STDs Flashcards

0
Q

UTIs

ET (1 Elderly, 2 Male Infants, 1 Women), RF (6), Mech,
Urine, DX (3 Tests)?

A

ET:

  • Elderly: Enlarged prostate
  • Males (Infants): Congenital defects, Vesicoureteral reflux
    • Women (shorter urethras colonized by fecal flora)

RF:

  • GU malformation
  • Obstruction
  • Kidney Surgery
  • Catheterization
  • Diabetes
  • Pregnancy

MECH = Ascension of microbes from urethra -> bladder.

URINE:
- WBCs (NOT WBC Casts)

DX:

  • Leukocyte Esterase test: + = Bacterial
  • Nitrite Test: + = Gram -
  • Urease Test: + = Urease-producing bug (eg Klebsiella, Proteus)
    - = E coli or Enterococcus
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1
Q

Common Vaginal Infections (3)

A
  • Bacterial Vaginosis (NO INFL)
  • Trichomoniasis
  • Candida Vulvovaginitis (pH NORMAL)
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2
Q

Bacterial Vaginosis

Causative Bug, Assoc (2),
Chars / Micro Findings (3, incl 2 Clues),
Pres, RX?

A

Gardnerella vaginalis (Gram - rod, anaerobic).

ASSOC:

  • Sexual activity (however not sex-trans)
  • Overgrowth of anaerobic bacteria in vagina

FINDINGS: NO Infl

  • “Clue cells”
  • “Fishy amine odor in KOH”
  • pH > 4.5

PRES:
- Thin white/yellow discharge with fishy odor

RX: Metronidazole

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3
Q

Trichomoniasis (Vaginitis)

Causative Bug, Chars / Micro Findings (2), Pres (CLUE + 1), RX?

A

Trichomonas vaginalis.

FINDINGS: INFL.

  • pH > 4.5
  • “Strawberry cervix”

PRES: Vaginitis

  • “Frothy grey-green foul-smelling” discharge
  • Burning + Itching

RX: Metronidazole
** Treat sexual partner **

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4
Q

Candida Vulvovaginitis

Chars / Micro Findings (2), Pres (CLUE + 1), RX?

A

FINDINGS: INFL.

  • Pseudohyphae
  • pH NORMAL (4 - 4.5)

PRES:

  • “Thick white cottage cheese” discharge
  • Painful

RX: -azoles

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5
Q

Non-Specific Chlamydial Urethritis

Pres, Labs, Comp?

A

PRES:
- Dysuria +↑urinary freq

LABS:
- Sterile Pyuria

COMP:
- Reiter Sx (in HLA-B27 Male)

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6
Q

PID

Causative Bugs (2),
Pres (CLUE + 4), Possible Pres (3),
Comp?

A
  • Neisseria gonorrhoeae (acute)
  • Chlamydia trachomatis (subacute- often undiagnosed)

PRES: Onset often follows menses

  • Fever
  • “Chandelier sign” (cervical motion tenderness)
  • Purulent cervical discharge
  • Adnexal tenderness + Dyspareunia
  • MONOarticular Arthritis

POSSIBLE PRES:

  • Endometritis
  • Hydrosalpinx / Salpingitis
  • Tubo-Ovarian abscess

COMP:
- Fitz-Hugh-Curtis Sx

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7
Q

Salpingitis

Comp (4)?

A

COMP:

  • Adhesions
  • Chronic pelvic pain
  • Ectopic pregnancy
  • Infertility
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8
Q

Condyloma Acuminatum (Genital Warts)

Causative Bug, Assoc, Pres (2), Micro Finding (Clue), RX (2)?

A

HPV.

ASSOC: Cervical Ca

PRES:

  • Papillary / wart-like lesions
  • Sessile (permanently attached) or Pedunculated

FINDING: Koilocytotic atypia

RX:

  • Imiquimod
  • Podophyllin
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9
Q

Syphilis

Causative Bug, DX (2ry + 3ry), RX?

A

Treponema pallidum.

DX: FTA-Abs

RX: Penicillin

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10
Q

1ry Syphilis

Path (Incubation), Pres, DX?

A

PATH: 3 week Incubation = Spirochetes spread throughout body.

PRES:
- PAINLESS Chancre (heals within 1-3 months)

DX: Dark-Field Microscopy

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11
Q

2ry Syphilis

Pathogenesis (Timing), Pres (4)?

A

PATH: Devel 1-2 months after 1ry Syphilis.

PRES:

  • Fever
  • Lymphadenopathy
  • RASH (local or generalized) on palms / soles, lasting 1-3 months
  • Condylomata lata
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12
Q

3ry Syphilis

Pathogenesis, Locations Affected (3),
Pres (Char Lesion + 2), Eyes,
Comp?

A

PATH: Devel in 1/3 of untreated patients.

  • CNS: -> Neurosyphilis (meningovascular, paresis, Tabes Dorsalis)
  • Heart: -> Obliterative Endarteritis of Vaso Vasorum (Aorta)
  • Skin

PRES: Char Lesion = ‘Gumma’: Single or multiple. MC in bone, liver, testes.

  • Tabes Dorsalis
  • General paresis

EYES: “Argyll Robertson pupil”

COMP:
- Aortitis of vasa vasorum -> Thoracic Aneurysm

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13
Q

Congenital Syphilis

Transmission, Pres (5, incl 4 facial abnormalities), Prev?

A

TRANS: Mother with 1ry (chancre) or 2ry (dissem rash) Syphilis.
(Trans occurs after 1st trimester)

PRES:
- Hydrops Fetalis / Stillbirth
(if neonate survives)
- Facial abnormalities:
       - "Saddle" nose
       - Short maxilla
       - "Rhagades": linear scars at angles of mouth
       - "Hutchinson teeth": notched + widely-spaced central teeth
- Sniffles
- "Saber" shins
- CN 8 deafness

PREV: Treat mother early in pregnancy

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14
Q

Lymphogranuloma Venereum

Causative Bug, Def’n, Pres (3), RX (2)?

A

Chlamydia trachomatis (serotypes L1-3).

Infection of lymphatics.

PRES:

  • Genitals: PAINLESS ulcers + Elephantiasis
  • Lymph Nodes: PAINFUL and enlarged (lymphadenopathy)

RX:

  • Erythromycin
  • Tetracyclines
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15
Q

“ToRCHES” Infections (6)

Def’n, Trans (2 options), Common Pres in Neonate (6)?

A
  • Toxoplasma gondii
  • Rubella
  • CMV
  • HIV
  • HSV-2
  • Syphilis (1ry or 2ry)

Microbes that pass from mother -> fetus.

TRANS:

    • Transplacental
  • Delivery (esp HSV-2)

COMMON PRES:

  • Neuro abnormalities
  • Vision / Hearing problems
  • Growth retardation
  • Hepatosplenomegaly
  • Jaundice
  • Thrombocytopenia