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Women's Health > STDs 1 > Flashcards

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
Q

All patients diagnosed with lymphogranuloma venereum should be tested for _____

A

other STIs, including HIV

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26
Q

What organism causes syphilis?

A

Tremponema pallidum (sphirochete)

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27
Q

What is late latent syphilis?

A

Reactive testing > 1 year after onset of infection
OR
Timing cannot be determined
* No symptoms

28
Q

What is early latent syphilis?

A

Reactive testing within 1 year of infection - no symptoms

29
Q

What is the gold standard of Syphilis testing?

A

Darkfield examination of exudate tissue

30
Q

What are the serologic tests for syphilis?

A

-Nontreponemal (RPR, VDRL)
-Treponemal (FTA-AB and TP-PT)

31
Q

Which syphilis tests fade over time and which stay?

A

RPR, VDRL, fade
FTA-AB and TP-PA stay positive

32
Q

How is syphilis transmitted?

A

-Direct contact of mucocutaneous lesion (including sexual activity)
-Maternal-fetal via the placenta

33
Q

How long does syphilis incubate?

A

10-90 days, (3 weeks average)

34
Q

How does syphilis spread in the body?

A

Enters and forms chancre at inoculation site, then travels via lymph nodes

35
Q

What is primary syphilis?

A

-A chancre (painless ulcer) at or near the ulceration site with raised indurated edges
-Nontender, regional LAD near the chancre

36
Q

How long does the chancre usually last in primary syphilis?

A

3-4 weeks

37
Q

How long does the LAD usually last in primary syphilis?

A

3-4 weeks

38
Q

When does secondary syphilis present?

A

A few weeks to six months after infection (usually 2-8 weeks after chancre)

39
Q

What are the possible presentations of secondary syphilis?

A

-Maculopapular rash
-Condyloma lata
-Mucous patches
-Systemic symptoms

40
Q

Where does the rash of secondary syphilis primarily present?

A

Does not spare palms and soles

41
Q

What is the classic presentation of a secondary syphilis rash?

A

Diffuse bilateral maculopapular lesions

42
Q

Secondary syphilis lesions may be _____ in some patients

A

Pustular

43
Q

Condyloma ____ is a presentation of secondary syphilis

A

Lata

44
Q

____ lata is a presentation of secondary syphilis

A

Condyloma

45
Q

Condyloma lata is a presentation of _____

A

secondary syphilis

46
Q

_______ are wart-like, moist lesions involving the mucous membranes and other moist areas in secondary syphilis

A

Condyloma lata

47
Q

Condyloma lata are ____-like, moist lesions involving the mucous membranes and other moist areas in secondary syphilis

A

wart

48
Q

Condyloma lata are wart-like, ____lesions involving the mucous membranes and other moist areas in secondary syphilis

A

moist

49
Q

Condyloma lata are wart-like, moist lesions involving the ____ and other moist areas in secondary syphilis.

A

mucous membranes

50
Q

Condyloma lata are wart-like, moist lesions involving the mucous membranes and other ___ in secondary syphilis

A

moist areas

51
Q

Condyloma lata are wart-like, moist lesions involving the mucous membranes and other moist areas in ____

A

secondary syphilis

52
Q

What systemic symptoms may present in secondary syphilis?

A

-Fever
-LAD
-Arthritis
-Meningitis
-HA
-Alopecia

53
Q

What abdominal organ may be affected by secondary syphilis?

A

Liver (hepatitis, elevated Alk phos)

54
Q

Tertiary syphilis may present with what two things?

A

-Gumma
-Cardiovascular syphilis

55
Q

______ are noncancerous granulomas on skin and body tissue in tertiary syphilis

A

Gumma

56
Q

What is the treatment for tertiary syphilis?

A

Pen G 2.4 million units IM x 3 weeks (Bicillin)

57
Q

In _______, tabes dorsalis is the demylenation of posterior columns leading to ataxia, areflexia, burning pain and weakness

A

neurosyphilis

58
Q

In neurosyphilis, ________ is the demylenation of posterior columns leading to ataxia, areflexia, burning pain and weakness

A

tabes dorsalis

59
Q

In neurosyphilis, tabes dorsalis is the ________ leading to ataxia, areflexia, burning pain and weakness

A

demylenation of posterior columns

60
Q

In neurosyphilis, tabes dorsalis is the demylenation of posterior columns leading to ____, _____ burning pain and weakness

A

ataxia, areflexia

61
Q

In neurosyphilis, tabes dorsalis is the demylenation of posterior columns leading to ataxia, areflexia, _____ and _____

A

burning pain and weakness

62
Q

What is Argyll-Robertson pupil a sign of?

A

Neurosyphilis

63
Q

What is Argyll-Robertson pupil?

A

Small irregular pupil that constricts with accommodation but is not reactive to light

64
Q

What is the Jarish-Herxheimer reaction?

A

Acute febrile reaction with HA and myalgia to abx treatment in sphirochete reaction

65
Q

What can be used for syphilis treatment in penicillin allergies?

A

Doxycycline or Ceftriaxone

66
Q

How should syphilis be addressed in pregnancy?

A

-Screen at first prenatal visit, repeat 3rd trimester for high risk or high prevalence areas
-Treat for appropriate stage

67
Q

What does congenital syphilis cause?

A

-40% stillborn or die
-Nerve damage: vision and hearing

Women's Health (13 decks)

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