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Infectious Disease > Sexually Transmitted Infections > Flashcards

Sexually Transmitted Infections Flashcards

1
Q

what are the 3 modes of transmission of HIV?

A

sexual
parenteral
vertical

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2
Q

what gene is used in serological tests for HIV?

A

p24

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3
Q

which HIV type has a lower transmissibility/lower progression to AIDS?

A

HIV-2

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4
Q

what is the pathophys of HIV?

A

infects CD4 + cells and kills them = suppresses cell-mediated immunity

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5
Q

a patient presents with a frequent sore throat, painful ulcers, lymphadenopathy, fever, headache, N/V/D, weight loss, and arthralgias. Dx?

A

acute HIV

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6
Q

what can acute HIV be confused with?

A

mononucleosis

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7
Q

what 3 serologies can be used to diagnose HIV?

A

IgM
IgG
p24 antigen

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8
Q

what treatment in all patients with HIV?

A

antiretroviral therapy (ART)

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9
Q

AIDS is primarily a consequence of continuous, high-level replication of _____, leading to virus and immune-mediated killing of CD4 lymphocytes.

A

HIV-1

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10
Q

stage 1 with CD4 over 1500 with flu-like symptoms: fever, rash, lymphadenopathy, and myalgias. Dx?

A

acute HIV

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11
Q

stage 2 of HIV characterized by CD4 of 200-1500, the patient becomes sicker with thrush, cervical dysplasia, herpes zoster, and peripheral neuropathy.

A

clinical latency

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12
Q

stage 3 with CD4 less than 200, the most severe phase of HIV

A

AIDS

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13
Q

which stage of HIV requires prophylaxis to be started for opportunistic infections?

A

stage 3 (AIDS)

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14
Q

what physical exam finding can be expected in the latent period of HIV or during chronic HIV without AIDS?

A

lymphadenopathy

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15
Q

what are the 3 criteria that can indicate AIDS?

A

CD4 cell count < 200
CD4 % < 14.5
AIDS-defining condition

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16
Q

what will be seen in chest radiograph to indicate pneumocystis jiroveci pneumonia?

A

diffuse or perihilar infiltrates

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17
Q

what are 3 sputum labs to diagnose pneumocystis jiroveci pneumonia?

A

wright-giemsa stain
direct fluorescence antibody test (DFA)
bronchoalveolar lavage

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18
Q

what is the treatment for pneumocystis jiroveci pneumonia?

A

trime-sulfa

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19
Q

caused by intense replication of Epstein-Barr virus that presents with a white lesion on the lateral aspect of the tongue

A

oral hairy leukoplakia

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20
Q

what are 2 treatment options for oral hairy leukoplakia?

A

zidovudine
acyclovir

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21
Q

a patient presents with odynophagia or pain on swallowing. Endoscopy shows mucosal plaque-like lesions and biopsy shows yeast and pseudohyphae. Dx? Treatment?

A

candidal esophagitis
fluconazole

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22
Q

low-grade vascular tumor associated with infection with human herpesvirus 8. presents as purple/brown papular lesions

A

kaposi sarcoma

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23
Q

what is the treatment for kaposi sarcoma?

A

anti-retroviral therapy

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24
Q

what is the rule of thumb for HIV treatment?

A

once treatment is started, patient should never come off it

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25
Q

what must we do before treating patient for HIV?

A

test for hypersensitivity to drugs (abacavir)

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26
Q

what should be monitored after starting HIV treatment?

A

viral load

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27
Q

what is the goal for monitoring HIV treatment?

A

suppress below the limits of assay detection

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28
Q

who should be screened for HIV?

A

patients 15-65 years at least once

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29
Q

used for HIV-uninfected patients at high risk for acquiring HIV

A

tenofovir disoproxil fumarate-emtricitabine (PrEP)

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30
Q

what can be used for post-exposure prophylaxis (PEP)?

A

bictegravir-emtricitabine-tenofovir alafenamide

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31
Q

how is syphilis contracted? (2)

A

sexual
vertical transmission

32
Q

a patient presents with a painless papule at site of inoculation with regional lymphadenopathy. Dx?

A

primary syphilis

33
Q

a patient presents with a rash, fever, headache, malaise, anorexia, sore throat, weight loss, condyloma (weeping papules) in moist skin areas, moth-eaten alopecia, and lymphadenopathy. Dx?

A

secondary syphilis

34
Q

what form of syphilis is noninfectious to sex partners but can be transmitted to the fetus?

A

late latent syphilis

35
Q

a patient presents with gummas (heaped up granulomatous lesions), dilated aorta, and aortic valve regurgitation. Dx?

A

late syphilis

36
Q

a patient presents with unequal reflexes, irregular pupils with poor light and accommodation reflexes (argyll robertson pupils), and local motor taxia (tabes dorsalis). Dx?

