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Sexually Transmitted Infections > Sexually transmitted diseases > Flashcards

Sexually transmitted diseases Flashcards

1
Q

AIDS is defined by an absolute CD4 count of less than how many cells

A

200 or the presence of an opportunistic infection

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2
Q

Signs and symptoms that suggest AIDS are

A

Oral candidiasis/thrush, fever, weight loss, diarrhea, cough, night sweats, purple to bluish-red bumps on the skin, and opportunistic infection

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3
Q

What infection causes the most deaths in HIV

A

Pneumocystis jirovecii

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4
Q

An acute and brief illness that occurs in 50-80% of persons within a few weeks of exposure to the HIV virus

A

Acute retro viral syndrome, flu-like symptoms, fever, night sweats, and weight loss

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5
Q

Is universal screening for HIV recommended

A

Yes

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6
Q

ELISA is an initial screening for what?

A

HIV

Sensitivity is >99%

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7
Q

Produces a malodorous vaginal discharge

A

BV

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8
Q

DNA probe is used for screening

A

Gonorrhea and chlamydia

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9
Q

RPR is used for screening

A

Syphilis

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10
Q

FTA-ABS, MHA-TP Are diagnostic test for this STI (treponema pallidum)

A

Syphilis

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11
Q

Western blot is confirmatory test for what?

A

HIV

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12
Q

Etiologic agent is a virus

A

HIV, herpes and HPV

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13
Q

This STD produces a discharge

A

HPV, gonorrhea, chlamydia, BV, herpes, trichomonas

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14
Q

Treated with acyclovir, valacyclovir, and famciclovir with equal efficacy

A

Herpes

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15
Q

May be associated with involuntary weight loss

A

HIV

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16
Q

Can produce rash on palms of the hands soles of feet

A

Syphilis

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17
Q

What STI is associated with a positive chandelier test

A

PID

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18
Q

What is a positive chandelier test

A

Tender cervical area

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19
Q

What STD produces a chanere

A

Syphilis

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20
Q

What STD produces vesicles on mucous membranes

A

Herpes type one

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21
Q

What is the initial screening test for HIV?

A

ELISA

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22
Q

What is the confirmatory test for HIV?

A

Western blot - confirmatory

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23
Q

In HIV infected patients what disease progresses faster

A

Liver disease and it affects the choice of anti-retroviral therapy

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24
Q

What is a significant risk factor for reactivation of latent TB

A

HIV

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25
Q

What vaccines do HIV infected patients need annually

A

Pneumococcal, tetanus, hepatitis A and B, and flu shot

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26
Q

Do you administer alive or attenuated vaccine’s to HIV infected patients

A

No

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27
Q

How often do you obtain a CD4 count in an HIV infected patient

A

First CD4 count baseline then repeat once and usually every 3 to 4 months.

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28
Q

How often to check viral load and HIV infected patient

A

Need baseline and then every 3 to 4 months

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29
Q

If on ART, How long does it take for the viral load to be undetectable

A

Within 16 to 24 weeks of therapy

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30
Q

What other screening tests do HIV infected patients need

A

Hepatitis A, B and C, glucose and lipid panel, and STD assessment

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31
Q

If an HIV infected patient has a CD4 count of less than 200 what are they at risk for

A

Pneumocystis jiroveci, still called PCP

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32
Q

What is the prophylactic treatment for pneumocystis jiroveci with a CD4 count less than 200

A

TMP-SMX (Bactrim)

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33
Q

A patient with new onset HIV would present with what symptoms

A

Fever, night sweats, pharyngitis, nonpruritic macular skin rash, malaise, headache, lymphadenopathy, abrupt eruption of skin disorder such as hives, psoriasis at a later age

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34
Q

A 20-year-old male has suspected acute infection of HIV. How should he be screened?

A

ELISA

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35
Q

When taking metronidazole or tinidazole what precautions need to be taken

A

No alcohol until 24 hours after her last dose

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36
Q

With recurrent bacterial vaginosis what must be ruled out

A

HIV

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37
Q

What is the most frequently reported infectious disease in the United States

A

Chlamydia

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38
Q

At what age is chlamydia most common

A

Less than 25 years old

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39
Q

What can cause PID, ectopic pregnancy, infertility, and pelvic pain

A

Chlamydia

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40
Q

What is Chlamydia trachomatis?

S/S?

