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infectious disease > Sexually Transmitted Infections > Flashcards

Sexually Transmitted Infections Flashcards

1
Q

HSV Infection

A

HSV 1 and HSV 2
Both serotypes can cause either type of infxn
Very common: 50 mil. in US.

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2
Q

Types of HSV infxn

A

Primary: infxn w/o antibodies to HSV 1 or 2
Non-primary: first episode infxn due to acquiring HSV-1 w/ antibodies to HSV-2 or vice versa.
Recurrent: The lesion and the serum have the same antibodies.

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3
Q

Primary HSV

A

Highly variable symptoms
Sx tend to be more severe in women
Local itching, dysuria, lymphadenopathy

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4
Q

HSV transmission

A

Highly transmittable
Can be transmitted by oral/genital
Greater risk with male source
70% transmission in asymptomatic patients

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5
Q

Condom use declines HSV transmission by ____%

A

50

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6
Q

HSV diagnosis

A

Viral culture if lesions present
PCR study
Serology for type specific antibody

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7
Q

HSV Tx

A

Acyclovoir (Zovirax)
Famcilovir (Famvir)
Valacyclovoir (Valtrex)
Primary HSV should be treated within 72 hrs**

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8
Q

Recurrent HSV Tx

A

Chronic suppressive therapy

Episodic therapy: Treat at prodromal symptoms for 3 days.

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9
Q

HSV in Pregnancy

A

Most common transmission is from direct contact of fetus with infected vaginal secretions.
Maternal immunity is important**
Do a prophylactic c-section if active lesions at birth

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10
Q

Syphillis

A

Causative agent: Treponema Palidum
Cannot be cultured, but serologic tests available
Can be seen with dark field microscopy
Is a reportable disease in the US

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11
Q

Syphilis: who to screen

A 
Pt w/ suspected disease
High-risk populations
Multiple partners
Pregnant women
Hookers/Jiggalos
Sexually active HIV folks
Man on man action
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12
Q

Syphilis is associated with increased risk for acquisition of _____?

A

HIV.

All patients diagnosed with syph should be given the option for HIV testing.

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13
Q

Syphilis Transmission

A

Primary and secondary produces chancres, mucous patches and condyloma lata.
Transmission from an infected person is 30%
Can be spread by kissing and touching
Can be passed through the placenta

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14
Q

Primary Syphilis

A

Incubation period of 2 - 3 weeks.
A papule forms and soon ulcerates to the chancre
Chancres heal within 3 - 6 weeks without tx
Bilateral lymphadenopathy

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15
Q

The syphilis chancre is usually ______.

A

Painless

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16
Q

Secondary Syphilis

A

Weeks to months later 20% of people w/ untreated infxns will develop systemic illness.
Rash, condyloma lata, systemic symptoms, hepatitis, GI abnormalities, musculoskeletal/renal abnormalities

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17
Q

Tertiary Syphilis

A

1 - 25 years after secondary syphilis
subcutaneous granulomas
ascending thoracic aorta dilates, aortic regurg
CNS symptoms

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18
Q

Syphilis Neuro symptoms

A

Early: Meningitis, meingiovascular disease
Late: General paresis, tabes dorsalis, ocular, otosyphilis

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19
Q

Neurosyphilis

A

When suspected do an LP
Lymphocytic pleocytosis
Need to follow CSF during tx to ensure a response

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20
Q

Tx of early syphilis

A

2.4 million units benzathine PCN G IM
For primary and secondary, early latent
If PCN allergic, doxycycline 100mg BID for 14 days

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21
Q

Neurosyphilis Tx

A

IV penicillin 3-4 million units q 4 hrs
OR
18 - 24 million units/day continuous infusion for 10 - 14 days
Patients w/ PCN allergy should be desensitized!

22
Q

Non-PCN regimens are ____ ______ for patients w/ neurosyphilis.

A

NOT recommended.

