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IInfectious Disease > Sexually Transmitted Disease > Flashcards

Sexually Transmitted Disease Flashcards

1
Q

3 most common STDs

A
  • HSV - 2
  • Trichomonas
  • HPV
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2
Q

Populations at risk of STDs

A
  • Under 24
  • Minorities
  • Multiple partners
  • People native to endemic areas
  • Homeless/incarcerated/migrants/mental illness/substance use
  • Most common: Trichomonas, HPV & HSV-2
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3
Q

4 reportables STDs

A
  • HIV
  • Syphilis
  • Gonorrhea
  • Chlamydia
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4
Q

DDx for genital or perinal ulcers

A

Genital herpers

Syphilus

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5
Q

DDc for urethritis or cervicitis

Men
Women
Men & women
+ Sysyemic infections

A 
•	Gonorrhea
•	Chlamydia (CT)
•	Nongonococcal urethritis 
o	M urethritis without gram – diplococci
o	Remaining symptomatic after treatment 
•	Specific to women
o	Vaginitis
	Candidiasis
	Bacteria
	Trichomoniasis
o	Pelvic Inflammatory Disease
	Gonorrhea
	Chlamydia
o	Cervicitis
•	Men
o	Epididymitis & prostatitis
•	Men & Women
o	Proctitis
•	Systemic infections without genial symptoms
o	HepB
o	HIV
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6
Q

Chlamydia

2 serotypes

A
  • D-K: common

* L1-L3: Lymphogranuloma venereum (rare

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7
Q

2 forms of chlamydiae

A

• 2 Forms
o Elementary body (extracellular)
o Reticulate (intracellular & replicative)

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8
Q

Chlamydiae is

A

Obligate

Intracellular

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9
Q

Chlamydiae pathophysiology

A
  • Columnar epithelial cells
  • Receptor endocytosis
  • Inflammation (mild or fulminant)
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10
Q

Natural history of chlamydiae in adults

A
  • Infertility
  • Asymptomatic
  • Urethritis
  • Cervicitis
  • Epididymitis
  • Proctitis
  • PID
  • Reactive arthritis
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11
Q

Natural history of chlamydiae in neonates

A
  • Inclusion conjunctivitis: ”Cobblestoning” without exudate

* Interstitial pneumonia

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12
Q

Diagnosis as chlamydiae

A 
DNA (urine or genital specimens)
•	PCR
•	Ligase chain reaction
•	NAAT
•	Tissue culture (rare)
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13
Q

Treatment for chlamydiae

A
  • Azithromycin
  • Doxycycline
  • Rest test 3-4 weeks or months post treatment
  • HIV testing
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14
Q

chlamydiae screening (risk factors) in females

A

•

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15
Q

chlamydiae screening (risk factors) in males

A

•

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16
Q

Gonorrhea is a

A

• Gram- diplococci

17
Q

Gonorrhea pathophysiology

A
  • Attach with pili to mucosal surfaces
  • Invade local tissues
  • Oral/vaginal or anal intercourse
18
Q

Risk factors gonorrhhea

A
  • Young adults
  • Urban poor adults
  • Minorities
  • Commercial sec workers
  • Men who have sex with men
19
Q

Manisfestations of mucosal gonorrohea

A
  • Urethritis/cervicitis/prostatitis/epididymitis
  • Proctitis
  • Pharyngitis
  • Conjunctivitis
20
Q

Manisfestations of invasive gonorrohea

A
  • PID
  • Perihepatitis (Fitz-Hugh-Curtis Syndrome)
  • Disseminated gonococcal infection
  • Septic arthritis
21
Q

Diagnosis of gonorrhea

A 
Gram stain
•	Less sensitive in women
•	Discharge
DNA
•	PCR/LCR/NAAT
•	Vaginal swabs
Culture
•	Thayer-Martin medium (non-sterile sites has antibiotics)
•	Chocolate agar (Sterile sample)
22
Q

Treatment for uncomplicated gonorrhea

A
  • Ceftriaxone IM
  • Azithromycin (oral)
  • Retesting not necessary
23
Q

Treatment of complicated gonorrhea

A
  • Ceftriaxone IM or IV
  • Azithromycin or doxycline
  • Retest at 3 months
24
Q

Other testing for gonorrhea

A

• HIV testing
• Resistance to penicillin & Cipro
• Repeat testing not necessary
•

25
Syphalis is
* Treponem pallidum | * Spirochete
26
Pathophysogy syphalis
* Intercourse/kissing * Micro abrasions on mucus membranes * Granuloma formation * Vasculitis-like * “Great imitator”
27
4 stages of syphalis infection
``` Incubation • Asymptomatic • 3 weeks Primary Skin Lesions • Chancre • Painless • 2-4 weeks healing Secondary Bacteremia • 6-24 weeks post-I • Condyloma late on genital • Generalized lymphadenopathy • Constitutional symptoms Latent Stage • Seroreactivity without symptoms • 1 year = low relapse Tertiary Stage • Years – decades post-I • Benign gummatous • Ascending aortitis • Neurosyphilis ```
28
Symptoms of neurosyphalis
* Tabes dorsalis * Dementia * Stroke * Meningeal * Abnormal CSF * Asymptomatic
29
Diagnosis of syphalis
``` • Darkfield microscopy • Direct immunofluorescence • Serological diagnosis o Nontreponemal  VDRL  RPR o Treponemal  FTA-ABS • CANNOT BE CULTURED ```
30
Treatment of syphalis
• IV or IM penicillin or doxycycline
31
Who is screened for syphalis
* Pregnant women * For a marriage license * High risk sexual functions * Symptomatic * HIV test

IInfectious Disease (6 decks)

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