infections part 2 Flashcards

1
Q

What is the causative pathogen for a Chancroid?

A

Haemophilus ducreyi- Gram negative rod

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What PE finding will you see in about half of patients with chancroid?

A

There will also be marked lymphadenopathy in the inguinal chain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Dx of chancroid?

A

Gram stain, Culture and biopsy used in combination because of the high false negative rates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tx for chancroid in the genital area?

A

Ceftriaxone 250mg IM x 1dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If someone has a chancroid and a fluctuant lymphadenopathy what should you do?

A

Needle aspiration to prevent spontaneous rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is lymphogranuloma venereum (LGV)

A

This is an ulcerative disease of the genital area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What pathogen causes LGV?

A

Chlamydia trachomatis especially serotypes L1, L2, and L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some risk factor for contracting LGV?

A

MSM
HIV
HCV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How many stages are there with LGV? Describe them.

A

3 stages

Stage 1- development of painless genital ulcer or papules

Stage 2- Development of unilateral or bilateral tender inguinal and/or femoral lymphadenopathy

Stage 3- strictures, fibrosis, and fistulae of the anogenital area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you diagnose LGV?

A

Really made by clinical suspicion but should do serological testing to rule out syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the Tx for LGV?

A

Doxycycline 100mg orally twice a day given for 21 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some other options for tx LGV other than doxy?

A

An alternate regimen is erythromycin 500 mg orally four times a day given for 21 days

Azithromycin 1 gm orally once weekly for three weeks is also an effective alternative regimen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If a woman is pregnant and has LGV how should you tx her?

A

well dont give doxy, she can be given erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where does the infection that causes PID usually come from, like what gets infected first?

A

Infection usually ascend from the cervix or vagina to involve the endometrium and or the fallopian tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are two primary causative agents of PID?

A

Gonorrhea and Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If someone has tenderness with motion of the cervix this is called what sign?

A

Chandelier sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

If a women who is sexually active reports fever, pelvic pain and vaginal discharge what should you think and want to rule out?

A

PID

18
Q

What is the main/worst complication with PID

A

Infertility

19
Q

List some clinical findings with PID?

A

abdominal tenderness, cervical motion tenderness, and adnexal tenderness plus one or more of the following:

Temperature > 38°C
WBC count > 10,000/mm3
Pelvic abscess found by manual examination or ultrasonography

20
Q

What is the tx for PID?

A

outpatient: Ceftriaxone IM 250mg once along with doxycyline 100mg x 14days can add flagyl is she is prone to yeast infections with antibiotic use

21
Q

For inpatient treatment for PID what are your two options?

A

Doxycycline + IV cefotetan or cefoxitin × 48 h until the condition improves, then PO doxycycline 100 mg BID × 14 d

Clindamycin + gentamicin daily, if normal renal function, ×48 h until the condition improves, then PO doxycycline 100 mg BID × 14 days

22
Q

What is the Tx for syphilis?

A

Benzathine PCN G, 2.4 million units IM × one dose for primary and secondary disease

23
Q

How do you diagnose syphilis?

A

RPR/VDRL and confirmed by the treponemal antibody-absorption test (FTA-ABS).

24
Q

What can cause a false positive while testing for syphilis?

A

Lyme disease

25
Q

if someone is penicillin allergic but has syphilis and needs to be treated what can you use?

A

doxycycline

26
Q

Clumpy or cheesy vaginal discharge, pruritus burning, vaginal or vulvar edema and erythema makes you think of what?

A

Candida vaginitis

27
Q

How do you Dx candida vaginitis?

A

KOH showing budding hyphae, with PH <4.5 acidic

28
Q

Tx for candida?

A

oral fluconazole 150mg po x1 then repeat in 7 days

29
Q

if someone wants a topical cream to tx candida what can they use?

A
Topical clotrimazole (Gyne-Lotrimin)
Topical tioconazole (Monistat)
30
Q

This type of vagina grossness is caused by Gardnerella?

A

BV

31
Q

What would you expect to see on PE with someone w/BV?

A

Frothy, grayish-white fishy-smelling vaginal discharge

32
Q

When evaluating epithelial cells for someone you suspect to have BV what would you see?

A

Clue cells

33
Q

What is the amine Criteria to dx BV?

A

Thin, homogenous vaginal discharge. Vaginal pH greater than 4.5. Positive whiff test (fishy amine odor when 10 percent potassium hydroxide solution is added)

34
Q

What is the first line treatment for BV?

A

Metronidazole oral 500mg PO bid x 7days

35
Q

What is second line tx for BV?

A

Clindamycin
Tablets: 300 mg PO b.i.d. × 7 days
Vaginal suppositories 100 g intravaginally QHS × 3 days
Bioadhesive cream 2%: 5 g × 1 dose

36
Q

What should someone not do when being trated with the first line therapy for BV?

A

Not drink as single thing

37
Q

Greenish gray frothy vaginal discharge with mild itching is suspicious for what?

A

Trichomonas

38
Q

What would you see on microscopy for trich?

A

mobile and pear shaped protozoa with flagella

39
Q

Tx for Trich?

A

Metronidazole 2g PO x 1 dose

40
Q

Should the partner of someone with trich also be treated?

A

Yes yes they should

41
Q

woman in her 50s presents with Irritation, dryness, painful intercourse, increased UTIs, urinary incontinence, what do you suspect

A

atrophic vaginitis

42
Q

Tx for atrophic vaginitis?

A

Conjugated estrogens vaginal cream