STDs Flashcards by Danielle Dilday

What are the five major strategies for the prevention and control of STDs?

Assess risk, educate, and counsel on STDs and recommend prevention
Pre-exposure vaccination
Identification of asymptomatically and symptomatically diseased individuals
Diagnose, treat, counsel, and follow up of infected persons
Evaluate, treat, and counsel partners

These strategies are essential for effective STD management and prevention.

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What does the acronym ‘5 P’s’ in sexual history stand for?

Partners
Practices
Pregnancy Prevention
Protection from STIs
Past history of STIs

The 5 P’s provide a comprehensive framework for obtaining sexual history.

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What are the clinical presentations of Herpes Simplex Virus (HSV)?

Acute primary episode
Non-primary first episode
Recurrent episode

Each presentation has distinct characteristics and symptom severity.

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Which pathogen causes Chancroid?

Haemophilus ducreyi

Chancroid is characterized by painful ulcers and is primarily transmitted through sexual contact.

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What is the most common sexually transmitted infection (STI) in the U.S.?

Human Papilloma Virus (HPV)

HPV has more than 40 types that infect the genital area, with types 16 and 18 being high-risk for cervical cancer.

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What is the incubation period for Chancroid?

3-10 days, up to 14 days

This time frame is important for understanding the timeline of symptoms.

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True or False: Lymphogranuloma Venereum (LGV) starts with a small, painful ulcer.

False

LGV typically begins with a painless ulcer that may go unnoticed.

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What type of discharge is associated with Trichomonas?

Sexually Transmitted Vaginal/Cervical Discharge

Trichomonas is one of the infections that can lead to this type of discharge.

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Fill in the blank: The pathogen responsible for Granuloma Inguinale is _______.

Klebsiella granulomatis

Granuloma Inguinale is characterized by painless nodules that can ulcerate.

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What are the symptoms of Scabies?

Hypersensitivity
Erythematous papules
Linear tracks/excoriations

Scabies symptoms often worsen at night or after bathing.

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What is the clinical diagnosis method for Human Papilloma Virus (HPV) when warts are present?

Inspection; biopsy confirmation if atypical

Biopsy may be needed if the wart does not respond to treatment.

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What is a common complication associated with untreated syphilis?

Neurosyphilis

Neurosyphilis can occur at any stage of syphilis and requires specific testing for diagnosis.

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Fill in the blank: The incubation period for Molluscum Contagiosum is usually _______.

2-3 months (1 week to 6 months)

This variability in incubation period can affect the timing of symptom appearance.

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What is the characteristic feature of a primary syphilis ulcer?

Chancre, non-purulent, smooth edge, indurated, solitary

Primary syphilis typically presents with one chancre that may last up to 6 weeks.

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What are common symptoms of abnormal vaginal discharge?

Color change
Consistency change
Pruritis/irritation
Odor
Erythema
Bleeding
pH change

Abnormal discharge can indicate underlying infections or conditions.

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True or False: Granuloma Inguinale presents with painful ulcers.

False

Granuloma Inguinale typically presents with painless, beefy red ulcers.

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What are common pathogens associated with abnormal vaginal discharge?

lactobacilli
gardnerella vaginalis
candida species
Trichomonas vaginalis
Ureaplasma
Mycoplasma
uncultivated anaerobes

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What are the most frequent causes of abnormal vaginal discharge?

bacterial vaginosis
candidiasis
trichomoniasis

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List the symptoms or signs of abnormal vaginal discharge.

color
consistency
pruritis/irritation
odor
erythema
bleeding
pH change

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Is medical history alone sufficient for diagnosing abnormal vaginal discharge?

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What is the clinical presentation of Bacterial Vaginosis (BV)?

Asymptomatic
Thin, white-gray discharge
Malodorous; ‘fishy’ odor

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What are the Amsel’s criteria for diagnosing Bacterial Vaginosis?

Homogeneous, thin, white-gray discharge that smoothly coats vaginal walls
Clue cells on microscopy
pH > 4.5
Fishy odor of discharge before or after addition of 10% KOH (whiff test)

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What is the gold standard test for diagnosing Bacterial Vaginosis?

Gram stain

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What characterizes the clinical presentation of Candidiasis?

Thick, white discharge
Pruritus
‘External’ dysuria
Vulvar burning pain
No odor

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Is Candidiasis considered a sexually transmitted infection (STI)?

What is the most prevalent non-viral STI?

Trichomonas vaginalis

What is a common clinical presentation of Trichomoniasis?

