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Q4 Women's Health > STD (lec 1) > Flashcards

STD (lec 1) Flashcards

1
Q

Vulvovaginal Candidiasis (VVC) is?

A 
yeast infec (Not STD)
(U) c. albacans
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2
Q

VVC presentation?

A

itching, burning
dyspareunia (painful sex)
thick, white d/c

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3
Q

VVC diagnostics?

A

Wet prep = buds/hyphae

Cx = candida

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4
Q

VVC tx?

A

Uncomplicated:
1-3 d topical azole

Complicated (≥4/yr, non-albican, DM, immuncomp):
7-14 d topical or
oral fluconazole

**if non-albicans, NO fluconazole (choose other azole)

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5
Q

VVC tx men?

Recurrent/difficult?

Preggos?

A

Not neces u/l blanitis

eval for DM, HIV

topical only

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6
Q

Bacterial Vaginosis (BV) is?

A

disruption in N flora, Not STD

(U) gard. vaginalis/mobiluncus G-var anaerobes

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7
Q

BV presentation?

Risks?

A

fishy, gray d/c

(P) ↑ risk HIV, HSV, gonor, chlam

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8
Q

BV diagnostics?

A 
Amsel's (3 of 4):
thin/white d/c
clue cells
vag pH >4.5
fishy KOH

Gram Stain = anaerobes and ↓ lactobacilli

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9
Q

BV tx?

A

Tx all symptomatic pts:
DOC: Oral Metro 7d (avoid etoh)
or Topical Metro 5d
or Clindamycin

**Preggos use ORAL!

No partner tx

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10
Q

Trichomoniasis caused by?

Presentation?

A

t. vaginalis

vag pH > 4.5
irrit, odor, yellow-green froth
petechiae cervix/vagina

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11
Q

Trichomoniasis diagnostics?

In men?

A

Wet mount = motile protoz
Nuc Acid Amp test (NAAT), esp for male

Difficult
5-20% of non-gon urethritis is trich

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12
Q

Trichomoniasis tx?

A

Treat pt and partners:
Oral Metro
No sex until well

Preggos -> tx if sxs

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13
Q

Trichomoniasis complications?

A

↑ risk HIV
Preggos -> preterms (tx doesn’t reduce risk)
No breast feeding during tx

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14
Q

Chlamydia (CT) screening?

A

yearly for under 26 yo or high risk
all preggos

frequent co-inf w/ gonorr

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15
Q

CT presentation?

A

(C) asympt
oral or rectal also P

Women:
CERVIX d/c, bleeding, low abd pain, fever/chills

Men:
urethritis, d/c, dysuria

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16
Q

CT diagnostics?

A 
NAAT:
Swab
Urine
Pap
Pharynx/rectal
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17
Q

CT tx?

A

Treat all pts/partners:
Doxy 7d or Azith 1d
No sex for at least 7d
Retest 3-4 mo

Preggos:
NO doxy
Retest 3 wks post tx

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18
Q

CT complications?

A

↑ risk HIV
PID
Epididy

Preterms
Neonate eye inf/PNA

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19
Q

Gonorrhea (GC) screening?

A 
at risk (prior inf, > partners, sex workers)
(C) co-inf w/ CT
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20
Q

GC sxs?

Diag?

A

like CT, more severe

like CT

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21
Q

GC tx?

A

Treat all pts/partners:
ceftriaxone IM + azith or doxy
No sex
Retest 3-4 mo

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22
Q

GC complications?

A

same as CT

Neonate also meningitis, endocard

23
Q

Non-gono Urethritis (NGU) caused by?

A

anything other than gonorr

(U) chlamy

24
Q

NGU diagnostics?

Tx?

A

test for GC/CT

azith or doxy

25
Q

PID is?

A

inflamm disorders of up genital tract
(U) from STDs (ascending infection)
(P) h. flu

26
Q

PID presentation?

A

Acute:
d/c, low abd pain, cervical motion tenderness, fever

Chronic:
from insuff tx
vague sxs

27
Q

PID risk factors?

A 
< 25 yo
blacks
x partners
IUD
prior PID
28
Q

PID diagnostics?

