Infections/STDs part 2 Flashcards

1
Q

what HPV types are MC associated w anogenital warts

A

types 6 and 11

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2
Q

tubo-ovarian abscess (TOA)

A

an inflammatory mass involving the fallopian tubes, ovaries, or occasionally other pelvic organs

most occur as a complication to PID

typically polymicrobial with mixtures of aerobic and anaerobic organisms

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3
Q

sx TOA

A

acute lower abdominal pain, vaginal discharge, and systemic symptoms, such as fever and chills

similar to PID

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4
Q

when is TOA thought to have ruptured

A

it is leaking contents into the abdominal cavity. Most patients with a ruptured TOA present with an acute abdomen and sepsis, which requires immediate surgical exploration.

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5
Q

dx TOA

A

made clinically based on hx and an exam suggestive of PID and the presence of an inflammatory adnexal mass on pelvic imaging

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6
Q

MC imaging modality for TOA

A

TVUS

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7
Q

Tx TOA

A

admit for IV abx - Cefoxitin and doxy or cefotetan and doxy

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8
Q

what pts w TOA should be treated initially w abx ALONE

A

hemodynamically stable, no signs of an acute abdomen, abscess size < 7 cm in diameter, and premenopausal status

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9
Q

Postmenopausal women w TOA

A

higher risk for malignancy –> surgical intervention is recommended for dx and therapeutic purposes

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10
Q

sx vulvovaginal atrophy

A

vulvovaginal dryness, burning, and irritation; urinary symptoms, such as dysuria, urinary frequency, and recurrent urinary tract infections; and reduced lubrication during sexual intercourse causing dyspareunia

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11
Q

PE vulvovaginal atrophy

A

tissue fragility or fissures, vulvovaginal pallor, vulvovaginal erythema, loss of vaginal rugae, and decreased vulvovaginal secretions

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12
Q

initial tx vulvovaginal atrophy

A

vaginal moisturizers (two or three times per week) and lubricants (during intercourse)

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13
Q

C/I vaginal estrogen

A

prior or current estrogen-dependent tumors

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14
Q

How does the normal vaginal pH compare to the vaginal pH in postmenopausal women?

A

Postmenopausal pH is more basic. The normal pH in reproductive-aged women is 3.5–5.0, and the pH in postmenopausal women is often 5.5–6.8

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15
Q

how long should ppl abstain from sexual activities for gonorrhea

A

abstain from sexual activities until at least 7 days after the initiation of therapy and they no longer have symptoms

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16
Q

cardiovascular syphilis

A

develops 10 years after primary

causes aneurysm formation in the aorta

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17
Q

neurosyphilis

A

damage to brain and spinal cord at any stage of disease causing gait abnormalities, disruption in pain and temp sensations, memory and speech impairment, psychosis and progressive dementia

18
Q

nontreponemal testing for syphilis

A

venereal disease research laboratory (VDRL)
rapid plasma reagin (RPR)
Toluidine Red Unheated Serum Test (TRUST)

19
Q

treponema test for syphilis

A

fluorescent treponema antibody absorption (FTA-ABS)
Microhemagglutination test for antibodies to T pallidum (MHA-TP)
T pallidum particle agglutination assay (TPPA)
T pallidum enzyme immunoassay (TP-EIA)
chemiluminescence immunoassay (CIA)

20
Q

How often should ppl w syphilis be monitored

A

repeat RPR or VDRL at 6 and 12 month intervals to ensure treatment success

21
Q

What is the nickname for syphilis?

A

the great imposter

22
Q

strawberry cervix int rich is also called

A

colpitis macular (punctate macular hemorrhages on the cervix)

23
Q

dx trich

A

wet mount is MC used

24
Q

wet mount for trich

A

flagellated protozoa moving in corkscrew patterns, shaking, or rotating

25
if wet mount is negative but still suspicious of trich, what next
nucleic acid amplification testing
26
tx trich
oral metronidazole 500 mg by mouth twice a day for 7 days all sexual partners should receive tx as well
27
repeat testing for trich
repeat testing should be performed 2 weeks to 3 months after abx completion to ensure curative therapy sexual abstinence is strongly encouraged during this time
28
complications women trich
urethritis cystitis PID infertility
29
complications men trich
prostatitis epididymitis infertility prostate CA
30
sx Vulvovaginal candidiasis
most common symptom is vulvar pruritus and other common symptoms include vulvar burning, soreness, or irritation. Patients may have dysuria or dyspareunia
31
PE vulvovaginal candidiasis
erythema, excoriations, or fissures of the vulva and the vagina may have discharge - white, thick, and clumpy discharge sx may be worse the week prior to menses
32
dx vulvovaginal candidiasis
detecting Candida on a wet mount, Gram stain, or culture of vaginal discharge dx should not be made solely based on clinical findings
33
tx vulvovaginal candidiasis
asx - no tx sx - oral fluconazole administered as a single oral dose if vulvovaginal candidiasis and uncontrolled diabetes mellitus = complicated; tx = two doses of oral fluconazole administered as oral doses 3 days apart
34
Vulvovaginal candidiasis is caused by an overgrowth of
C. albicans (MC) C. glabrata
35
challenge of C. glabrata
resistance to azole therapy
36
what lesions are common w vulvovaginal candidiasis infxn
Satellite lesions (small, erythematous, well-demarcated patches with scalloped edges)
37
does discharge have an odor in vulvovaginal candidiasis
no
38
is pH abnormal in vulvovaginal candidiasis
no
39
The microscopic evaluation of a vaginal sample using either saline or potassium hydroxide for vulvovaginal candidiasis
hyphae and spores sometimes referred to as spaghetti and meatballs for the shape and distribution of the fungal components.
40
tx chlamydia
azithromycin 1 gram PO as a single dose, doxycycline 100 mg PO twice daily for 7 days plus ceftriaxone 500 mg IM as a single dose, or cefixime 400 mg PO as a single dose
41
tx chlamydia in pregnancy
amoxicillin 500 mg PO three times per day for 7 days with repeat testing 3–4 weeks after therapy
42