Infections

Question 1

chancroid caused by waht bacteria?

Answer 1

Haemophils ducreyi, gram negative bacilli

Question 2

how describe chancroid?

Answer 2

vesicular form to puustular form, painful soft ulcer with necrotic base . multiple lesions often and dense matted lymphadenopathy on ipsilateral side of lesion. affected nodes can spont rupture

Question 3

tx chancroid?

Answer 3

azithromycin, cipro, and ceftriaxone

Question 4

lymphogranuloma venereum caused by what organism and occurs how long after contact?

Answer 4

chlamydia trach type L1 and L3 , 1-4 weeks

Question 5

S&S lymphogranuloma venereum?

Answer 5

vesicular or ulcerative lesions on external genitialia, progresses to inguinal lymphadenitis or buboes, lesions can fuse and create multiple draining sinuses

Question 6

tx of lymphogranuloma venereum?

Answer 6

doxycycline and erythromycin

Question 7

what causes acute epididymitis?

Answer 7

c trach and ecoli

older 35 usually secondary to prostatitis

Question 8

Diagnostics/test for acute epididymitis?

Answer 8

preh’s sign - elevation of scrotum above pubis relieves pain

culture/UA

Question 9

S&S of epididymitis?

Answer 9

irritative voiding, penile discharge, fever, acitely painful enlarged epididymitis, scrotal swelling, epididymoorchitis in later stages of dx

Question 10

tx epipidydmitis?

Answer 10

• ceftriaxone 250mg AND doxycyline 100mg x 10 days
• risk for epididymoorchitis (enterobacteria) direct tx at culture , likle use ciprofloxacin (FQ) 500 mg QID or levofloxacin 750 mg QIF x 10-14 days
• MSM likely levofloxacin or ofloxacin

Question 11

Tx acute bacterial prostatitis

Answer 11

250 IM ceftriaxone AND doxycycline 100mg PO 10 days -14 days

Question 12

signs of acute bacterial prostatitis?

Answer 12

irritative voiding, suprapubic pain, perineal pain, fever, tender, boggy prostate, leukocytosis

Question 13

Tx acute bacterial prostatitis > 35

Answer 13

levofloxacin 500-750 mg IV/PO QID or

Cipro 500 mg PO BID or 400 mg IV BID x 10-14 days

Question 14

tx chronic bacterial prostatitis ?

Answer 14

covers enterbacter and enterococci, negative rods ciprofloxacin 500mg BID x 4-6 weeks,or levofloxacin 750 mg PO QID x 4 weeks

alter: TMP-SMX DS 1 tab BID x 1-3 months

Question 15

Gonorrhea incubation and S&S

Answer 15

1-5 days incubation, dysuria, milky penile discharge, occ blood tinged discharge, diff urination

Question 16

gonorrhea organism and tx?

Answer 16

gram negative diplococci, beta lactam resistant, FQ resistance developing. use cephalosporin (doxy or

uncomplicated proctatitis/urethritis- ceftriaxone IM 250 mg AND single dose azithromycin 1g PO or doxycycline 100mg BID x 7 days

alt:
uncomplicated w/allergy PCN and cephalosporin: azithromycin 2 g orally . test of cure in 1 week

Question 17

uncomplicated Gonorrhea urethritis and single dose option: single dose therapy

Answer 17

• cefixime

Question 18

S&S acute bacterial prostatitis?

Answer 18

irritiative voiding, suprapubic pain, perineal pain, fever, tender and boggy prostate. leukocytosis and neutrophilia (left shift). urine culture + . if negative culture might be chronic

Question 19

common cause of bacterial prostatitis?

Answer 19

negative rods, e coli or pseudomonas.
younger - gon or chlamy
MSM 0 enterobacter to consider

Question 20

S&S chronic bacterial prostatis

Answer 20

voiding sutmp, low back pain and perineal pain, hx UTI. tender and boddy and indurated prostate.

UA normal. PRostatic massage then UA and culture - leukocytosis and + culture.

dont do massage if acute.

Question 21

HPV sequalae in men?

Answer 21

anorectal carcinoma

Question 22

HPV anal pap tests indicated when?

Answer 22

not routine. 1-3 years if MSM HIV +

Question 23

genital warts or HSV symptoms of intial outbreak?

Answer 23

lesions painful ulcer, inguinal lymph, associated also with flu-like symptoms.