Sexually transmitted differential diagnosis Flashcards
Chancre DDX
Chlamydia - painful (soft) “weepy”
Chancroid - painful (soft) “bloody”
Syphilis - painless (hard)
Chlamydia DDX
chlamydia
lymphogranuloma venereum (scar tissue in lymphatics)
PID
Reiters disease/ Reactive arthritis (HLAB27) (feet)
Causes of PID
e.coli
chlamydia
gonorrhea
staph infection
Asymptomatic female DDX
chlamydia
gonorrhea (knee)
human papilloma virus HPV
Asymptomatic male DDX
trichomonas
candida albicans
Most common STD in US
Chlamydia
- yellow, odorless discharge
- painful soft lesions
- reiter’s (reactive arthritis) (feet)
Chlamydia
- Gram negative
- copious clear discharge
- tonsillitis, pharyngitis => arthritis (knee)
Gonorrhea
- Neisseria Gonorrhea
- painful vesicles
- latency
- red lesions with yellow oozing center
- watery discharge
- type I and II recturrent
- prodrome of itching
Herpes
- Protozoa
- greenish yellow, itchy, foul discharge
Trichomonas
- trichomonas vaginalis
- Haemophilus Ducrey (soft chancre)
- lesions rapidly ulcerate and bleed
- large painful ulcers, pus => buboes
Chancroid
- “How he do cry, he has a bloody chancre on his wanker bloody buboes”
- thrush, yeast, fungus, moniliasis
- gram positive*
- white cheese material covers vaginal walls
Candidiasis
- candida albicans
- Primary: 4-8 weeks
- (one) painless lesion, hard, firm
Syphilis one
Treponema Pallidum (spirochete)
Syphilis
– spirochete = congenital = crosses placenta
- appears 12 weeks later
- rash persists for months (80%)
- lymphadenopathy (50%)
- condylomata lata (warts)
- alopecia (hair loss)
Syphilis 2 (skin)
- Gumma (skin, visceral granulomatous lesion)
- General paresis (damentia)
- Argyll Robertson pupil
- Tabes Dorsalis - posterior column tracts
- positive romberg’s test
- charcot’s joints
- specific test - FTA
Symphilis 3 (inside)
Adults get what stages of syphilis?
1,2,3
- Hutchinson’s triad = _____, ____, and ____
- associated with?
saddle nose, interstitial keratoses (hardening of eyes), peg teeth
– Congenital syphilis
What do syphilis and herpes have in common?
- periods of latency
- DRG
- caused by chlamydia
- enlarged regional inguinal lymph nodes that may lead to elephantiasis and rectal strictures and abscesses
Lymphogranuloma venerum
- Donovania Granulomatous
- painless, velvety, slow going
- Bright beefy red granulomatous lesions
- Donavon bodies
Granuloma inguinale
- Human papilloma virus (16&18)
- Condylomata acuminata
- cervical dysplasia leads to cervical cancer
- usually small, itchy, cluster
- speculum = SCREEN
- PAP = confirm (specific test)
Genital Warts
- multiple skin tags that exfoliate, waxy papules
Molluscum Contagiosum
- Autoimmune
- most common Bulla lesion
- lethal
- South americans
- IgG
Pemphigoid
- genital and extensor lesions
- bulla
- papules
- IgA
- gluten sensitivity
- hereditary (black, asians)
Dermatitis Herpetiformis (aka ichthyosis bullous siemens)
