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Micro > STD and Related > Flashcards

STD and Related Flashcards

1
Q

It is a predisposing factor in salpingitis, PID, abortion, PTL, PPROM, chorioamnionitis

A

Bacterial vaginosis

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2
Q

Disease that can cause ishy, foul-smelling discharge with pooling at the posterior fornix

A

Bacterial vaginosis

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3
Q

Physiologic ovulation

A
  • Thin,
  • clear,
  • mucoid,
  • stretchable
  • stringy
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4
Q

Physiologic discharge before menstruation

A

thick, whitish, viscous

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5
Q

Vulvar erythema, edema, excoriations, abnormal color, amount and consistency type of discharge

A

Pathologic

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6
Q

Diagnosis of Bacterial vaginosis

A

AMSEL Criteria

Gram Stain

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7
Q

Gold standard for Diagnosing Bacterial vaginosis

A

Gram Stain

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8
Q

Yellow green, purulent frothy, may have vaginal erythema, strawberry cervix with a high pH and + of Trichomoniads

A

Trichomoniasis

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9
Q 
Diagnosis:
Thin, whitish discharge
Amine: +
Clue cells: +
Mycelia: -
pH: 6
Trichomoniads: -
A

Bacterial vaginosis

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10
Q 
Diagnosis:
White, floccular, milky, creamy discharge
Amine: -
Clue cells: -
Mycelia: -
pH: 4
Trichomoniads: -
A

Normal

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11
Q 
Diagnosis
Thick, whitish, curdy cheesy attached to vaginal wall discharge
Amine: -
Clue cells: -
Mycelia: +
pH: 3
Trichomoniads: -
A

Candidiasis

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12
Q

Cause of musty smell or the pH of Bacterial vaginosis

A

Anaerobes produce aminopeptidases and decarboxylases that degrade CHON and A Atoamines increasing pH

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13
Q

NUGENT Scoring System in Gram Stain

0-3:
4-6:
7-10:

A

0-3: predominantly lactobacilli (normal flora)
4-6: intermediate flora w/ gradual disappearance of LB
7-10: flora other than LB(BV)

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14
Q

Treatment fo BV for Pregnant

A

Metronidazole 500mgBIDx7days
Metronidazole 250mgTIDx7days
Clindamycin 300mgBIDx7days

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15
Q

Management/ Tx of Sexual partner in BV

A

Not recommended

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16
Q

Can vulvo vaginal candidiasis acquire thru sexual contact

A

No

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17
Q

Risk factor of VULVO VAGINAL CANDIDIASIS

A
  • Pregnancy
  • DM
  • antibiotic/immunosuppressive Tx
  • OCPs
  • Obesity
  • tight clothing
  • hyperhidrosis
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18
Q

Ssx of VULVO VAGINAL CANDIDIASIS

A
  • pruritus,
  • erythema,
  • edema,
  • excoriation,
  • tenderness
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19
Q

Diagnosis of VULVO VAGINAL CANDIDIASIS

A

WET MOUNT with 10%KOH or NSS: mycelia/pseudo hyphae

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20
Q

Management for VULVO VAGINAL CANDIDIASIS

A 
Miconazole100mg vagsup OD x7days
Miconazole200mg vagsup ODx3days
Miconazole1200mgvagsup SD
Terconazole80mgvagsupODx3days
Fluconazole150mgPOSD
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21
Q

Management for Pregnant and Sex partner for Volvu vaginal Candidiasis

A
  • only topicalazoles x7days

* not recommended for sexual partner

22
Q

Causative agent of TRICHOMONIASIS

A

T. vaginalis

23
Q

Classified as STI so further evaluation for other STIs is important

A

TRICHOMONIASIS

24
Q

Anaerobic protozoan parasite, proliferates during menstruation and frequently associated with leukocytosis

A

T. vaginalis

25
Q

Ssx in TRICHOMONIASIS infection

A
  • dysuria,
  • urinary frequency,
  • vaginal pruritus,
  • dyspareunia,
  • offensive odor,
  • low back pain,
  • urethral discharge,
  • involvement of Bartholin and Skene’s glands
26
Q

mc dx test employed in TRICHOMONIASIS

A

Wet mount mx

27
Q

Most specific and sensitive test for TRICHOMONIASIS

A

Nucleic acid amplification test (NAAT)

28
Q

Management for TRICHOMONIASIS and for sexual partner

A

• Metronidazole or Tinidazole 2g POSD
Alternative: Metronidazole 500mg BIDx7days

• recommended

29
Q

Associated of TRICHOMONIASIS in Pregnancy and Lactation

A
  • Preterm premature rupture of the membranes (PPROM)
  • Pulmonary tuberculosis (PTB)
  • low BW (birth weight)
30
Q