A

neurosyphilis (tertiary syphilis)

37
Q

what serological diagnostics can be used for syphilis? (3)

A

VDRL or Rapid Plasms Reagin (RPR)
+
FTA-ABS or MHA-TP

38
Q

what diagnostic can show us a spirochete to diagnose syphilis?

A

darkfield microscopy

39
Q

what is the treatment for syphilis?

A

penicillin

40
Q

what is a common complication in early syphilis that occurs due to massive destruction of spirochetes during the treatment of syphilis?

A

jarisch herxheimer reaction

41
Q

which HSV causes symptomatic infections in the genital tract?

A

HSV 2

42
Q

what is a common occurrence in HSV contraction?

A

viral shedding without lesion

43
Q

where are lesions most commonly present in HSV?

A

oral

44
Q

a patient presents with a cold sore that occurred with prodromal pain. on physical exam, they have vesicular, ulcerative lesions with severe mouth pain, fever, itching and cervical lymphadenopathy. Dx?

A

HSV

45
Q

what are 6 manifestations of HSV?

A

herpetic whitlow
herpes gladiatorum
erythema multiforme
eczema herpeticum
ocular infections (keratitis, chorioretinitis)
encephalitis

46
Q

what is the gold standard to confirm a HSV diagnosis?

A

viral culture (HSV cell culture) of the lesion

47
Q

what is the treatment for HSV?

A

acyclovir

48
Q

what are 2 topical treatment options for HSV?

A

penciclovir
docosanol

49
Q

what is the treatment for HSV that has involvement of the eye or disseminated infection due to immunosuppression? (2)

A

urgent referral
IV antiviral therapy

50
Q

predominantly a disease of lymphatic tissue that is reported among men-sex-with-men

A

chlamydia lymphogranuloma venereum

51
Q

a patient presents with genital ulcers/mucosal inflammatory reaction, painful inguinal buboes, fever, malaise, anal pruritis, and rectal discharge. Dx?

A

chlamydia lymphogranuloma venereum

52
Q

how to diagnose chlamydia?

A

NAAT

53
Q

what is the treatment for chlamydia lymphogranuloma venereum? alternative? for allergies/pregnancy?

A

doxycycline
alt: tetracycline

erythromycin for allergies/pregnant

54
Q

what is the most common site of chlamydia in women?

A

cervix

55
Q

what is the most common site of chlamydia in men?

A

urethra

56
Q

chlamydia is a major cause of nongonoccal _____ and _____

A

cervicitis
urethritis

57
Q

a female patient presents with cervicitis, PID, proctitis, conjunctivitis, and pharyngitis. Dx?

A

chlamydia

58
Q

a male presents with urethritis, epididymitis, prostatitis, proctitis, conjunctivitis, pharyngitis, Reiter syndrome (reactive arthritis). Dx?

A

chlamydia

59
Q

what is the treatment for chlamydia in a confirmed diagnosis or a pregnant patient?

A

azithromycin

60
Q

what is the treatment for chlamydia in a suspected case?

A

doxycycline

61
Q

gonococcal infections (gonorrhea) commonly causes what in men and women?

A

urethritis
cervicitis

62
Q

a patient presents with mucopurulent/copious discharge, pruritis, urethritis, cervicitis, epididymitis, prostatitis, Reiter syndrome, conjunctivitis, and pharyngitis. Dx?

A

gonorrhea

63
Q

how to diagnose gonorrhea?

A

NAAT

64
Q

what should all patients diagnosed with gonorrhea be offered?

A

HIV testing

65
Q

what is the treatment for gonorrhea? (2)

A

ceftriaxone + doxycycline

66
Q

caused by HPV infection and is the most common viral sexually transmitted disease in the US; causes cervical cancer

A

condylomata acuminata

67
Q

how is condylomata acuminata acquired?

A

sexual activity

68
Q

a patient presents with a skin-colored/pink wart that has smooth flattened papules, and has a verrucous papilliform appearance. Dx?

A

condylomata acuminata

69
Q

what are 4 patient applied treatments for condylomata acuminata?

A

podophyllin/popfilox
imiquimod
sinecatechins

70
Q

what are 4 provider administered treatments for condylomata acuminata?

A

cryotherapy
trichloroacetic/bichloroacetic acid
surgical removal
laser therapy

71
Q

what is the vaccination for condylomata acuminata used for?

A

prevent cancer

72
Q

a flagellated, sexually transmitted protozoan that causes infection of the vagina or male genital that can be asymptomatic, or cause urethritis, vaginitis, cystitis, epididymitis, or prostatitis

A

trichomoniasis

73
Q

a female patient presents with copious yellow-green, frothy discharge with a fishy odor, vulva and perineum soreness, with punctate/red strawberry spots on the cervix. Dx?

A

trichomoniasis

74
Q

a male patient presents with urethritis, transient/frothy/purulent discharge, dysuria and frequency. Dx?

A

trichomoniasis

75
Q

how to diagnose trichomoniasis?

A

NAAT

76
Q

what is the treatment for trichomoniasis?

A

metronidazole

Infectious Disease (4 decks)

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