A

Serum quant HCG (pregnancy)
GC/CT
WBCs in vag fluid
CBC, ESR, CRP

US -> r/o ectopic, abscess

29
Q

PID tx?

F/U?

A

Emphiric while waiting for tests

Outpt:
Ceftri IM +
Doxy 14d +
Metro 14d

Inpt:
IV

48 hr f/u

30
Q

PID hospitalize when? (5)

A 
can't r/o ectopic, append, etc
preggos
no abx response 48 hrs
tubo-ovarian cysts
looks ill
31
Q

Fitz-Hugh-Curtis is?

A

(P) complication of PID

perihepatitis w/ RUQ pain/adhesions

32
Q

HSV diagnostics?

A 
Swab cx (standard):
P false +, requires lesion

Ab serology:
Ab not present until 3 wks post
+ result not definitive for genital herp

33
Q

HSV tx?

A

clovirs
Initial outbreak 7-10d
Recurrent 1-5d
Suppression daily

34
Q

Neonatal HSV syndromes? (3)

A

1) Skin/Eye/Mouth (localized)
2) CNS (long-term morbidity)
3) Disseminated (organ involv)

35
Q

Neonate HSV prevention?

A

Supression @ 36 wks for active/recurrent

C-section for active or prodrome

36
Q

HPV diagnostics?

A

Visible warts
Pap smear
No test for men

37
Q

HPV tx?

A

treat dzs caused by HPV, no cure

Destruction:
LN2, TCA
Podofilox
Imiquimod

Vaccine:
Cervarix (girls)
Gardasil (girls/boys)

38
Q

HPV complications?

A

CA, esp cervical (U) types 16/18

rare transmission to neonate

39
Q

Syphillis caused by?

At risk?

A

trep. pallidum
direct contact w/ lesion

(U) M 20-29yo

40
Q

°Syphilis presents?

A

painless chancre 4-6 wks

41
Q

2° Syphilis presents?

A

U 2-6 wks

No itch rash (U) includes palms/soles

Condyloma lata (moist warts)
(U) intertriginous areas
CONTAGIOUS

Mucous patches, not painful
mouth/genitals
CONTAGIOUS

Malaise, LAD

42
Q

Latent Syphilis?

A

asympt
not transmittable
can last yrs

43
Q

Late Syphilis?

A

yrs post infection

Neurosyphilis

44
Q

Syphilis diagnostics?

A

Darkfield for chancre
Rapid Plasma Reagin -> titer = dz (confirm w/ FTA-ABS Ab test)

Neurosyphilis:
Lumbar punct -> VDRL test

45
Q

Syphilis tx?

A

Treat all pts/partners:
Benazthine PCN-G IM single dose unless had dz for > 1 yr, then multi dose

Oral Doxy for PCN allergy

Confirm clearance w/ RPR titer 3, 6, 12, 24 mo
(4 x DECREASE = cleared)

46
Q

Syphilis in preggos:

Complications? (4)

Screen?

A

stillbirths
deafness
neuro defects
bone deformities

screen at 1st visit
high risk again 28 wks and delivery

Close serology monitoring

47
Q

Chancroid caused by?

Presentation?

A

h. ducreyi

Painful genital ulcer
Foul, contagious d/c
Inguinal adenitis/Buboes

48
Q

Chancroid diagnostics?

A

r/o syphilis

report to county health

49
Q

Lymphogranuloma Venereum (LGV) caused by?

Most at risk?

A

chlamydia trachomatis

MSM

50
Q

LGV presentation? (5)

A 
Systemic infection,
Unilateral inguinal bubo (swollen node),
Self-limit ulcer/papule
Anal d/c or bleeding,
Groove sign
51
Q

LGV diagnostics?

A

r/o syphilis

report

52
Q

Pediculosis Pubis tx?

A

Treat pt/partner:

permethrin 1% crm

53
Q

STD screening for Pregnancy?

A

1st visit:
HIV, syphilis, Hep B, GC/CT
Hep C if risk
Hx for HSV

Q4 Women's Health (20 decks)

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