Renal. STD (07-26) (1)

Question 1

Chlamydia the most common STD

Answer 1

.

Question 2

Chlamydia. what infects Ch. trachomatis? 4

Answer 2

genital tract
urethra
anus
eye

Question 3

Chlamydia. risk factors?

Answer 3

unprotected sex
new partner
multiple partners

Question 4

Chlamydia. coexists OR mimic what infection?

Answer 4

N. gonorrhea

Question 5

Chlamydia. what serovars of this m/o cause proctocolitis?

Answer 5

lymphogranuloma venereum (LGV) serovars of C trachomatis cause LGV, an emerging cause of proctocolitis.

Question 6

Chlamydia. often symptom in males?

Answer 6

often asymtomatic

Question 7

Chlamydia. symptoms in females? 3

Answer 7

urethritis, mucopurulent cervicitis, PID

Question 8

Chlamydia. examination findings of women?

Answer 8

cervical/adnexal tenderness

Question 9

Chlamydia. examination findings in men?

Answer 9

penile discharge and testicular tenderness

Question 10

Chlamydia. differential?

Answer 10

gonorrhoe, endometriosis, PID, orchitis, vaginitis, UTI

Question 11

Chlamydia. how presents in primary form LGV?

Answer 11

painless, transient papule or shallow ulcer

Question 12

Chlamydia. how presents in secondary form LGV?

Answer 12

painfull swelling of the inguinal nodes

Question 13

Chlamydia. how presents in tertiary form LGV?

Answer 13

can present as ,,anogenital syndrome” = anal pruritus with discharge, rectal strictures, rectovaginal fistula, elephantiasis

Question 14

Chlamydia. gold standard diagnostics?

Answer 14

CULTURE

but diagnosis usually clinical

Question 15

Chlamydia. what urine test for rapid detection?

Answer 15

nucleic acid amplification test

Question 16

Chlamydia. what urine test for take 48-72h?

Answer 16

immunofluorescence (same for gonorrhea)

Question 17

Chlamydia. what shows gram staining?

Answer 17

urethral and genital discharges
Shows PMN leukocytes but no bacteria - Chalmydia is INTRACELLUAR

Question 18

Chlamydia. treatment? nonpregnant

Answer 18

Doxycycline 7d
or
Azithromycin once

Question 19

Chlamydia. treatment? pregnant

Answer 19

Azithromycin or amoxicillin

Question 20

Chlamydia. also treat sexual partners.!!

Answer 20

.

Question 21

Chlamydia. about what aspect when prescribe treatment need to think?

Answer 21

treat for concurrent N. gonorrhea, because it often coexists with chalmydia

Question 22

Chlamydia. in case of LGV serovars - how long treat?

Answer 22

require prolonged treatment, for 21 day.

Question 23

Chlamydia.key fact. what parts of the body infect?

Answer 23

arthritis, neonatal conjuctivitis, pneumonia, nongonococcal urethritis, PID, LGV.

Question 24

Chlamydia. complications?

Answer 24

chronic infection and pelvic pain
Reiter syndrome
Fitzh-Hugh-Curtis syndrome

Question 25

Chlamydia. what is Reiter syndrome?

Answer 25

Complication

urethritis + conjuctivitis + arthritis

Question 26

Chlamydia. what is Fitzh-Hugh-Curtis syndrome?

Answer 26

complication

perihepatic inflammation and fibrosis

buvo foto FHC in PID - adhesions from peritoneum to surface of liver

Question 27

Chlamydia. prominent complications in women?

Answer 27

ectopic pregnancy/infertility can result from PID

Question 28

Chlamydia. prominent complication in men?

Answer 28

epididymitis

Question 29

Gonorrhea. what mo?

Answer 29

gram negative intracellular diplococcus.

Question 30

Gonorrhea. what part infect in women and what in men?

Answer 30

in women - can infect almost any part

in men - tends to be limited to the urethra

Question 31

Gonorrhea. presentation? women

Answer 31

greenish-yellow discharge, pelvic or adnexal pain, swollen Bartholin glands.

Question 32

Gonorrhea. presentation? men

Answer 32

purulent urethral discharge, dysuria, erythema of urethral meatus

Question 33

Gonorrhea. differential?

Answer 33

chalmydia, endometriosis, pharyngitis
PID, vaginitis, UTI, salpingitis, tubo-ovarian abscess

Question 34

Gonorrhea. gold standard diagnosis?

Answer 34

gram stain and culture for any site (pharynx, cervix, urethra, anus)

Question 35

Gonorrhea. what urine test for diagnosis?

Answer 35

nucleic acid amplification (rapid answer)

penile/vaginal tissue or from urine

Question 36

Gonorrhea. presentation of disseminated disease?

Answer 36

monoarticular septic arthritis, rash, tenosynovitis

Question 37

Gonorrhea. treatment?

Answer 37

Ceftriaxone i/m and azitromycin p/o (regardless of whether chalmydia present)

Question 38

Gonorrhea. effective prophylaxis?

Answer 38

condoms

Question 39

Gonorrhea. also treat sexual partner

Answer 39

.

Question 40

Gonorrhea. why dont use fluoroquinolones?

Answer 40

due to emerging resistance

Question 41

Gonorrhea. disseminated disease treatment?

Answer 41

IV cextriaxone for at least 24 h.

Question 42

Gonorrhea. complications.

Answer 42

Persistent infection with pain

infertility
tubo-ovariant abscess with rupture
disseminated disease (migratory polyarthralgia, tenosynovitis, pustular skin lesions)