A

-Parasitic STD caused by Chlamydia trachomatis that
produces serious reproductive tract complications in
either sex

-Often asymptomatic
Women Men
-Dysuria -Dysuria
-Intramenstrual spotting -Thick, cloudy penile discharge
-Postcoital bleeding -Testicular pain
-Dyspareunia
-Vaginal discharge

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41
Q

How do you diagnose Chlamydia/Labs?

A 
Enzyme immunoassay (EIA), 30-120 min for results
Chlamydia culture most definitive, results takes 3-9 days
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42
Q

Who should be screened for Chlamydia and how often

A

Screen all sexually active females less than 25 years of age and all pregnant women. Re-screen in three months after treatment due to higher rates of reinfection. Follow up in one month if pregnant and symptoms persist they can cause reinfection

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43
Q

How do you treat Chlamydia?

A

Azithromycin 1 gram PO x1
Doxycycline 100 mg PO BID x7 days
Alternatives: Erythromycin, Ofloxacin, Levofloxacin

Report to the health department

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44
Q

What is gonorrhea?

A

-Bacterial STI caused by Neisseria gonorrhoeae (gram - diplococci),
-Cultured from genitourinary tract, oropharynx, and/or
anorectum
-Produces urethritis in men and cervicitis in women
-Leading cause of infertility among females in US
-Male to female transmission is 80-90% after exposure

45
Q

S/S of gonorrhea include?

A

Females Males

  • Often asymptomatic -Often asymptomatic
  • Dysuria -Dysuria
  • Urinary frequency -Urinary frequency
  • Green mucopurulent DC -White/yellow/green DC
  • Labial pain/swelling -Testicular pain
  • Lower abdominal pain
  • Fever
  • Abnormal menstrual periods
  • Dysmenorrhea
46
Q

Gonorrhea Labs/Diagnostics

Treatment

A

-Gram stain of discharge smear shows gram- diplococci
and WBC
-Cervical culture using modified Thayer-Martin Media

-Ceftriaxone (Rocephin) 250 mg IM x1 dose
-Azithromycin (Zithromax) 1 gram po x1 dose to cover
chlamydia

Report to health department

47
Q

Does a minor require parental consent for STD care

A

No

48
Q

Epididymitis and prostatitis are possible side effects of which type of infection?

A

Chlamydia

49
Q

What STD causes Reiters syndrome in males?

A

Chlamydia

50
Q

If a patient is positive for gonorrhea what must they be co-treated for?

A

Chlamydia

51
Q

What may reduce the risk of PID

A

Oral contraceptives

52
Q

Chlamydia and/or gonococcal and infection of the liver capsule resulting in expensive scarring between the liver capsule and abdominal contents. Scars look like a violin strings. A complication of disseminated gonorrhea or PID

A

Fitz-Hugh-Curtis Syndrome (perihepatitis)

53
Q

Sexually active female with symptoms of PID complains of right upper quadrant abdominal pain and tenderness on palpation. The liver function test is normal.

A

Fitz-Hugh-Curtis Syndrone

54
Q

How do you treat Fitz-Hugh-Curtis syndrome

A

Treated as a complicated got a real/chlamydial infection for 14 days

55
Q

More common in males. And immune mediated reaction secondary to infection with certain bacteria i.e. chlamydia that spontaneously resolved. Treatment is supportive i.e. NSAIDs

A

Reiters syndrome

56
Q

A male with current history of chlamydia genital infection i.e. urethritis complains of red and swollen joints that come and go and ulcers on the skin of the glans penis

A

Reiters syndrome

57
Q

Mneumonic. I can’t to see, Pee, or climb up a tree

A

Reiters syndrome

58
Q

Is PID a clinical diagnosis

A

Yes i.e. cervical motion tenderness. Even if gonorrhea and chlamydia test are negative treat a sexually active patient who has signs and symptoms of PID

59
Q

What is syphilis?
Cause?
Diagnostics?
Treatment?

A
  • STI involving multiple organ systems
  • Caused by Treponema pallidum, spirochete
  • 3rd most common reported infectious disease in US
  • 4 stages: primary, secondary, latent, and tertiary
  • VDRL/RPR
  • Pen G, if allergic, doxycycline or erythromycin

Report to health department

60
Q

Primary syphilis

Treatment if <1 yr duration?

A
  • Chancre is painless
  • Indurated ulcer
  • Located at the site of exposure

-benzathine penicillin G, 2.4 million units IM

Report to health department

61
Q

Secondary syphilis

Treatment if <1 yr duration?

