Infectious Disease/STDS

Question 1

Lyme

Answer 1

Sx: Fever, myalgia, HA 1w-1m after tick bite. Erythema migrans, Bells Palsy
PE: Gait, cranial N
Labs: Antibody titer
Ddx: Hepatitis, MS, Rheumatic fever, Herpes zoster
Tx: Doxycycline

Question 2

N. Gonorrhea

Answer 2

Sx: Green purulent dc, Pelvic pain, Dysuria, Fever
PE: Kidney punch, inguinal lymph nodes, Infx Barhtolin & Skene glands
Labs: Culture, DNA probe
Ddx: UTI, Chlamydia, Vaginosis
PARQ: PID, Bartholin gland abscess, Disseminated GC
Tx: Doxycycline 100mg bid x7d, Sitz bath, Casto oil packs

Question 3

Chlamydia Trachomatis

Answer 3

Sx: Most asx. Dysuria. Frequency, Clear dc, Dyspareunia
PE: Skenes glands, milk urethra, kidney punch
Labs: Culture
Ddx: Urethritis, Epididymitis, Gonorrhea, UTi
Tx: Doxycycline

Question 4

Trichomonas vaginalis

Answer 4

Sx: Vulvar itching, Dysuria, Yellow frothy dc, Postcoital bleeding
PE: Strawberry cervix
Labs: Wet prep, culture
Ddx:GC, Vaginitis, UTI
Tx: Metronidazole, Vaginal acidification

Question 5

HSV I and HSV II

Answer 5

Sx: Lesions/vesicles
Labs: Viral culture, Tzanck Smear
Ddx: Herpes, Warts
Tx: Acyclovir, stress mngmt, Zinc
PARQ-Teratogen

Question 6

HPV & Condyloma Accuminata

Answer 6

Sx: Mass, pruritus, dx, blood c sex, soft raised mass
Labs: STI testing, pap, Biopsy
Imx: Colonoscopy
Ddx: Nevi, SCC, Molloscum contagiousum
Tx: Cryotherapy

Question 7

HIV

Answer 7

Sx: Asx or flu like
Labs: CBC, CMP, UA, STI, ELISA (confirmatory)
Imx: CXR to ro TB, CA
Ddx: EBV, TB, Syphillis, DCG, Viral Hepatitis
Tx: HAART combination

Question 8

Hep A, B, C

Answer 8

Sx: GI issues, flu like
PE: fever, jaundice, splenomegaly
Labs: Liver, UA (hyperbilirubinemia), CBC, Liver biopsy
DDX: Gastroenteritis, EBV, CMV, AI hep
Tx: A (self limiting) B (Interferon alpha) C (Saquinavir), Milk thistle
PARQ: Cirrhosis

Question 9

Scabes

Answer 9

Sx: Wavy lines covered by lichenified skin, pruritic, erythematous papule, burrows***
PE: Skin and hair
Lab: Woods lamp, KOH
Ddx: Bites, fungus, eczema
Tx: Wash everything. Benadryl, tea tree oil, Zinc

Question 10

Lice

Answer 10

Sx: Pruritis, post cervical LAD, Nits on body hair, Red punch, Brown specks
PE, Labs, Ddx: Same as Scabes
Tx: Ovide, Essential Oils (tea tree, neem, rosemary, lavender, peppermint, eucalyptus)