STD's Flashcards
gonorrhea, chlamydia, vaginitis, syphilis, HIV/AIDS, genital herpes, genital warts, chancroid, granuloma inguinale, molloscum contagiosum, and pubic lice are all ___.
STD’s
STI screening for chlamydia and gonorrhea:
trichomonas:
HSV, syphilis:
HIV, hepatitis:
cervical culture
vaginal swab
lesion swab
serologic
Chlamydia is an obligate intracellular bacteria w/a gram-___ cell wall. ___ are highest risk group.
negative, adolescents
Consider ___ ___ if STD’s found in young children.
sexual abuse
The pathogens C. pneumoniae, C. psittaci, and C. trachomatis can all cause ___.
pneumonia
Usual agents that cause cervicitis include ___ and ___.
chlamydia, gonococcus
There is testicular inflammation and scrotal pain in ___.
epididymitis
A torsion requires emergency ___.
surgery
First-line tx for chlamydia is:
Azithromycin - single dose OR doxycycline 100mg BID x 7 days
Lymphogranuloma venereum is a ___ infection that presents with multiple, enlarged, matted, tender ___ lymph nodes and may produce a ___. DOC is ___.
chlamydia, inguinal, doxycycline
Chlamydia conjunctivitis shows up ___-___ days after birth. Gonococcal conjunctivitis shows up ___-___ days after birth. HSV conjunctivitis shows up in first ___ days after birth.
7-14, 2-4, 14
Chlamydia conjunctivitis is tx’ed w/:
Erythromycin topical AND erythromycin oral
Chlamydia education after being dx’ed: no intercourse for ___ days after completion of azithromycin, no intercourse until ___ has been tx’ed, repeat testing ___ wks after Rx for pregnant women, all women should have repeat testing ___-___ months post-infection.
7, partner, 3, 3-4
Presentation of gonorrhea in men:
in women:
urethritis (symptomatic), epididymitis
cervicitis (asymptomatic), urethritis, PID, perihepatitis, accessory gland inf
Presentation of chlamydia in men:
in women:
urethritis, epididymitis, Reiter’s syndrome
cervicitis, urethritis, PID, perhepatitis
Pregnant women w/STD’s should not be tx’ed w/___ or ___.
quinolones, tetracyclines
Gonorrhea education includes: no sex until ___ is completed and symptoms have ___, treat the pt’s ___, follow up for repeat testing in ___ months.
therapy/antibx, resolved, partner, 3
___ usually presents w/discharge, irritation, and odor. It is NOT an ___. ___ ___ is the most common cause of vaginitis.
Vaginitis, STD, bacterial vaginosis
With vaginitis, a speculum exam is important to r/o ___ as the source of discharge.
cervicitis
DOC for bacterial vaginosis is: ___. Alternative is ___.
metronidazole, clindamycin
___ in women has risk for premature rupture of membranes, preterm delivery, and low birthwt. Can cause ___ in women.
Trichomonas, vaginitis
DOC for trichomonas is ___. ___ should be avoided d/t antabuse.
metronidazole 2 gms single dose or 500mg BID x 7 days, alcohol
Trichomonas should be tested for other ___. It is almost always ___ transmitted. It is associated w/increased susceptibility to ___. ___ should be tested as well.
STD’s, sexually, HIV, partners
Candidiasis is not considered to be an ___. Typically caused by ___. Appears as thick, white, and clumpy like ___-___.
STD, antibx, cottage-cheese
Candidiasis DOC is: ___. Contraindicated in ___ women. Maintain vaginal flora and avoid ___ b/c it can alter vaginal flora and makes it more prone for infection.
fluconazole, pregnant, douching
Differential btwn BV, candidiasis, and trichomoniasis is based on ___.
microscopy
Normal pH is ___-___. In BV and trichonomoniasis, it is ___ 4.5, and in candidiasis, it is ___ 4.5
3.8-4.2, >, <
___ ___ has been associated w/pregnancy complications, HIV, and PID.
Bacterial vaginosis
You need 3 of the 4 diagnostic criteria for Dx of BV: ___ homogenous discharge, pH > ___, + ___ test, > 20% clue cells on ___.
gray, 4.5, whiff, microscopy
___ partners of pt’s w/BV do not need to be tx’ed, but ___ partners should.
male, female
S/E of metronidazole include: severe ___ if consume ___ while taking it (aka ___), sharp ___ taste, ___ urine.
vomiting, alcohol, antabuse, metallic, dark
Meds that can cause candida/yeast infections:
antibx, corticosteroids, pregnancy, diabetes, HIV disease
Dx for candida is not by ___, but by visualization through ___.
culture, microscopy
___ should not be used during pregnancy or lactation d/t it being a category ___.
Metronidazole, C
The 3 etiologies for vaginitis include:
bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis
Partners should be tx’ed for ___.
trichomoniasis
___ syphilis present w/ulcer or chancre that is usually ___ and heals w/in ___.
primary, painless, wks
Chancroid is an ulcer that is ___ and has tender ___. Tx is w/___.
painful, lymphadenopathy, azithromycin
___ syphilis presents w/HA, fever, malaise, ___ on palms and soles, and involves the ___ and ___ organs.
secondary, rash, kidney, liver
___ syphilis presents w/___-like lesions. Involves ___ and ___ systems. Can show up ___ later.
tertiary, rubbery, neuro, cardio, decades
DOC for primary, secondary, and early latent syphilis is ___. If allergic to PCN, then ___ or ___.
