STD Flashcards
Gonorrhea
green vaginal discharge
gonorrhea definition
a bacterial STD caused by nisseria goorrhoea (gram negative diplococci
asymptomatic
dysuria
gonorrhea discharge men
white or yellow not green
gonorrhea labs
gram stain shows gram negative diplococci and wbc
gonorrhea female labs
thayer martin media cervical culture for N gonorrhoea
gonorrhoea treatment
ceftriaxone - (rocephin) 250mg IM x one dose to treat gonorrhea
plus
zithromax, 1 g orally x one dose to cover chlamydia
report to the health department
Syphilis definition
STD involving multiple organ systems and caused by treponema pallidum - a spirochete
syphilis pearls
third most reported infectious disease in the US
over 200k new cases annually
clinical stages of syphilis Primary
CHANCRE IS PAINLESS
indurated ulcer
located at site of exposure
tx is 2.4 million units IMx1
clinical stages of syphilis secondary
FLU LIKE SX highly variable rash on skin palmar and plantar rash mucous patches alopecia, anorexia malaise, arthalgias and lymphadenopathy
tx is 2.4 million units pcn G IM weekly x 3 weeks
syphilis latent
seropositive but asymptomatic
tx is 2.4 million units pcn G IM weekly x 3 weeks
reportin diseasees
gonorrhea
claymmadia
syphilis
TB
HIV
Tertiary syphilis
lekoplakia cardiac insufficiency aortic annurysim meningitis hemiparesis hemiplegia
lesions that hurt =
herpies
Serologic tests for syphilis
Nontreponemal VDRL/RPR may be positive or neagitve for primary
Treponemal- used to confirm
MHA-TP or FTA-ABS
Siphilis treatment allergy to PCN G
PCN G2.4 million units IM
(doxy 100mg orally bid
reythromycin 500mg orally 4times daily
Chlamydia
parasitic STD caused by chlamydia trachomatis with produces serious reproductive tract issues in both sexes
most common bacterial STD in US
Chlymidia 4millin new infections annually
Chlamydia S and S
female often asymptomatic dysuria PAINFUL INTERCOURSE vaginal discharge
men
often asymptomatic -dysuria
THICK CLOUDY PENILE DISCHARGE
testicular pain
Labs for chlymidia
chlamydia culture- most definitive test (3-9 days for results)
Enzyme immunoasssay EIA methods preferred low cost and get results back in like 2 hours
drugs for chlymidia
azithromycin (zithromax) 1g po x1dose OR
doxy (vibramycin 100mg by mouth x7days
report to health department
cross cover drugs for chlymidia and gonnerhea
zithromax 1g po dose shot of ceftriaxone
Vulvovaginitis inflamation
inflamation or infection of vulva and vagina most commonly caused by bacteria, protozoan and or fungi
Vulvovaginitis - trichomoniasis
bacterial vaginosis, and candidiasisi and are commonly responsible for Volvovaginitis, Only trichomonas (often asymptomatic in men) is considered an STD
vulvovaginitis SX thrichomonas
malodourous, frothy YELLOWISH GREEN DISCHARGE, puritis, vaginal eryhtema, STRABERRY PATCHES, on cervix, and vagina, dysparuenia (pain on sex) dysuria
vulvovaginitis thrichomonas labs and tx
ns mixture shows motile trichomonads
flagyl 2g by mouth single dose then 500mg by outh bid for 7 days
vulvovaginitis bacterial vaginosis sx
FISHY smelling discharge that is watery and grey, vaginal spotting
vulvovaginitis bacterial vaginosis labs and tx
ns mixture shows CLUE cells
flagyl- 2g by mouth single dose, 500mg by mouth bid x7days, 0.75% gel 5g, intravaginally bid for 5 days
clindamycin (cleocin) vaginal cream 2%, 5g intravaginally at bedtime x 7 days , 300mg by by mouth bid for 7 days
vulvovaginitis candidiasis sx
THICK WHITE CURD LIKE DISCHARGE, VULVOVAGINAL ERYTHEMIA WITH PURITIS
vulvovaginitis candidiasis treatment and labs
miconazole (mono-stat) or clotrimazle, (gyne-lotrimin 1% 5g intravaginally at bedtime for 7 days
terconazole suppository
butaconazole
azole things
chancroid definition
hemophilus ducreyi- a gram negative bacillus
chancroid pearls
endemic in many areas in the US, must be a part of the differential dx for genital ulcers
well established co factor for HIV transmission (high rate of HIV for individuals presenting with chancroid
estimated up to 10% of patients are also infected with syphilis and HSV
chancroid s and s
women -asymptomatic
men- single or multiple superficial, PAINFUL ulcers, surrounded by erythematous halo
ulcers may be necrotic or severely erosive
chancroid diagnosis
diagnosis is usually by exclusion
involves genitals and unilateral bubo or both
painful genital ulcers in the absence of T pallidum and HSV (by inspection or culture)
sensitivity
degree to which those who have disease test positive
specificity
degree to which those who DO NOT have the disease test negative
chancre treatment
Zithromax 1gpo or
rocephin 250mg IM or
cipro 500mg po for tthree days
herpes definition
a recurrent viral STD with no cure associated with painful genital lesions
herpes type 1
infection of face lips and oral mucosa
herpes type 2
genitals type two is down near where u poo
herpes transmission
direct contact with active lelsions or by virus containing fluid saliv or cervical secretions
herpes sx initial vs recurrent
fever, malaise, dysuria, prutic ulcers for usually 12 days
Recurrent: less painfull pruritic ulcers for up to 5 days
herpes labs and diagnostics
papanicolaou or tzanc stain
most definitive test is viral culture
herpes management
no cure
symptomatic treatment with drying or anti itch
acyclovir Zovirax recommended for topical oral and IV use
famciclovir
valciclovir-
herpes drug most useful for asymptomatic viral shedding of hsv2
valacyclovir
