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Obstetrics and Gynecology > Infections of the Lower Female Reproductive Tract > Flashcards

Infections of the Lower Female Reproductive Tract Flashcards

1
Q

Symptoms of UTI (2)?

A

Urethritis (dysuria) and cystitis (frequency).

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2
Q

Symptoms of pyelonephritis that are not found in UTI (2)?

A

Costovertebral angle tenderness and fever.

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3
Q

Most common cause of vulvitis (vulvar pruritis)?

A

Candidiasis (yeast infection).

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4
Q

Cause of knife cut vulvar ulcers?

A

Chrohn’s Disease.

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5
Q

Cause of destructive vulvar lesions, fenestrations in the labia, and scarring?

A

Behcet disease?

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6
Q

A woman presents with one painless, red, round, firm, 1cm ulcer.

  1. Infectious agent?
  2. Secondary presentation of the disease?
  3. Most common cutaneous tertiary presentation?
  4. Most cfamous neurological tertiary presentation?
A
  1. Treponema Pallidum - Syphilis
  2. 1-3 months later after primary syphylis resolves, maculopapular rash on the palms and soles.
  3. Gumma (granulomas of the skin)
  4. Tabes dorsalis.
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7
Q

Screening tests for syphilis?
How long will they remain positive after treatment of primary syphilis?
Confirmatory tests?

A

RPR (Rapid Plasma Reagin) or VDRL (Venereal Disease Research Laboratory).
6-12 months.
FTA-ABS (fluorescent treponemal antibody absorption test) or TPPA (T. pallidum particule agglutination test).

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8
Q

Treatment of Syphilis?

Treatment of Neurosyphilis?

A

Oral benzathine penicillin.

IV penicillin.

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9
Q

A patient receiving treatment for syphilis develops fever, chills, headache, malaise, myalgia, and a rash about 8 hours later.

  1. Diagnosis?
  2. More common in primary or secondary syphilis?
A

Jarisch-Herzheimer reaction.

Secondary syphilis.

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10
Q

Most common cause of genital herpes lesions?

Cause of 40% of new genital herpes lesions?

A

HSV2.

HSV1.

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11
Q

A woman complains vulvar pruritis with multiple genital lesions that become painful after 36 hours.

  1. Diagnosis?
  2. Tests?
  3. Treatment?
A
  1. HSV
  2. Viral culture
  3. Herpes is forever…but acyclovir can suppress primary infection and recurrence. Treat partners as well.
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12
Q

A woman complains of a painful, demarcated, non-indurated ulcer in the anogenital region.

  1. Diagnosis and infectious agent?
  2. Tests?
  3. Treatment?
A
  1. Chancroid - Haemophilus ducreyi.
  2. Clinically rule out other sources of infection (no good test).
  3. IM Ceftriaxone once or PO Azithromycin once. Treat partners as well.
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13
Q

What are the three stages of presentation for lymphogranuloma venereum (LGV)?

A

Primary: local transient, painless papule/ulcer that often goes unnoticed.
Secondary: (Inguinal Syndrome) Painful enlargement of inguinal nodes +/- fever, headaches, malaise, anorexia.
Tertiary: (Anogential Syndrome) Anal pruritus that develops into fistulas, strictures, and elephantiasis.

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14
Q

Infectious agent that causes LGV?
Diagnostic tests?
Treatment?

A

Chlamydia trachomatis (L1, L2, L3 serotypes).
Clinical assessment and culture of C. trachomatis.
PO Doxycycline 2/day or erythromycin 4/day.

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15
Q

What should be included in the ddx regaurding non ulcerative lesions in the pubic region?
Infectious agent?

A

Folliculitis.

Staph Aureus.

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16
Q

A sexually active patient presents with multiple warty regions in the anogential region that are itchy and occasionally bleed.

  1. Diagnosis?
  2. Which serotypes cause condyloma acuminata?
  3. Which serotypes cause cervical cancer?
  4. Treatments?
  5. Recurrance rate regardless of treatment?
A
  1. HPV
  2. 6 and 11
  3. 16, 18 and 31
  4. Local excision, cryotherapy, laster, podophyllin, 5-FU cream
  5. 20%
17
Q

Water warts are the colliqual name of what infection?
Where do these warts not occur?
Treatments?

A

Molluscum Contagiosum.
Palms or soles.
Local excision or trichloroacetic acid.

18
Q

What is a healthy vagina predominately colonized with?

A

Lactobacillus

19
Q

What species is often found in Bacterial vaginosis?

Concerning complication?

A

Gardnerella vaginalis.

Preterm births in infected mother.

20
Q

A patient presents with profuse, non-irritative, vaginal discharge with a fishy amine odor.

  1. Diagnosis?
  2. Diagnostic tests (3)?
  3. Treatment?
A
  1. Bacterial Vaginosis
  2. A. Gram stain with examination of bacteria in discharge (gold standard)
    B. Thin white homogenous discharge coating the vaginal walls
    C. Clue cells present
  3. PO Metronidazole or clindamycin for 7 day course.
21
Q

A patient presents with vulvar and vaginal pruritis, urethritis, and vaginal discharge.

  1. Diagnosis and infectious agent?
  2. Diagnostic test?
  3. Treatment?
A
  1. Candidiasis - most commonly Candida albicans
  2. KOH prep of discharge
  3. Azole agents (topical/vaginal micronazole or terconazole). Recurrent cases use oral fluconazole.
22
Q

A patient presents with profuse, colored, odorous vaginal discharge. pH is 6.5.

  1. Diagnosis?
  2. Common cervical finding?
  3. Diagnostic test?
  4. Treatment?
A
  1. Trichomonas vaginalis
  2. Strawberry cervix
  3. Wet preps of vaginal swabs - see them swimming
  4. Metronidazole 2g orally single dose. Partners should be treatd (75% infected)
23
Q

Most common infectious agents that cause cervicitis (2)?

A

Neisseria gonorrhoeae and Chlamydia trachomatis.

24
Q

A neonate presents with fevers, red macular skin lesions, tenosynovitis, and septic arthritis. His mother is 22 y/o and has a history of STI. Diagnosis?

A

Disseminated infection from Neisseria gonorrhoeae.

25
Q

Diagnostic tests for N. gonorrhoeae infection?

A

Thayer Martin chocolate agar (Culture) or nucleic acid amplification tests.

26
Q

Treatment for N. gonorrhoeae infection?

Additional treatment if concurrent chlamydial infection has not been ruled out?

A

Ceftriaxone 125mg IM once or cefixime 400mg PO once.

1g azithromycin PO once.

27
Q

Which agent has seen a recent increase in infections - Chlamydia or Gonorrhoeae? Which agent is typically more symptomatic - Chlamydia or Gonorrhoeae

A

Chlamydia - due to better diagnostic testing (NAAT).

Gonorrhoeae - chlamydia often completely asymptomatic.

28
Q

Treatment for Chlamydia infection?

A

1g azithromycin PO once OR

100 mg Doxycycline PO 2x/day for 7 days.

Obstetrics and Gynecology (34 decks)

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