Benzathine PCN G, doxycycline, tetracycline
If syphilis is tx’ed w/PCN, a common reaction is ___. Occurs when a large amt of ___ die and release their cell walls in the ___. Tx for it is ___.
Jarisch-Herxheimer, bacteria, bloodstream, antipyretics
Want to evaluate pt’s w/syphilis for ___. Return for follow-up serology at ___ and ___ months or every ___ months if HIV +.
HIV, 6, 12, 3
HSV-1: HSV-2: HSV-3: HSV-4: HSV-5: HSV-6: HSV-7: HSV-8:
stomatitis/herpes labialis
genital herpes
varicella-zoster
Epstein-Barr (EBV)
cytomegalovirus (CMV)
exanthem subitum ("roseola")
works in tandem w/HHV-6
Kaposi'e sarcomaHSV-1 and HSV-2 can cause ___ ___ ___. The predominant one is ___.
genital herpes simplex, HSV-2
Herpes simplex virus (aka ___ ___) appears ___-___ days after exposure and resolves over ___-___ wks. Dx is w/ ___ of lesion. Tx is w/ ___, as well as ___ for pain.
genital herpes, 3-7, 1-2, culture, acyclovir, analgesics
When collecting a culture, can only collect from ___ lesions, not ___ lesions.
open/erupted, crusted-over
True or False: tx recurrent episodes the same as primary/initial episodes.
true
The 3 medications for tx of HSV/genital herpes include:
acyclovir, valacyclovir, famciclovir
___ therapy reduces the frequency of genital herpes by 70-80% and is taken ___ to prevent breakouts.
Suppressive, daily
Women w/out S/S of genital herpes can give birth ___. Women w/recurrent breakouts must have ___ birth.
vaginally, abdominal
HSV can be transmitted to a partner during ___ periods b/c viral shedding can still occur.
asymptomatic
___ is arguably the most common STD. Majority of sexually active adults acquire ___ at some point in their lives.
HPV, HPV
Tx for condyloma acuminata (aka ___ ___) include:
genital warts, cryotherapy, laser, sharp excision, topical cream (imiquimod, trichcloroacetic acid, podphyllum)
Genital warts Dx is usually made by ___.
visualization
Pt-applied topical Rx for genital warts/HPV include:
podofilox (Condylox), imiquimod (Aldara)
Cryotherapy is ___ administered.
provider
Follow up for ___ is not mandatory and is not ___.
HPV, reportable
Vaccines for HPV include: ___ and ___. Cervarix only tx’s ___ ___, whereas gardasil tx’s both ___ ___ and ___ CA. Recommended for females ages ___-___ and males ages ___-___.
Cervarix and Gardasil, cervical cancer, genital warts, cervical, 13-26, 9-26
Higher risk for cervical cancer is HPV types ___ and ___. Lower risk for cervical cancer and genital warts is present in HPV types ___ and ___.
16, 18, 6, 11
___ includes gonorrhea and chlamydia.
Cervicitis
Chancre refers to ___. Chancroid refers to etiology of ___
syphilis, H. ducreyi
___ presents w/friable, red, inflamed cervix and ___ discharge.
Cervicitis, mucoid
Obligated to perform ___ exam if pt having discharge.
pelvic
___ is DOC for uncomplicated gonorrhea tx. Unless ___ infection is r/o, CDC recommends co-tx for both since one usually accompanies the other.
Ceftriaxone, chlamydial
___ ___ has a “fish” odor. This and ___ have odorous discharge.
Bacterial vaginosis, trichomonias
___ ___ is an anaerobic bacterial overgrowth and is the most common cause of vaginitis. Not considered an ___.
Bacterial vaginosis, STD
Intravaginal metronidazole is ineffective in the tx of ___.
trichomonas
Nontreponemal and treponemal are serology tests used to dx ___. Look at ___ and ___.
syphilis, VDRL, RPR
Reactivation of genital herpes simplex could include:
trauma, fever, ultra-violet light, stress
___ is the first-line tx for condyloma acuminata (aka ___ ___)
trichcloroacetic acid (TCA)
With tx of imiquimod, wash w/soap and water ___-___ hrs after application.
6-10
The quadrivalent HPV vaccine (___) is used in males aged 9-26
Gardasil