PCN G is drug of choice

23
Q

Syphilis monitoring

A

Pts should be reexamined clinically and serologically at 6 and 12 months after tx

24
Q

Human Papillomavirus (HPV)

A

Double stranded DNA virus
More than 100 types of HPV
75 - 80% of sexually active adults will acquire HOV before the age of 50

25
Q

HPV manifestations

A 
Genital warts
Bowenoid Papules and bowens disease
Giant Condyloma
Carcinoma of genito areas
Plays a role in squamous cell carcinomas of head, neck and oral cavity.
26
Q

Which are the 2 types of HPV associated with 70% of cervical cancer?

A

HPV 16 and 18

27
Q

What are the 2 types of HPV that cause 90% of genital warts?

A

HPV 6 and 11

28
Q

Most HPV infxns resolve in ___ to ___ months.

A

6 - 12 months

29
Q

Anogenital warts

A

Most common viral STD in U.S.

67% of pt pop is women

30
Q

Anogenital wart Dx

A

Usually made by visual inspection

5% acetic acid turns lesion white

31
Q

Warts Tx

A

Spontaneous regression occurs in 20-30% of cases
All therapies have 30 - 70% regression
Ablative therapies
Excisional therapies

32
Q

HPV Vaccine

A

Gardasil - oncogenic and warts

Cervarix - just oncogenic

33
Q

Common cause of urethritis in males

A

Gonorrhea

34
Q

Trichomonas Vaginalis

A

Accounts for 20 - 35% of vaginitis
Flagellated Protozoan
Organism identified in 30-40% of male sexual partners of infected women.

35
Q

Trichomoniasis presentation in women

A 
Asymptomatic carrier state
Purulent, maladorous thin discharge (70%)
Burning, pruritis
Dysuria, frequency
Dyspareunia, postcoital bleeding
36
Q

Trichomoniasis Dx

A

Vaginal swab: wet mount shows motile trichomonads-diagnostic
Classic, green frothy foul smelling discharge
Elevated pH, increased PMN’s

37
Q

Trichomoniasis Tx

A

Tinadazole or Metronidazole (flagyl)
SIngle oral dose of 2 mg
Metronidazole 500mg BID for 7 days for symptomatic pregnant women
Male partners must be treated as well

38
Q

Trichomoniasis in men

A

Usually transient w/ spontaneous resolution
typical urethritis symptoms
Tx is usually because of +female dx or NGU

39
Q

NGU = ?

A

Non-gonococcal urethritis

40
Q

Neisseria Gonnorrhoeae

A

Second most commonly reported communicable disease in US.

Increasing abx resistance

41
Q

Gonorrhea Manifestations

A 
Women:  any portion of genital tract (PID)
Most common site is cervix
Urethritis
Anorectal infxn/proctitis
Men: Urethritis, epididymitis, proctitis
42
Q

Disseminated Gonococcal Infections (DGI)

A

Occurs in 1 - 3% of infected pt’s.
More common in women
Tenosynovitis, dermatitis, polyarthralgias

43
Q

DGI presentation

A

Purulent arthritis
Painless lesions, transient
Multiple inflamed tendons

44
Q

Gonorrhea Dx

A

Gram stain for urethritis in men

NAAT - optimal method

45
Q

Gonorrhea Tx

A 
Ceftriaxone: 250mg IM single dose
PLUS (for chlamydia)
Azithromycin (1 gram dose single)
OR
Doxycycline 100mg BID for 7 days
46
Q

Chlamydia Trachomitis

A

Small gram- organism
Persistent infxn is common
Screen women, treat men empirically

47
Q

Chlamydia manifestations in women

A

Cervicitis, urethritis, PID
30% of women will develop PID if untreated
Can cause pregnancy complications

48
Q

Chlamydia manifestations in men

A

Urethritis
Epididymitis
Proctitis: uncommon

49
Q

Chlamydia Dx

A

Culture
NAAT - gold standard
This is a reportable infxn

50
Q

Chlamydia Tx

A

Azithromycin 1 gram single dose
doxycycline 100mg BID for 7 days
Test for cure in pregnant patients

infectious disease (12 decks)

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