Sexually transmitted diseases LECT (Unrein) Flashcards
A 19 y/o male college student presents with a generalized macular rash, patchy hair loss, generalized lymphadenopathy and flat grey white lesions in the perianal area. In order to diagnose his disease, you should order which test first? He relates having unprotected sex two months ago.
A) Culture in a high CO2 environment B) PCR for HPV types 6 and 11 C) Urethral DNA probe D) RPR E) Gram stain
RPR
the patient has secondary syphilis (2 month incubation period)
disseminated maculopapular rash
can start out as a vesicle and quickly breaks down into painless chancre (smooth round border)
incubation time for neisseria gonorrhea
acutely (2-6 days)
culture in a high CO2 environment
Neisseria gonorrhoea
Urethral DNA probe used to diagnose what
Neisseria gonorrhea and chlamydia trachomatis
RPR used to diagnose what
rapid plasma reagin
antibody screenings for suspected syphilis
this is a blood test
very non specific and can be positive in things like pregnancy
confirm with fluorescent treponemal antibody testing
gram stain made for diagnosis of what
neisseria gonorrhea and would identify gram negative diplococci intracellular organisms bean shaped organism
A 26 y/o female presents with right lower quadrant tenderness equivocal for rebound tenderness, a low grade fever, normal bowel sounds, and exudative and tender cervical examination. Her white blood cell count is 15,000 (4,000-10,000/L). You suspect which organisms?
A) GI tract coliforms B) Treponema pallidum C) Human papillomavirus D) Human Immunodeficiency Virus E) Chlamydia trachomatis
chlamydia trachomatis
cervix has purulent exudative tender findings
what is the treatment for syphilis
IM Penicillin
one dose for having it for less than 1 year
GI Tract coliforms
acute appendicitis
treponema pallidum
causative agent for syphilis
HPV
causes condyloma acuminata and cervical cancer
usually asymptomatic early in the disease
when evaluating and treating chlamydia trachomatis what other diseases must be considered
gonorrhea
Hep B and C
Syphilis
HIV
CMV
Trichomonas
treatment for chlamydia trachomatis
macrolides–> erythromycin (these work on the ribosome 50S)
AND
tetracycline (work at the 30S ribosome)
NOT penicillin or cephalosporin
-Chlamydia doesn’t have a cell wall and these drugs treat bugs with cell wall
A 35 y/o female presents with a thin gray vaginal discharge and vulvovaginal discomfort. She relates four current male sexual partners. None of her partners have any symptoms and have all been checked recently for sexually transmitted illness: all partners are negative. Pelvic exam notes normal appearing cervix that is non-tender. There is no unusual odor. Wet mount notes large numbers of leukocytes and motile organisms. You suspect the etiology to be:
A) Candida albicans B) Gardnerella vaginalis C) Trichomonas vaginalis D) Chlamydia trachomatis E) Neisseria gonorrhoeae
Trichomonas Vaginalis
perform wet mount in clinic and you will see motile organisms
STD and non STD
large numbers of leukocytes
men are often asymptomatic
treatment for gonorrhea
ceftriaxone
gardnerella vaginalis
not an STD
usually associated with fishy vaginal odor
few leukocytes on wet mount
treatment for trichomonas vaginalis
metrondiazole
DON’T DRINK WITH THIS
A 22y/o male presents with multiple painful vesicles on the glans of his penis. He relates a new unprotected sexual encounter after a concert one week ago. He has no discharge, but has bilateral swollen lymph nodes in the groin. You suspect the following most likely etiology:
A) Chlamydia trachomatis B) Treponema pallidum C) Haemophilus ducreyi D) Herpes Simplex-2 E) Klebsiella granulomatis
vesicles !!! —> herpes simplex 2
lymph nodes in the groin
haemophilus ducreyi
disease of third world countries
causes the disease chancroid
presents initially as a vesicular pustule but progresses to a painful genital ulcer
irregular border and a gray necrotic exudate at its base
unilateral LAD is common
associated with sex workers/ injection drug workers
Klebsiella granulomatis
make this flashy
A 24 y/o male presents to the community health center with an eight-day history of sore throat, generalized aches, fever and anorexia. Today he developed a trunk and abdominal rash. He has had multiple male and female sexual contacts and uses condoms variably. His last sexual encounter was four weeks ago. You are most suspicious of which infection:
A) Hepatitis B B) Human papillomavirus C) Herpes Simplex-1 D) Human Immunodeficiency Virus E) Primary Treponema pallidum
HIV
nonspecific viral syndrome with a fever, sore throat, swollen lymph nodes
how do you confirm the diagnosis of haemophilus ducreyi
Chocolate agar plate
treatment of haemophilus ducreyi
Ceftriaxone
azithromycin
either one as a single dose
how do you confirm the diagnosis of klebsiella granulomatis
tissue biopsy
treatment of klebsiella granulomatis
erythromycin or tetracycline for 3 weeks
ampicillin for 12 weeks
this is a more deep seeded infection
how do you confirm diagnosis herpes simplex 2
viral culture (vesilces) and serology - PCR
Tzanck smear (old test and operator dependent)
treatment for herpes simplex 2
Acyclovir, famciclovir, valacyclovir
A 20 y/o female presents to the emergency department with a new onset of a rash, fever, and joint pain. Initially the pain began in her right knee but has progressed to her right ankle and hip. Her rash is represented by scattered painful lesion on the hands and feet.
The suspected cause of this disorder is: A) Chlamydia trachomatis B) Treponema pallidum C) Neisseria gonorrhoeae D) Herpes Simplex-2 E) Human Immunodeficiency Virus
neisseria gonorrhea
disseminated gonorrhea occurs weeks after the primary infection
migratory polyarthritis (septic arthritis of muliple joints)
sparsely distributed necrotic pustules
common for women to present in the above fashion without GU complaints
19 y/o female presents to you with a painless papule on her lip and cervical lymphadenopathy. You suspect which disorder? She relates a new unprotected sexual encounter 1 month ago.
A) Haemophilus ducreyi B) Neisseria gonorrhoeae C) Treponema pallidum D) Herpes Simplex-2 E) Human Immunodeficiency Virus
treponema pallidum
singular lesion
lymphadenopathy
genital ulcers are caused by what
syphilis
herpes simplex
chancroid
lymphogranuloma venereum
urethritis and cervicitis are caused by what
what?
make this
genital warts are caused by what?
HPV
confusion with secondary syphilis
