Infectious Diseases

Question 1

True or false.

Herpes simplex virus is a double-stranded RNA.

Answer 1

False.
HSV is a double-stranded DNA

SOGC 207

Question 2

Recurrent genital herpes is most commonly due to which type of herpes virus?

Answer 2

Herpes simplex virus type 2
(Only 10% due to HSV1)

SOGC 207

Question 3

Name 7 risk factor for the development of genital herpes.

Answer 3

1) Higher number of sexual partners
2) History of STI (including HIV)
3) Hx of genital ulceration in partner or self
4) Female
5) Increasing age
6) Non-caucasian race
7) Lower SES

SOGC 207

Question 4

What are two types of tests possible for the diagnosis of HSV?

Answer 4

1. Viral identification
   - viral culture
   - NAAT
2. Serologic tests

SOGC 207

Question 5

Name 2 treatment options for initial episode of HSV and 2 treatment options fo recurrent HSV.

Answer 5

Initial episode
	Acyclovir 200mg PO 5 times daily x 10 days
	Acyclovir 400mg PO TID x 10 days
	Famcyclovir 250mg PO TID x 5 days
	Valacyclovir 1000mg PO BIDx 10 days

Episodic treatment
Acyclovir 200mg PO 5 times daily x 5 days
Famcyclovir 125mg PO BID x 5 days
Valacyclovir 1000mg PO daily x 3 days

SOGC 207

Question 6

What are 5 situations in which suppressive treatment for HSV is suggested?

Answer 6

1) Significant problems with health-related quality of life
2) Social and sexual dysfunction
3) Need to lower risk of transmission to partner or fetus
4) Significant complications with less than 6 episodes per year
5) More than 6 episodes per year

SOGC 207

Question 7

What is the most common bacterial species found in bartholin gland abscesses?

Answer 7

E. Coli

William’s Gyn p.97

Question 8

What percentage of women will have a urinary tract infection in their lifetime?

Answer 8

50 to 60%

SOGC 250

Question 9

What is the definition of recurrent UTIs?

Answer 9

More than 2 uncomplicated UTIs in 6 months
OR
3 positive cultures within the last year

SOGC 250

Question 10

Name some of the most common organisms that cause UTIs. (4)

Answer 10

80% of UTI caused by e.coli
Staphylococcus saprophyticus 4%
Klebsiella pneumoniae 4%
Proteus mirabilus 4%

SOGC 250

Question 11

Name some risk factors for the development of UTIs.

Answer 11

Risk factors for UTI
1) Pre-menopausal women
• Behavioral risks (intercourse frequency, use of spermicide and new sexual partners)
• Non-behavioral risks (age <15 years old, maternal history of UTI)
2) Post-menopausal women
• Estrogen loss at menopause results in thinning of vaginal epithelium and decreased amounts of glycogen
○ Environment hostile to lactobacilli and numbers decrease
○ Vaginal pH increases and increased propensity for colonization with uropathogens
• Women with incontinence or have pelvic floor prolapse and elevated post-void residual volumes are at increased risk for recurrent UTI
3) Diabetes mellitus
4) Previous hx of UTI

SOGC 250

Question 12

If a urine culture is positive for which (4) organisms should further workup for renal calculi or structural anomalies be pursued?

Answer 12

Proteus
Pseudomonas
Klebsiella
Enterobacter

SOGC 250

Question 13

Name 4 risk factors for developing resistance to Septra.

Answer 13

○ Diabetes
○ Recent hospitalization
○ Antibiotic use in the past 3-6 months
○ Recent Septra use

SOGC 250

Question 14

When a UTI is diagnosed and treated in pregnancy, how should we manage the remaining of the pregnancy?

Answer 14

Test for cure of UTI 1 week after completion of therapy, then monthly cultures until completion of pregnancy

SOGC 250