STD Cases Flashcards
Dx of HSV
clinical dx, but should be __
sensitivity declines as ___
Standard: __ or __
culture often __ bc low ___
PCR of HSV DNA usually more ___
Tzank smear: visualize multinucleated __ or ___ inclusion bodies
__ causes most cases of recurrent genital herpes in US
confirmed
lesions heal
culture/PCR
false neg, sensitivity
more sensitive
giant cells, Cowdry intranuclear
HSV 2
Most people w __ are asx. and do not ___
thus, __ is occurring
can test for __ or __ to type specific ___
IgM appears w/in __, gone __m after active infection
IgG appears after ___m
remains __
can use these to confirm dx if ___ negative or dx partner w ___
individuals will be __- and __ +
HSV, manifest sx
viral shedding
IgM, IgG, glycoprotein
wk, 3-6m
1-3m
indefinitely
viral culture, unrecognized infection
IgM-, IgG+
HSV Primary tx \_\_\_ E\_\_\_ Suppressive > \_\_ episodes a yr or \_\_\_ dec \_\_ and \_\_\_
Nucleoside analogs include A, F, V
all
episodic
6, distress
viral shedding, recurrence
acyclovir, famciclovir, valcyclovir
2 strategies
Episodic if < __ per yr
Suppressive if > __ per yr
Disseminated/severe tx w
6
6
IV acyclovir
Dx HPV
standard __ or __
can be on G, A, M, U, C
___ adequate for dx
Biopsy needed if __, doesnt respond to ___, aytpical sx (P, B, U) or if pt is ____
Spread via __ to __ contact
can lead to __ and __ and __ cancer
type __ and __ mc
genital wrts w type __/__
Oncogenic potential is __
excision/biopsy
genitals, anus, meatus, urethra, cervix
gross appearance
unclear, therapy, pigmented/bleeding/ulcerated, IC
skin to skin
cerical, penile, anal
16, 18
6, 11
low
Tx HPV
if untreated, may resolve __ or remain __ in size/number
primary goal is ___
__ may persist even on skin w/out lesions
__ does not dec infectivity/transmission
Topical tx w P, I, S
C
L
S or __
spontaneously, unchanged
remove visible warts
viral infection
elimination
podoflox, imiquimod, sinecatechins
cryotherapy
laser ablation
surgical excision, electrosurgery
___ may dec HPV transmission, but only __
Gardasil (quadrivalent) types
Cervarix (bivalent) types
___ HPV is inc, leading to ___ cancers
condoms, area covered
- 11, 16, 18
16, 18
laryngeal, head/neck
Primary syphillis presentation
secondary syphillis presentation
tertiary presentation
Latent has __ w/out evidence of dz
early is w/in ___
late is __ or > ___
Neurosyph
TD leads to __ and __
AR pupil: pupil __ but does not __
painless ulcer/chancre
skin rash
cardiac/optho/auditory
seroreactivity
1 yr
unknown, 1yr
impaired vibration/proprioception
accomodates, react
Definitive Syph dx
__ or __ for DFA
___ on darkfield micro
Serologic tests
Non treponemal w __ and __
Treponemal w ___ or __
Primary tx w/out allergies, dose
PCN allergy and not pregnant, tx w ___ or ___, dose
Pregnant: __ to PCN and give
Secondary, early latent tx __
Late latent& no allergies tx w ___
PCN allergy
tissue/exudate
spirochetes
VDRL, RPR
FTA-ABS, TP-PA
Penicillin G (1x IM) doxycycline (BIDx 28d) or tetracycline (QID x 28d) desensitize
same
PenG IM x 3
same as primary
Tertiary syphillis w/out neurosyph tx same as ___
Neurosyph & no allergies, tx w ___ (IV q4H x 10-14d)
PCN allergy tx w ___ daily x 10-14days and __
Jarisch herxheimer rxn occurs w __ and __ and __ sx
late latent
PenG IV
Rocephin, desensitize
low grade fever, muscle aches, HA
Ulcerative lesion Painful think (2)
non painful (3)
Lymphogranuloma venereum
Small ___ on penis
Enalrged ___
____ nodes w/in inguinal ligament
comps __ and ___
ultimately caused by
HSV, chancroid
Syphillis, granuloma inguinale, lymphogranuloma venereum
painless papule
LN
groove sign
rectal fistula, strictures
Clamydia trachomantis
PID Pt may also present w RUQ pain because of ___ syndrome
result of __ inflamm, involvng the __ and not ___ of liver
__ are normal
look for __ on laparoscopy
Fitz High curtis
perihepatic, capsule, parenchyma
LFTs
violin sign