Treatment for TRICHOMONIASIS in Pregnancy and Lactation

A

Metronidazole (CatB) no longer restricted in 2nd and 3rd trimester
Tinidazole (CatC) no safety profile established

Breast feeding withheld during treatment up to 24hrs (metronidazole SD), 3days (Tinidazole) after last dose

31
Q

Flushing, throbbing in head and neck, headache, breathing difficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitations, tachycardia, hypotension, syncope, uneasiness, weakness, vertigo, confusion upon alcohol intake while ongoing treatment with Metronidazole and Tinidazole up to 1 and 3 days, respectively.

A

Disulfiram reaction

32
Q

2nd mc bacterial STI which cause by N. gonorrheae

A

GONOCOCCAL INFECTION

33
Q

Incubation period of N. gonorrheae

A

3-5 days

34
Q

Ssx of GONOCOCCAL INFECTION

A
  • vaginal discharge,
  • urethral discharge,
  • dysuria,
  • AUB (Abnormal uterine bleeding)
  • pelvic discomfort
35
Q

Hallmark of GONOCOCCAL INFECTION

A

mucopurulent cervicitis

36
Q

Patients must be screened for chlamydia, syphilis and HIV if the patient have GONOCOCCAL INFECTION

A

TRUE

37
Q

Greenish, abudant, thick vaginal discharge

A

GONOCOCCAL INFECTION

38
Q

CLINICAL PRESENTATION of GONOCOCCAL INFECTION

A
  • Raise suspicion: increased leukocytes in endocervical gram stain (>10/hpf) in the absence of trichomoniasis
  • Non-pregnant: may result to urethritis, cervicitis and PID
  • Pregnancy: may result to Gonorrhea ophthalmic neonatorum
39
Q

Mc systemic complication of GONOCOCCAL INFECTION. (Early and Late)

A

Disseminated Gonococcal Infection

Early: migratory arthritis, tenosynovitis, dermatitis

Late: arthritis, perihepatitis, endocarditis, meningitis pericarditis, osteomyelitis

40
Q

Gold Standard in diagnosing GONOCOCCAL INFECTION

A
  • Culture media - Mod Thayer Martin Medium

* Gram Stain- Gram (-) intracellular diplococcici

41
Q

Management for GONOCOCCAL INFECTION

A

• Ceftriaxone250mg IMSD+
• (1g for DGI/conjunctivitis) +
- Azithromycin1g SD or
- Doxycycline 100mg BID Pox 7days

• Ceftriaxone not available: Cefixime 400mg POSD +

  - Azithromycin1gSDor
  - Doxycycline100mg BIDPOx7days
42
Q

Guidelines for mgt: PREGNANT in GONOCOCCAL INFECTION and the sexual partner

A

• Ceftriaxone 250mgIMSD+ Azithromycin1g SD
• Spectinomycin 2gIM
–if can’t tolerate cephalosporins
• Azithromycin 2gPO (if no spectinomycin)

• Management of sexual partner: recommended (preceding 60days)

43
Q

MC sexually transmitted bacterial pathogen

A

CHLAMYDIAL INFECTION

44
Q

Major cause of mucopurulent discharge and its Incubation period: long (1-3weeks)

A

CHLAMYDIAL INFECTION

45
Q

Serotpye of C trachomatis that cause LGV

A

L1, L2, L3

46
Q

Management for VULVO VAGINAL CANDIDIASIS

A 
Miconazole100mg vagsup OD x7days (Daily)
Miconazole200mg vagsup ODx3days
Miconazole1200mg vagsup SD
Terconazole80mg vagsup ODx3days
Fluconazole150mg POSD
47
Q

Diagnosis of CHLAMYDIAL INFECTION

A

• Endocervical discharge: yellow/green mucus
~ >10pmn/OIF of gram stain
~ friable, erythematous, edematous, cervical ectopy

  • Associated with sterile pyuria (no bacteriuria)
  • Ascending infection is common:
    • Acute Salpingitis (mc complication)
    • FitzHugh Curtis Syndrome
48
Q

Gold std in diagnosing CHLAMYDIAL INFECTION

A

NAAT

49
Q

Management for CHLAMYDIAL INFECTION and sexual partner

A

Azithromycin 1g POSD
Doxycycline 100mg POBIDx7days

Management of sexual partner: recommended with abstinence for 7days post treatment

50
Q

Management for CHLAMYDIAL INFECTION for pregnant

A

Azithromycin 1gPOSD

Amoxicillin 500mg POTIDx 7days

Micro (17 decks)

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