Reproductive infections

Question 1

PID- Eti

Answer 1

• Polymicrobial infection of upper tract
• Young, nulliparous, multiple sex partners
• Tb in developing countries

Question 2

PID- Sx

Answer 2

• Uterine, adenexal & cervical motion tenderness
• Abnormal discharge
• Systemic sx
• RUQ pain
• Absence of competing dx

Question 3

PID- Dx

Answer 3

Min dx criteria: Uterine, adenxal or CMT

- Increased temp, ban discharge, ESR, CRP adds to dx

Question 4

PID- Tx

Answer 4

• Tx sex partner

- Cefoxitin, probenicid & doxycycline + metronidazole

Question 5

Gonorrhea- Eti

Answer 5

• Neisseria gonorrrhoeae
• STD
• 15 - 29 YO

Question 6

Gonorrhea- Sx

Answer 6

• Asymptomatic
• Copious discharge
• Dysuria, frequency & urgency
• Progression to cervicitis, conjunctivitis

Question 7

Gonorrhea- Dx

Answer 7

-NAAT swab

Question 8

Gonorrhea- Tx

Answer 8

• Ceftriaxone +

- Azithromycin or doxycycline

Question 9

Syphillis- Eti

Answer 9

• Treponema pallidum, spirochete
• Sexual contact
• MSM
• Rate is increasing

Question 10

Syphillis- Sx

Answer 10

1- painless chancre on genitalia, lymph enlargement
2- Maculopapular rash, lesions, weeping papules, fever, lymphadenopathy
3- Tumors, gummas, CNS disorders

Question 11

Syphillis- Dx

Answer 11

VDRL and RPR

• Enzyme assay & CLIA, PCR
• Darkfield microscopy

Question 12

Syphillis- Tx

Answer 12

IM penicillin G

Question 13

Trichomonas vaginalis- Eti

Answer 13

• Protozoan infection
• Motile trichomonads
• incubation period of 5 days to 4 weeks

Question 14

Trichomonas vaginalis- Sx

Answer 14

• Copious vaginal discharge
• Frothy yellow or green
• Pruritus, dysuria, abd pain
• Inflammation of vaginal walls & cervix

Question 15

Trichomonas vaginalis- Dx

Answer 15

• Wet mount
• NAAT tests
• Contaminant with BV

Question 16

Trichomonas vaginalis- Tx

Answer 16

Metronidazole or tinidazole

Question 17

Genital herpes- Eto

Answer 17

• HSV-2
• Blacks, women, hx of STIs
• 25% adults have evidence of infection
• Recur due to stress, trauma or sun exposure

Question 18

Genital herpes- Sx

Answer 18

• Prodrome of burning & tingling
• Small, grouped vesicles on erythematous base
• Lesions crust & heal

Question 19

Genital herpes- Dx

Answer 19

• Viral culture, direct fluorescent Ab test

- PCR

Question 20

Genital herpes- Tx

Answer 20

Acyclovir

Question 21

Bacterial vaginosis- ETI

Answer 21

• Most freq. cause of vag. discharge

- Complications of pregnancy,

Question 22

Bacterial vaginosis- Sx

Answer 22

• Vaginal discharge with fishy odor

Question 23

Bacterial vaginosis- Dx

Answer 23

• Clinical

- Elevated pH & + sniff test

Question 24

Bacterial vaginosis- Tx

Answer 24

• Metronidazole & clindamycin

Question 25

Condylomata accumulata- Eti

Answer 25

• Gram negative rod, Haemophilus ducreyi

- 4-10 day incubation

Question 26

Condylomata accumulata- Sx

Answer 26

• Chancroid lesion into pustule
• Tender, heavy foul discharge from pustule
• Inguinal adenitis

Question 27

Condylomata accumulata- Dx

Answer 27

• Rule out other STIs

Question 28

Condylomata accumulata- Tx

Answer 28

• Hygiene

- Azithromycin, ceftriaxone or cipro

Question 29

Vulvovaginal candidiasis- Eti

Answer 29

• Candida infection
• Opportunistic pathogen
• Heat, moisture & occlusive clothing

Question 30

Vulvovaginal candidiasis- Sx

Answer 30

• White, curd like discharge

- Pruritis, vulvovagnial erythema

Question 31

Vulvovaginal candidiasis- Dx

Answer 31

KOH prep- hyphae & spores

Question 32

Vulvovaginal candidiasis- Tx

Answer 32

• Miconazole

- Fluconozaole