A

-Flu-like symptoms
-Highly variable skin rash on palmar and plantar surfaces,
mucous patches
-Lymphadenopathy
-Malaise
-Anorexia
-Alopecia
-Arthralgias

-benzathine penicillin G, 2.4million units IM

Report to health department

62
Q

Latent syphilis

Treatment?

A

-Seropositive, but asymptomatic

–benzathine penicillin G, 1.4 million units IM 1/week x3
weeks

Report to health department

63
Q

Tertiary syphilis

Treatment?

A
  • Leukoplakia
  • Cardiac insufficiency
  • Aortic aneurysm
  • Meningitis
  • Hemiparesis
  • Hemiplegia

–benzathine penicillin G, 1.4 million units IM 1/week x3
weeks

Report to health department

64
Q

What is the screening test for syphilis

A

RPR or VDRL - Nontreponemal

Report to health department

65
Q

For patients with syphilis prophylaxis for all sexual contacts should be given in the last how many days

A

90

66
Q

What is the treatment for syphilis

A

Benzathine penicillin G 2.4 million units IM in adults

If PCN allergic…
DOxycycline 100 mg BID
Erythromycin 500 mg QID

Report to health department

67
Q

Treponema infection is associated with

A

Syphilis

Report to health department

68
Q

What is the order of screening test for syphilis?

A

First order screening test is RPR or VDRL.
If reactive, next step is to confirm with FTA – ABS.
Confirms 85-90% of primary cases and 100% of
secondary cases
Microhemagglutination assay for antibody to T. palladium
(MHA-TP)

Report to health department

69
Q

If both the RPR and FTA-ABS or positive

A

This is diagnostic for syphilis

70
Q

When do you recheck the RPR or VDRL after treatment

A

At six and 12 months

71
Q

RPR and VDRL are screening tests for

A

Syphilis

Report to health department

72
Q

If RPR or VDRL a positive how do you confirm?

A

FTA – ABS (treponemal test)

73
Q

Maculopapular rash on the palms and soles are signs and symptoms of?

A

Secondary syphilis

74
Q

The most common criterion collection is used to diagnose PID is

A

Cervical motion tenderness

75
Q

Used to stage HIV infection and to determine when to start prophylaxis. Check at the same time of the day using the same laboratory each time

A

CD4 T cells counts

76
Q

What is the screening test for HIV

A

ELISA Enzyme Linked Immunosorbent Assay

77
Q

What is the confirmatory test for HIV

A

Western blot

78
Q

Went a CD4 count is less than 100 Cells what kind of cause

A

Toxoplasma Gondii infections (Protozoa)

Causes brain abscesses. Avoid cleaning cat litter boxes and eating undercooked meats

79
Q

When a patient is on HAART and ART how should their viral load be monitored

A

Check every 1 to 2 months until viral load is undetectable then every 3 to 4 months

80
Q

What are the recommended vaccines for HIV and AIDS patients

A

HIV and AIDS patients can receive inactivated vaccines such as hepatitis A, hepatitis B, annual flu vaccine, pneumococcal vaccine, TD/TDAp

81
Q

What is some HIV education teaching points

A

Do not handle cat litter or eat uncooked lamb, beef, or pork as this is a risk for toxoplasmosis. Avoid Bird stool, turtles and other amphibians, and use gloves or avoid gardening.

82
Q

When is PCP prophylaxis initiated in HIV patients

A

CD4 less than 200

83
Q

If a patient with HIV is allergic to sulfa what drug should be used for PCP prophylaxis

A

Dapsone 100 mg PO daily

84
Q

What is used for both prophylaxis and treatment of PCP

A

Bactrim DS

85
Q

If a patient presents with hairy leukoplakia on the tongue, recurrent candidiasis thrush what must be ruled out

A

HIV

86
Q

Can patients with HIV breast-feed

A

No

87
Q

What is another name for genital warts?

Treatment?

A

-Condyloma acuminata
-Most common viral STD in the US
-Keratolytic agents - podophyllin (Pododerm),
trichloroacetic acid (TCA) or bichloracetic acid (BCA)
-Referral fo cryotherapy, laser therapy, electrocautery, or
excision

