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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
BV tx
Metronidazole 500mg PO BID x7days metronidazole 0.75% gel transvaginally QD x5days -If pt preg, PO thx preferred over cream (less GU infection)
26
gonorrhea sxs
``` itching, dysuria, urinary frequency systemic triad: polyarthralgia, tenosynovitis, dermatitis. conjunctivitis. purulent discharge. swelling. ```
27
gonorrhea complications entering reproductive tract
``` salpingitis pelvic infection/disseminated dz infertility ectopic preg scarring ```
28
gonorrhea dx
NAATs | culture (Thayer Martin) & antimicrobial susceptibility testing
29
gonorrhea tx
neonates; erythromycin ointent bil eyes @ birth | most recent sex partner should be tx
30
gonorrhea meds
CEFTRIAXONE 250mg IM x1 + AZITHROMYCIN 1G PO x1
31
disseminated gonorrhea meds
-Ceftriaxone 1g IM or IV q24hrs
32
what is the most common vaginal infection?
BV
33
what is the most common ID in the US?
chlamydia trachomatis
34
chlamydia organism
obligate intracellular organism. contains both DNA & RNA cell wall like bacteria, divide w/ binary fission like virus
35
chlamydia dx
NAAT (swabs from most areas FDA approved except for oropharyngeal or rectal specimens)
36
perihepatitis (complication of chlamydia)
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
chlamydia tx
A + C | pregnant= amoxicillin 500mg PO TID x7days.
38
PID sxs
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
when is the risk of PID high with IUD users?
first 21 days of insertion.
40
if IUD is removed, when should it be put back in?
3 months after infection
41
what kind of IUD is protective against PID?
levonorgestrel-releasing PID
42
which pts with PID need hospitalization?
1. pregnant. 2. surgical emergency cannot be excluded. 3. does not respond/tolerate PO tx 4. severe illness. 5. tubo-ovarian abscess
43
PID outpt thx
ceftriaxone (or cefoxitime) + doxy +/- metronidazole
44
PID inpt thx
cefotetan 2g IV q12 hrs + Doxy 100mg IV or PO q12hrs
45
color of vulvar epithelium or lesions depends on
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
white lesions due to
maceration of thickened keratin layer from increased moisture in vulvar area
47
red lesions due to
1. thinning epidermis, revealing cappillary vasculature. | 2. vasodilation assc with inflammation & neovascularization.
48
red lesions are assc with
``` acute candidal vulvovaginitis paget dz seborrheic dermatitis SLE psoriasis (topical corticosteroids) ```
49
dark lesions due to
1. increased quantity or concentration of melanin or hemosiderin pigments 2. trauma
50
persistent dark lesion presentation
1. melanosis or lentigo: benign | 2. capillary hemangioma: bx needed if hemangiomas bleed repeatedly.
51
lichen sclerosus etiology
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
lichen sclerosus sxs
itching labia minora agglutination --> phimosis introital stenosis --> kraurosis development of islands of hyperplastic epithelia w/in the atrophic lichen sclerosus
53
lichen sclerosus histologic features
``` thin hyperkeratotic layer thinning of epithelial layer glattening of papillae homogenization of the stroma deep lymphocytic infiltration ```
54
lichen sclerosus tx
1. stop itch-scrath cycle 2. vulvar hygeine. 3. Clobetasole diproprionate 4. PO antihistamine qhs
55
lichen sclerosus: clobestasole diproprionate application method
2x QD x2wks then 1x QD x 2wks then 2x qw x2wks then prn for rest of life.
56
lichen simplex chronicus
previously designated hyperplastic dystrophy, SC hyperplasia, atopic dermatitis, atopic eczema and neurodermatitis ===> benign epithelial thickening and hyperkeratosis.
57
what does lichen sclerosus have that LSC does NOT have?
dermal inflammatory infiltrate.
58
LSC tx
1. vulvar hygiene. 2. sitz baths 3. medium potency corticosteroid twice daily 4. oral antihistamines takes 6 weeks to heal
59
Behcet's syndrome triad
recurrent oral apthae or ulcers recurrent genital apthae or ulcers uveitis
60
behcet tx
1. colchicine tablets. | 2. systemic corticosteroids = immediate relief
61
molluscuscum contagiosum tx
desiccation, freezing, curettage and chemical cauterization of the base topical imiquimod
62
localized provoked vulvodynia
1. young F, 20-30yo 2. introital pain on vaginal entry 3. vestibular tenderness (cotton tip produces pain)
63
unprovoked vulvodynia
1. older pt 2. usually has tn 3. larger surface area than localized. 4. periods of relief and flares.
64
what will a wet prep of atrophic vaginitis show?
small, rounded parabasal epithelial cells | increased # of PMN
65
atrophic vaginitis tx
1. estrogen cream 2. estradiol hemihydrate (Vagifem) 1 tab intravaginally QD x2wks then 2X/wk x3-6 months 3. systemic estrogen thx
66
what is a C/I of atrophic vaginitis estrogen tx?
hx breast or endometrial cancer
67
atrophic vaginitis PE
thin vaginal mucosa pH 5-7 few vaginal folds
68
how to dx herpes simplex?
PCR (not recoverable w/in 7 days of infection)
69
when is HSV transmission from mom to baby highest?
if mom gets it near time of delivery
70
when is HSV transmission from mom to baby lowest?
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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