19
Q

Name 2 STIs with DISCHARGE.

A

gonorrhea (N. gonorrhoeae)

chlamydia (C. trachomatis)

20
Q

What causes condyloma acuminata?

21
Q

What organism causes chlamydia (non-gonoccocal urethritis/cervicitis)?

A

Chlamydia trachomatis

22
Q

Which is more painful and has more purulent, thicker discharge, gonorrhea or chlamydia?

A

Chlamydia is less painful and has less purulent, more watery discharge than gonorrhea.

23
Q

How is chlamydia diagnosed?

A

A patient with urethritis or cervicitis and absence of gram-negative diplococci on gram stain and of N. gonorrhoeae on culture is assumed to have chlamydial infection until proven otherwise.

24
Q

Treatment for chlamydia?

A

azithromycin
doxycycline
levofloxacin

25
Q

A 23 year old male resident of a New Jersey beach house comes to your clinic complaining of purulent, profuse urethral discharge, with painful, burning urination. Your diagnosis?

A

gonorrhea!

26
Q

What are the symptoms of disseminated gonorrhea?

A

rash, tenosynovitis, arthritis

27
Q

Treatment for gonorrhea? Just use any old antibiotic?

A

Lots of resistance has developed - use:

ceftriaxone + azithro or doxy

28
Q

What organism causes chancroid?

A

Haemophilus ducreyi

29
Q

How can you differentiate the ulcers of chancroid from the ulcers of syphilis?

A

syphilis: ulcer is painless with a hard base
chancroid: ulcer is painful, soft, with a necrotic base, has surrounding erythema, and undermined edges

30
Q

What organism causes lymphogranuloma venereum?

A

C. trachomatis

31
Q

What does lymphogranuloma venereum look like?

A

inguinal buboes (men), perirectal (women)

bilateral, fused/softened/broken down lymph nodes with multiple draining sinuses

Clin Med part II (12 decks)

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