88
Q

Specialize microscope for evaluating and treating cervix

A

Colposcopy

89
Q

What is the gold standard in diagnosing cervical cancer

A

Biopsy of cervical tissue

90
Q

The majority of general HPV external warts are caused by which HPV strain

A

HPV 6 or 11

91
Q

What is herpes?
S/S
Diagnostics
Management

A

-A recurrent viral STD with no cure, associated with
painful genital lesions
-Type 1 - associated with lips, face, and mucosa
-Type 2 - associated with genitalia
-Fever, malaise, dysuria, painful/pruritic ulcers for approx
12 days
-Recurrent episodes are usually less painful/pruritic for
appox 5 days
-Identified with Pap or Tzanck stain
-Most definitive test is a viral culture
-No treatment/cure
-Symptomatic treatment with drying and antipruritics
-Acyclovir recommended for topical, oral, and IV
-Famciclovir
-Valacyclovir

92
Q

What are prodrome herpes simplex symptoms

A

Itching, burning, and tingling

93
Q

Sudden onset of groups of small vesicles sitting on an erythematous base. Easily ruptures and it’s painful. Primary episode more severe and can last from 2 to 4 weeks. Vesicle fluid and crust are contagious.

A

Herpes simplex

94
Q

What Risk factor has the highest impact on HIV transmission?

A

Viral load

95
Q

A 32 year-old female was exposed to HIV after sexual intercourse. When do the majority of patients seroconvert if they are going to do so

A

3 weeks to 6 months

96
Q

Chancroid is considered a cofactor for transmission of

A

HIV

97
Q

HPV infection of the larynx has been associated with

A

Laryngeal Neoplasma

98
Q

Complication of having pelvic inflammatory disease that was caused by vaginal infection such as gonorrhea or chlamydia

A

Fitz-Hugh-Curtis

99
Q

How do you reveal subclinical lesions on the penile skin of a patient that presents with HPV infection

A

Apply acetic Acid to the penile shaft and look for Ace to white changes

100
Q

The diagnosis of human papilloma virus infection in males is usually made by

A

Clinical appearance

101
Q

Absolute CD4 lymphocyte normal count is

A

> 800

102
Q

What is viral load?

A

-PCR: Based quantitate copies of HIV-branched DNA or
RNA
-Results correlate closely with progression of HIV
-Ideally should be 0 or undetectable

103
Q

Prevention of HPV/Vaccinations

A

-Gardasil for Types 6, 11, 16, & 18
-Gardasil 9 for prevention of cervical, vulvar, vaginal, and
anal cancer
-Indicated for females and males ages 9-26
-Given in 3 injections
-Cervarix for Types 16 and 18
-Indicated for females ages 10-25
-Given in 3 injections

104
Q

HPV Types known to cause CA

A

Types 6, 11, 16, and 18

105
Q

What STI’s need to be reported to the health department?

A

Gonorrhea
Chlamydia
Syphilis

106
Q

Hep-B prevention and treatment

A

-Two vaccines, Recombivax HB and Engerix-B both
administered at 0, 1, and 6 months.

-Supportive and symptomatic care
-Hep B immune globulin (HBIG) IM single dose may be
given within 14 days of exposure, earlier administration
may be more effective

107
Q

What is lymphogranuloma venereum (LGV)
S/S
Dx
Treatment

A

-Immunotypes L1, L2, and L3 of Chlamydia trachomatis
-2-3 painless vesicles, bubo or nonindurated ulcer
-Regional adenopathy follows in approx 1 month and is
the most common finding
-Stiffness and aching in groin followed by unilateral
swelling of inguinal region
-May be confused with chancroid
-Definitive dx requires isolating C. trachomatis from an
appropriate specimen
-Doxycycline 100 mg po BID x21 days
-Aspirate bubos to prevent ulcerations

108
Q

What is molluscum contagiosum?
S/S
Dx
Treatment

A

-Virus
-Occurs infrequently, about 1:100 cases
-Lesions are 1-5 mm, smooth, rounded, firm, shiny flesh-
colored to pearly-white papules
-Commonly seen on trunk and anogenital region
-Inspection and microscopic exam
-Cryoanesthesia with liquid nitrogen, may resolve without
scarring

109
Q

What is lymphogranuloma venereum?
S/S?
Diagnosis?
Treatment?

A

(LGV)
-Caused by immunotypes L1, L2, or L3 of Chlamydia
trachomatis
- 2-3 mm painless vesicle, bubo, or non-indurated ulcer
-Regional adenopathy follows in approximately one
month and is the most common finding
-Stiffness and aching in the groin followed by unilateral
swelling of the inguinal region
-May be confused with chancroid
-Definitive dx requires isolated Chlamaydia trachomatis
from an appropriate specimen
-Doxycycline 100 mg BID x21 days
-Aspirate buboes to prevent ulceration

Sexually Transmitted Infections (1 decks)

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