Mehl. STDs trichomonas, candida, HSV Flashcards
Trichomonas. what disease?
Causes trichomoniasis.
Trichomonas. what seen on wet mount?
Flagellated protozoan
Trichomonas. discharge?
as yellow-green discharge.
Trichomonas. CP of cervix?
Can cause “strawberry cervix,” or punctate hemorrhages on the cervix.
If they don’t say this, they can sometimes say yellow-green discharge + a vaginal canal that is erythematous.
Trichomonas. Tx? for what people?
Treat with metronidazole for patient and partner (high rate of reinfection).
Candida. disease?
candidiasis.
Candida. discharge?
Buzzy thick, white, cottage cheese-like discharge in ~2/3 of questions.
Candida. The other ~1/3 of Qs will mention what about vaginal canal?
itchy/erythematous vaginal canal without any overt discharge (in contrast to trichomoniasis which can present with erythema of the vagina but has characteristic yellow-green discharge).
Candida. Tx with what? 2 options?
Treat with topical nystatin or oral fluconazole.
Candida. Step 1 NBME says oral Tx is given + wants MOA for drug inhibition -> answer =????
“P-450-mediated demethylation reaction,” where fluconazole inhibits 14a-demethylase in the conversion of lanosterol to ergosterol.
HSV 1/2. CP?
Causes painful vesicular lesions that recur at varying intervals (usually months).
HSV 1/2. Primary infection is most severe. Cp?
Often with fever, regional lymphadenopathy,
burning/stinging/itching pain (herpetic neuralgia), and many vesicles.
HSV 1/2. Recurrences are often less severe and preceded by?
herpetic neuralgia.
HSV 1/2. can also cause (neuro)???
encephalitis (confusion + blood in CSF due to temporal lobe hemorrhage) and herpetic whitlow (vesicle[s] on the finger).
HSV 1/2. Viral culture can be negative in stem (not 100% sensitive).
.
HSV 1/2. Tx?
100% sensitive).
- Treat
Haemophilus ducreyi. Causes what?
Causes chancroid, which is a painful ulcer.
It looks like a syphilitic chancre, but it’s not.
Haemophilus ducreyi. rod?
gram negative rod
Haemophilus ducreyi. Vs syphilic chancre?
The syphilitic chancre is painless; the H. ducreyi lesion is painful.
Haemophilus ducreyi.
Often a wrong/distractor answer for HSV Qs, where students get trigger-happy
and erroneously choose the weird answer (H. ducreyi).
.
Haemophilus ducreyi.
Chancroid will be the answer if they tell you there’s a single painful genital lesion
in someone who went abroad, classically backpacking in Africa or South America.
.
Haemophilus ducreyi.
If they tell you there’s a single, small painful lesion, but that it’s a recurrence,
this is …….????
HSV, not H. ducreyi.
The latter is bacterial and doesn’t cause recurrences
the way HSV does; HSV can rarely appear as a single vesicle.
Haemophilus ducreyi.
- There is a 2CK NBME Q where answer is actually H. ducreyi, but I once again
caution that this is usually a wrong answer, so be careful. But I have seen it
correct as a one-off.
.
Haemophilus ducreyi. Tx?
USMLE won’t assess treatment, but either azithromycin or ceftriaxone is considered first-line.
HSV prie TORCHes. Incr risk for what disease in neonates?
- Vaginal HSV1/2 infection in mother can lead to vertical transmission, increasing risk for
encephalitis in neonate.
HSV prie TORCHes.
- If a pregnant woman experiences prodromal symptoms (i.e., tingling, burning, etc.), even if no visible lesions are present, what recommended?
C-section is still recommended.
HSV prie TORCHes.
- If a pregnant woman has predictable intervals of vesicular episodes, what is given?
acyclovir is often
given within 4-6 weeks of parturition to decrease risk of peripartum episode.
