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STDs 1 Flashcards

1
Q

What is the most common bacterial cause of STDs in the US?

A

Chlamydia

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2
Q

What are the possible manifestations of chlamydia? (4)

A
  1. Urethritis
  2. PID
  3. Reactive arthritis
  4. Lymphogranuloma venereum
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3
Q

What are signs of chlamydia urethritis?

A

Discharge
Pruritis
Dysuria
Dyspareunia

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4
Q

Up to 40% of patients with chlamydia are _____

A

asymptomatic

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5
Q

What are PE signs of PID?

A

Abdominal tenderness
Cervical motion tenderness

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6
Q

What are possible manifestations of reactive arthritis from chlamydia?

A
  1. Urethritis
  2. Uveitis
  3. Arthritis
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7
Q

What kind of reaction is reactive arthritis?

A

Autoimmune

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8
Q

What mutation causes susceptibility to reactive arthritis?

A

HLA-B27

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9
Q

What testing is preferred for chlamydia?

A

NAAT (swab or urine)

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10
Q

How is chlamydia treated?

A

Azithromycin (1 g x 1 dose)
or
Doxycycline 100 mg bid for 10 days

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11
Q

When should retesting for chlamydia take place after treatment?

A

3 weeks to ensure organism clearance

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12
Q

What should be treated for concurrently with chlamydia tx?

A

Gonorrhea (Ceftriaxone 250 mg IM x 1 dose)

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13
Q

What is lymphogranuloma venereum?

A

A genital ulcer disease cause by chlamydia

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14
Q

What serovars of chlamydia cause lymphogranuloma venereum?

A

L1, L2 and L3

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15
Q

Where in the world is lymphogranuloma venereum most commonly seen?

A

Tropical and subtropical areas

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16
Q

What is the basic pathophys of lymphogranuloma venereum?

A

Infection site drains into lymph nodes

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17
Q

What is the initial clinical presentation of lymphogranuloma venereum?

A

Painless genital ulcer, papule or vesicle

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18
Q

What is the secondary stage of lymphogranuloma venereum?

A

Painful inguinal and/or femoral LAD (buboes) 2-6 weeks after initial ulcer presentation

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19
Q

What may develop secondary to lymphogranuloma venereum?

A

Proctocolitis

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20
Q

What is the presentation of proctocolitis?

A

-Rectal discharge
-Anal pain
-Constipation
-Fever
-Tenesmus

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21
Q

What are buboes?

A

Painful inguinal/femoral lymph nodes

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22
Q

What is the TOC for lymphogranuloma venereum?

A

Doxycycline 100 bid x 21 days

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23
Q

What is the alternative tx for lymphogranuloma venereum?

A

Azithromycin 1g orally weekly x 3 weeks

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24
Q

What may need to be done in tx of lymphogranuloma venereum?

A

Aspiration or I&D of buboes

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25
All patients diagnosed with lymphogranuloma venereum should be tested for _____
other STIs, including HIV
26
What organism causes syphilis?
Tremponema pallidum (sphirochete)
27
What is late latent syphilis?
Reactive testing > 1 year after onset of infection OR Timing cannot be determined * No symptoms
28
What is early latent syphilis?
Reactive testing within 1 year of infection - no symptoms
29
What is the gold standard of Syphilis testing?
Darkfield examination of exudate tissue
30
What are the serologic tests for syphilis?
-Nontreponemal (RPR, VDRL) -Treponemal (FTA-AB and TP-PT)
31
Which syphilis tests fade over time and which stay?
RPR, VDRL, fade FTA-AB and TP-PA stay positive
32
How is syphilis transmitted?
-Direct contact of mucocutaneous lesion (including sexual activity) -Maternal-fetal via the placenta
33
How long does syphilis incubate?
10-90 days, (3 weeks average)
34
How does syphilis spread in the body?
Enters and forms chancre at inoculation site, then travels via lymph nodes
35
What is primary syphilis?
-A chancre (painless ulcer) at or near the ulceration site with raised indurated edges -Nontender, regional LAD near the chancre
36
How long does the chancre usually last in primary syphilis?
3-4 weeks
37
How long does the LAD usually last in primary syphilis?
3-4 weeks
38
When does secondary syphilis present?
A few weeks to six months after infection (usually 2-8 weeks after chancre)
39
What are the possible presentations of secondary syphilis?
-Maculopapular rash -Condyloma lata -Mucous patches -Systemic symptoms
40
Where does the rash of secondary syphilis primarily present?
Does not spare palms and soles
41
What is the classic presentation of a secondary syphilis rash?
Diffuse bilateral maculopapular lesions
42
Secondary syphilis lesions may be _____ in some patients
Pustular
43
Condyloma ____ is a presentation of secondary syphilis
Lata
44
____ lata is a presentation of secondary syphilis
Condyloma
45
Condyloma lata is a presentation of _____
secondary syphilis
46
_______ are wart-like, moist lesions involving the mucous membranes and other moist areas in secondary syphilis
Condyloma lata
47
Condyloma lata are ____-like, moist lesions involving the mucous membranes and other moist areas in secondary syphilis
wart
48
Condyloma lata are wart-like, ____lesions involving the mucous membranes and other moist areas in secondary syphilis
moist
49
Condyloma lata are wart-like, moist lesions involving the ____ and other moist areas in secondary syphilis.
mucous membranes
50
Condyloma lata are wart-like, moist lesions involving the mucous membranes and other ___ in secondary syphilis
moist areas
51
Condyloma lata are wart-like, moist lesions involving the mucous membranes and other moist areas in ____
secondary syphilis
52
What systemic symptoms may present in secondary syphilis?
-Fever -LAD -Arthritis -Meningitis -HA -Alopecia
53
What abdominal organ may be affected by secondary syphilis?
Liver (hepatitis, elevated Alk phos)
54
Tertiary syphilis may present with what two things?
-Gumma -Cardiovascular syphilis
55
______ are noncancerous granulomas on skin and body tissue in tertiary syphilis
Gumma
56
What is the treatment for tertiary syphilis?
Pen G 2.4 million units IM x 3 weeks (Bicillin)
57
In _______, tabes dorsalis is the demylenation of posterior columns leading to ataxia, areflexia, burning pain and weakness
neurosyphilis
58
In neurosyphilis, ________ is the demylenation of posterior columns leading to ataxia, areflexia, burning pain and weakness
tabes dorsalis
59
In neurosyphilis, tabes dorsalis is the ________ leading to ataxia, areflexia, burning pain and weakness
demylenation of posterior columns
60
In neurosyphilis, tabes dorsalis is the demylenation of posterior columns leading to ____, _____ burning pain and weakness
ataxia, areflexia
61
In neurosyphilis, tabes dorsalis is the demylenation of posterior columns leading to ataxia, areflexia, _____ and _____
burning pain and weakness
62
What is Argyll-Robertson pupil a sign of?
Neurosyphilis
63
What is Argyll-Robertson pupil?
Small irregular pupil that constricts with accommodation but is not reactive to light
64
What is the Jarish-Herxheimer reaction?
Acute febrile reaction with HA and myalgia to abx treatment in sphirochete reaction
65
What can be used for syphilis treatment in penicillin allergies?
Doxycycline or Ceftriaxone
66
How should syphilis be addressed in pregnancy?
-Screen at first prenatal visit, repeat 3rd trimester for high risk or high prevalence areas -Treat for appropriate stage
67
What does congenital syphilis cause?
-40% stillborn or die -Nerve damage: vision and hearing

Women's Health (13 decks)

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