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Women's Health > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

granuloma inguinale causative organism

A

klebsiella granulomatis

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2
Q

lymphogranuloma venereum causative organism

A

aggressive serotypes of Chlamydia trichomatis

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3
Q

HPV 6 and 11

A

condyloma acuminata

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4
Q

condyloma acuminate sxs

A

cauliflower like masses; fingerlike projections contain capillaries
laryngeal papillomas on vocal cords in infants

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5
Q

condyloma accuminata dx

A

colposcopy & cytologic smear to check condylomas present inside (if only vulvar are tx’d then there might be recurrence)
BX to r/o malignancy

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6
Q

HPV tx

A

CO2 laser ablation + LD brushing under colposcopic guidance
Chemo agents: fluorouracil ointment/bleomycin
good hygiene, abstain from sex, condoms

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7
Q

chancroid sxs

A

soft, mild induration, strong erythema
VERY painful
+ve gram stain: Hemophilus ducreyi

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8
Q

HPV tx applied by HCP

A

bichloracetic acid or trichloracetic acid
podophyllin
cryo, electrosurgery, simple surgical excision, laser vaporization

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9
Q

HPV tx applied by pt

A

podofilox solution or gel

imiquimod cream

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10
Q

syphillis causative organism

A

treponema pallidum

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11
Q

when is syphillis transmissible

A

in primary and secondary stages

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12
Q

syphillis course

A
  1. enters thru abraded skin.
  2. 10-90 days later –> primary lesion, chancre forms
  3. 2-6months later (avg 6 wks) –> secondary syph (cutaneous eruption)
  4. can either enter:
    (a) latent phase – lasts lifetime
    (b) tertiary phase (4-20 or more yrs after disappearance of primary lesion) – systemic sxs
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13
Q

primary syphillis

A 
PAINLESS chancre (labia, vulva, vagina, cervix, anus, lips or nipples) 
\+regional LNpathy
dark field microscopy = T pallidum (70% cases)
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14
Q

secondary syphillis

A

bilaterally symmetric extragenital papulosquamous eruption
condyloma latum, mucous patches
+LNpathy
+serology & +dark field microscopy of moist lesions

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15
Q

tertiary syphillis

A

cardiac, neuro, ophto and auditory lesions

GUMMAS!

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16
Q

latent syphillis

A

+serology (titer may be low)

no lesions.

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17
Q

nontreponemal tests

A

rapid, used for screening, non-specific, false positives

VDRL, RPR, TRUST

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18
Q

treponemal tests

A

detects antibodies. sensitive & specific, remain positive despite thx
FTA-ABS, MHA-TP

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19
Q

Early syphillis and contacts tx

A

PCN G 2.4mil U IM x1

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20
Q

Late syphillis tx

A

PCN G 2.4 mil U IM qw x3

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21
Q

neurosyphilis tx

A

aqueous crystallin PCN G 18-24 mil U TOTAL

3-4mil U IV q 4hrs x10-14 days (or continous infusion)

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22
Q

syphillis tx pcn allergy

A

doxy 100mg BID x14 days

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23
Q

trichomoniasis is a RF for

A

development of post hysterectomy cellulitis
tubal infertility
cervical neoplasia

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24
Q

bacterial vaginosis characteristics

A

fishy odor
clue cells
lack of lactobacilli = ^pH, polymicrobial
assc w/ adverse preg outcomes

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25
Q

BV tx

A

Metronidazole 500mg PO BID x7days
metronidazole 0.75% gel transvaginally QD x5days
-If pt preg, PO thx preferred over cream (less GU infection)

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26
Q

gonorrhea sxs

A 
itching, dysuria, urinary frequency
systemic triad: polyarthralgia, tenosynovitis, dermatitis. 
conjunctivitis. 
purulent discharge. 
swelling.
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27
Q

gonorrhea complications entering reproductive tract

A 
salpingitis 
pelvic infection/disseminated dz 
infertility 
ectopic preg
scarring
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28
Q

gonorrhea dx

A

NAATs

culture (Thayer Martin) & antimicrobial susceptibility testing

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29
Q

gonorrhea tx

A

neonates; erythromycin ointent bil eyes @ birth

most recent sex partner should be tx

30
Q

gonorrhea meds

A

CEFTRIAXONE 250mg IM x1 + AZITHROMYCIN 1G PO x1

31
Q

disseminated gonorrhea meds

A

-Ceftriaxone 1g IM or IV q24hrs

32
Q

what is the most common vaginal infection?

A

BV

33
Q

what is the most common ID in the US?

A

chlamydia trachomatis

34
Q

chlamydia organism

A

obligate intracellular organism.
contains both DNA & RNA
cell wall like bacteria, divide w/ binary fission like virus

35
Q

chlamydia dx

A

NAAT (swabs from most areas FDA approved except for oropharyngeal or rectal specimens)

36
Q

perihepatitis (complication of chlamydia)

A
  1. liver capsule inflammation, adhesions.
  2. RUQ pain or pleuritic pain in lower GU infection context.
  3. LFT not elevated.
  4. tx= supportive, NSAIDs
37
Q

chlamydia tx

A

A + C

pregnant= amoxicillin 500mg PO TID x7days.

