Renal. STD (07-26) (1) Flashcards
Chlamydia the most common STD
.
Chlamydia. what infects Ch. trachomatis? 4
genital tract
urethra
anus
eye
Chlamydia. risk factors?
unprotected sex
new partner
multiple partners
Chlamydia. coexists OR mimic what infection?
N. gonorrhea
Chlamydia. what serovars of this m/o cause proctocolitis?
lymphogranuloma venereum (LGV) serovars of C trachomatis cause LGV, an emerging cause of proctocolitis.
Chlamydia. often symptom in males?
often asymtomatic
Chlamydia. symptoms in females? 3
urethritis, mucopurulent cervicitis, PID
Chlamydia. examination findings of women?
cervical/adnexal tenderness
Chlamydia. examination findings in men?
penile discharge and testicular tenderness
Chlamydia. differential?
gonorrhoe, endometriosis, PID, orchitis, vaginitis, UTI
Chlamydia. how presents in primary form LGV?
painless, transient papule or shallow ulcer
Chlamydia. how presents in secondary form LGV?
painfull swelling of the inguinal nodes
Chlamydia. how presents in tertiary form LGV?
can present as ,,anogenital syndrome” = anal pruritus with discharge, rectal strictures, rectovaginal fistula, elephantiasis
Chlamydia. gold standard diagnostics?
CULTURE
but diagnosis usually clinical
Chlamydia. what urine test for rapid detection?
nucleic acid amplification test
Chlamydia. what urine test for take 48-72h?
immunofluorescence (same for gonorrhea)
Chlamydia. what shows gram staining?
urethral and genital discharges
Shows PMN leukocytes but no bacteria - Chalmydia is INTRACELLUAR
Chlamydia. treatment? nonpregnant
Doxycycline 7d
or
Azithromycin once
Chlamydia. treatment? pregnant
Azithromycin or amoxicillin
Chlamydia. also treat sexual partners.!!
.
Chlamydia. about what aspect when prescribe treatment need to think?
treat for concurrent N. gonorrhea, because it often coexists with chalmydia
Chlamydia. in case of LGV serovars - how long treat?
require prolonged treatment, for 21 day.
Chlamydia.key fact. what parts of the body infect?
arthritis, neonatal conjuctivitis, pneumonia, nongonococcal urethritis, PID, LGV.
Chlamydia. complications?
chronic infection and pelvic pain
Reiter syndrome
Fitzh-Hugh-Curtis syndrome
Chlamydia. what is Reiter syndrome?
Complication
urethritis + conjuctivitis + arthritis
Chlamydia. what is Fitzh-Hugh-Curtis syndrome?
complication
perihepatic inflammation and fibrosis
buvo foto FHC in PID - adhesions from peritoneum to surface of liver
Chlamydia. prominent complications in women?
ectopic pregnancy/infertility can result from PID
Chlamydia. prominent complication in men?
epididymitis
Gonorrhea. what mo?
gram negative intracellular diplococcus.
Gonorrhea. what part infect in women and what in men?
in women - can infect almost any part
in men - tends to be limited to the urethra
Gonorrhea. presentation? women
greenish-yellow discharge, pelvic or adnexal pain, swollen Bartholin glands.
Gonorrhea. presentation? men
purulent urethral discharge, dysuria, erythema of urethral meatus
Gonorrhea. differential?
chalmydia, endometriosis, pharyngitis
PID, vaginitis, UTI, salpingitis, tubo-ovarian abscess
Gonorrhea. gold standard diagnosis?
gram stain and culture for any site (pharynx, cervix, urethra, anus)
Gonorrhea. what urine test for diagnosis?
nucleic acid amplification (rapid answer)
penile/vaginal tissue or from urine
Gonorrhea. presentation of disseminated disease?
monoarticular septic arthritis, rash, tenosynovitis
Gonorrhea. treatment?
Ceftriaxone i/m and azitromycin p/o (regardless of whether chalmydia present)
Gonorrhea. effective prophylaxis?
condoms
Gonorrhea. also treat sexual partner
.
Gonorrhea. why dont use fluoroquinolones?
due to emerging resistance
Gonorrhea. disseminated disease treatment?
IV cextriaxone for at least 24 h.
Gonorrhea. complications.
Persistent infection with pain
infertility
tubo-ovariant abscess with rupture
disseminated disease (migratory polyarthralgia, tenosynovitis, pustular skin lesions)