* Asymptomatic to minimal symptoms * Diffuse, thin, yellow-green discharge * Malodorous * With or without vulvar irritation * 'Frothy'

What test is used for diagnosing Trichomoniasis?

* NAAT * Wet mount + culture (if negative) or other FDA-approved test

What is the pathogen responsible for Chlamydial infections?

Chlamydia trachomatis

What are common symptoms of Chlamydial infections?

* Mucopurulent discharge * Dysuria * Testicular pain (male) * Pelvic or abdominal pain (female)

What is the gold standard test for Chlamydial infections?

Nucleic Acid Amplification Test (NAAT)

What is a common pathogen associated with Gonococcal infections?

Neisseria gonorrhoeae

What symptoms can Gonococcal infections cause in females?

* Abnormal uterine bleeding * Pelvic pain * Bartholin’s/Skene’s abscesses

What is the diagnosis method for Gonococcal infections?

Nucleic Acid Amplification Test (NAAT)

What is the clinical presentation of Disseminated Gonococcal Infections?

* Petechial or pustular acral lesions * Migratory arthritis * Tenosynovitis

What are the recommended screening guidelines for sexually active women under 25 years?

Annually test for GC and CT

What is a key consideration for follow-up after treatment of Chlamydial and Gonococcal infections?

Re-test in 3 months

What is the clinical presentation of Pelvic Inflammatory Disease (PID)?

* Lower abdominal and/or pelvic pain * Dyspareunia * Abnormal vaginal discharge * Fever, chills

What are the CDC minimum criteria for diagnosing PID?

* Pelvic or lower abdominal pain without other known etiology * Cervical Motion Tenderness * Uterine Tenderness * Adnexal Tenderness

What are some risk factors for Pelvic Inflammatory Disease?

* Age < 35 years * Number of sexual partners * New partner * Previous history

What is the transmission route for Hepatitis A?

Fecal-oral route

What is the transmission route for Hepatitis B?

* Wound exudates * Semen * Vaginal secretions * Saliva * Vertical transmission

What is the transmission route for Hepatitis C?

Blood exposure

What are the screening recommendations for HIV?

* Screen all patients aged 13-64 at least once in their lifetime * Screen all pregnant women, regardless of risk

What can produce negative results in a recently infected person regarding HIV?

Rapid HIV tests

What is the recommended frequency for repeat HIV testing for women at risk?

At least annually.

List some groups that should be offered repeat HIV testing.

* IV injection drug users * Exchange sex for money or drugs * Sex partners of HIV-infected persons * Have had sex with MSM since the most recent HIV test * Have had more than one sex partner since the most recent HIV test.

What are the types of tests used for the diagnosis of Human Immunodeficiency Virus (HIV)?

* Rapid HIV tests * Serologic tests detecting antibodies against HIV-1 & HIV-2 * Virologic tests detecting HIV antigens or RNA.

What is the advantage of rapid HIV tests?

Enables clinician to make a preliminary diagnosis of HIV infection within 30 minutes.

True or False: Rapid HIV tests can produce negative results in a recently infected person.

True.

What are the confirmation methods for an HIV diagnosis?

Confirmation by Western blot or other confirmatory test.

What are some healthcare considerations for HIV-infected patients?

* CD4 counts every 3-6 months * Viral load tests every 3-6 months and 1 month following a change in therapy. * PPD testing. * RPR or VDRL for syphilis.

Fill in the blank: For HIV-infected patients, the influenza vaccine should be given _______.

within season.

What is the most likely diagnosis for a sexually active female with lower abdominal pain, abnormal vaginal discharge, and cervical motion tenderness?

Pelvic Inflammatory Disease (PID).

List some symptoms commonly associated with Pelvic Inflammatory Disease (PID).

* Lower abdominal pain * Fever * Abnormal vaginal discharge * Cervical motion tenderness.

What distinguishes ectopic pregnancy from PID in terms of diagnosis?

Ectopic pregnancy is usually associated with a positive pregnancy test.

True or False: Endometriosis typically presents with fever and abnormal vaginal discharge.

False.

What is the common symptomatology of urinary tract infections (UTIs)?

* Dysuria * Frequency * Urgency.

What are some common symptoms of appendicitis?

* Right lower quadrant pain * Fever * Nausea.

What does AUB stand for?

Abnormal Uterine Bleeding.

What does the abbreviation RPR represent?

Rapid Plasma Regain.

Define NAAT.

Nucleic Acid Amplification Test.

What does TOC stand for in the context of medical testing?

Test of Cure.

What is a key aspect of preventing the spread of STIs?

Proper diagnosis, treatment, and follow-up.