38
Q

PID sxs

A
  1. purulent vaginal discharge
  2. n/v, HA, malaise
  3. inflammation of skene or bartholin’s glands
  4. purulent cervical discharge
  5. extreme tenderness on movement of cervix and uterus and palpation of the parametria.
39
Q

when is the risk of PID high with IUD users?

A

first 21 days of insertion.

40
Q

if IUD is removed, when should it be put back in?

A

3 months after infection

41
Q

what kind of IUD is protective against PID?

A

levonorgestrel-releasing PID

42
Q

which pts with PID need hospitalization?

A
  1. pregnant.
  2. surgical emergency cannot be excluded.
  3. does not respond/tolerate PO tx
  4. severe illness.
  5. tubo-ovarian abscess
43
Q

PID outpt thx

A

ceftriaxone (or cefoxitime) + doxy +/- metronidazole

44
Q

PID inpt thx

A

cefotetan 2g IV q12 hrs + Doxy 100mg IV or PO q12hrs

45
Q

color of vulvar epithelium or lesions depends on

A
  1. width of keratin layer
  2. vascularity of the dermis.
  3. thickness of the overlying epidermis.
  4. amt of intervening pigment wither melanin or blood pigment.
46
Q

white lesions due to

A

maceration of thickened keratin layer from increased moisture in vulvar area

47
Q

red lesions due to

A
  1. thinning epidermis, revealing cappillary vasculature.

2. vasodilation assc with inflammation & neovascularization.

48
Q

red lesions are assc with

A 
acute candidal vulvovaginitis 
paget dz 
seborrheic dermatitis 
SLE 
psoriasis (topical corticosteroids)
49
Q

dark lesions due to

A
  1. increased quantity or concentration of melanin or hemosiderin pigments
  2. trauma
50
Q

persistent dark lesion presentation

A
  1. melanosis or lentigo: benign

2. capillary hemangioma: bx needed if hemangiomas bleed repeatedly.

51
Q

lichen sclerosus etiology

A
  1. vit A deficiency
  2. AI process
  3. enzyme elastase excess
  4. decreased activity of 5-a reductase enzyme – prevents conversion of testosterone to DHEA
52
Q

lichen sclerosus sxs

A

itching
labia minora agglutination –> phimosis
introital stenosis –> kraurosis
development of islands of hyperplastic epithelia w/in the atrophic lichen sclerosus

53
Q

lichen sclerosus histologic features

A 
thin hyperkeratotic layer 
thinning of epithelial layer
glattening of papillae 
homogenization of the stroma 
deep lymphocytic infiltration
54
Q

lichen sclerosus tx

A
  1. stop itch-scrath cycle
  2. vulvar hygeine.
  3. Clobetasole diproprionate
  4. PO antihistamine qhs
55
Q

lichen sclerosus: clobestasole diproprionate application method

A

2x QD x2wks
then 1x QD x 2wks
then 2x qw x2wks
then prn for rest of life.

56
Q

lichen simplex chronicus

A

previously designated hyperplastic dystrophy, SC hyperplasia, atopic dermatitis, atopic eczema and neurodermatitis ===> benign epithelial thickening and hyperkeratosis.

57
Q

what does lichen sclerosus have that LSC does NOT have?

A

dermal inflammatory infiltrate.

58
Q

LSC tx

A
  1. vulvar hygiene.
  2. sitz baths
  3. medium potency corticosteroid twice daily
  4. oral antihistamines
    takes 6 weeks to heal
59
Q

Behcet’s syndrome triad

A

recurrent oral apthae or ulcers
recurrent genital apthae or ulcers
uveitis

60
Q

behcet tx

A
  1. colchicine tablets.

2. systemic corticosteroids = immediate relief

61
Q

molluscuscum contagiosum tx

A

desiccation, freezing, curettage and chemical cauterization of the base
topical imiquimod

62
Q

localized provoked vulvodynia

A
  1. young F, 20-30yo
  2. introital pain on vaginal entry
  3. vestibular tenderness (cotton tip produces pain)
63
Q

unprovoked vulvodynia

A
  1. older pt
  2. usually has tn
  3. larger surface area than localized.
  4. periods of relief and flares.
64
Q

what will a wet prep of atrophic vaginitis show?

A

small, rounded parabasal epithelial cells

increased # of PMN

65
Q

atrophic vaginitis tx

A
  1. estrogen cream
  2. estradiol hemihydrate (Vagifem) 1 tab intravaginally QD x2wks then 2X/wk x3-6 months
  3. systemic estrogen thx
66
Q

what is a C/I of atrophic vaginitis estrogen tx?

A

hx breast or endometrial cancer

67
Q

atrophic vaginitis PE

A

thin vaginal mucosa
pH 5-7
few vaginal folds

68
Q

how to dx herpes simplex?

A

PCR (not recoverable w/in 7 days of infection)

69
Q

when is HSV transmission from mom to baby highest?

A

if mom gets it near time of delivery

70
Q

when is HSV transmission from mom to baby lowest?

A

recurrent herpes at term or those who acquire HSV during first half of preg

hsv suppression thx @36wks

Women's Health (1 decks)

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