Fill in the blank: Proper counseling about _____ to patients and partners helps prevent further manifestations of diseases and infections.

safe sex.

what are the clinical manifestations of an HSV acute primary episode vs. the recurrent episode that comes later

acute: multiple BL lesions & longer duration recurrent: UL lesions & shorter duration

list the clinical presentations of chancroid.

tender, suppurative BL inguinal adenopathy

T or F: chlamydia trachomatis is primarily an infection of the lymph nodes?

true

the "groove sign" is assoc. w/ what?

painful buboes caused by LGV

LGV is assoc. w/ what GI symtpoms

proctocolitis and colorectal fistulas hemorrhagic rectal discharge

T or F: donovanosis or granuloma inguinale is assoc. w/ painful nodules.

false they are painless

describe the morphologic characteristics of granuloma inguinale

beefy, red, velvety ulcers that are highly vascularized pseudobuboes -no regional lymphadenopathy, only swelling of tissues near the area of ulceration

list the different technologies that can be used to Dx syphilis.

rapid plasma reagent dark-field microscopy Direct fluorescent antibody (most definitive test)

list the clinical manifestations of secondary syphilis

maculopapular rash on palms and soles that grow proximally condyloma lata upper respiratory symptoms

what are the clinical features of tertiary symphilis?

tabes dorsalis aortitis argyll robertson pupil gummas (chronic granulomas)

list the components of the DORSALIS acryounm

D: dorsal column degeneration O- orthopedic pain (charcot joints) R - reflexes decreased (deep tendons) S - shooting pain A - Argyll-robertson pupils L - locomotor ataxia I - impaired proprioception S - syphilis

what are the anogenital warts assoc. w/ HPV called?

condyloma acuminatum

what STDs can also be transmitted via fomites?

public lice scabies

what are the symptoms of pediculosis pubis (AKA "crabs")

local pruritus

the painless papules produced by molluscum contagiosum can spread to what regions?

lower abdomen upper thighs buttocks external genitalia

describe the morphologic characteristics of molluscum contagiosum.

wart-like bumps w/ central depression that are shiny & pink in appearance

list the components of the sequelae assoc. w/ molluscum contagiosum.

disseminated eczema secondary bacterial infections conjunctivitis scarring

what is the recommend FU for pts. w/ acute trichomoniasis?

FU within 3 months can re-test 2 weeks after treatment is completed

chlamydial infections are assoc. w/ what neonatal sequelae?

neonatal conjunctivitis AKA: ophthalmia neonatorum pneumonia

T or F: trichomoniasis produces smelly vaginal discharge.

false usually not assoc. w/ an odor

list the gynecologic components of the chlamydial sequelae

endometritis ectopic pregnancy infertility

what are the 1st Abx for chlamydial infections?

doxycycline azithromycin (pregnancy safe & allergy free)

pts. w/ a recent chlamydial infection should be retested how long after treatment?

3 months

gram stains are most appropriate for gonococcal infections of what urogenital components?

urethral secretions (applies to males only)

what type of culture is most appropriate for endocervical, vaginal, rectal, and oral pharyngeal swabs for suspected gonococcal infections

Thayer Martin Chocolate Agar

besides a gram stain, what other stain can be used to diagnose gonococcal infections

methylene blue genitan violet stain

T or F: gonococcal pathogens are intracellular diplococci.

true

list the clinical features of arthritis-dermatitis syndrome assoc. w/ gonococcal infections

triad of dermatitis, tenosynovitis, and migratory polyarthritis hemorrhagic, painful pustules on erythematous bases of palm and finger on opposite hand acral sites

T or F: all pregnant pts. should be screened for chlamydial and gonococcal infections during 3rd trimester of gestation

true

If a pt. is diagnosed w/ GC & CT what additional STDs should they be screened for?

HIV & syphilis

what are additional diagnostic criteria for PID?

oral temperature >101 WBCs on saline microscopy of vaginal fluid elevated ESR elevated CRP

MRI reveals thickened, fluid-filled tubes without free pelvic fluid. What is the dx?

PID

list the criteria for PID hospitalization

surgical emergency no response to oral ABx ineffective outpatient treatment high fever N/V tubo-ovarian abscess pregnancy

T or F: serologic HIV testing has high sensitivity but low specificity.

false it is highly sensitive and specific

what additional screenings should all pts. w. HIV get?

CMV and toxoplasma IgG serology

T or F: women w/ HIV should receive a pap test on an annual basis

false recommendation is every 6 months

what vaccines are HIV pts. recommended to get?

pneumococcal influenza hep B (if HBsAB-negative) H. influenzae type b