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STDs Flashcards

1
Q

What is the gram stain and morphology of Haemophilus ducreyi?

A

Gram negative streptobacillus

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2
Q

In whom is Chancroid more common in?

A

Commercial sex workers or immigrants

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3
Q

What is the relationship of chancroid and HIV?

A

Cofactor for HIV transmission–should test at the time of diagnosis

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4
Q

What are the s/sx of chancroid?

A

painful genital ulcer

Inguinal LAD

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5
Q

How do you diagnose chancroid?

A

Culture media–there is no FDA approved test

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6
Q

What is the treatment for chancroid?

A

Azithromycin
Ceftriaxone
Cipro
Erythromycin

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7
Q

What is the most common STI in women?

A

HSV

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8
Q

How do you diagnose HSV?

A

PCR

Culture

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9
Q

True or false: HSV is usually asymptomatic

A

True

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10
Q

What is the nonprimary first episode of HSV infection?

A

They have HSV and antibodies to HSV, but not the type that they’re presenting with

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11
Q

What is the transmission risk for HSV in pregnancy with a primary episode? Nonprimary first episode? What about reactivation?

A

50% -primary
30% -nonprimary
4%-recurrent

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12
Q

What is a primary HSV infection?

A

Culture proven herpes, but not antibodies yet

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13
Q

What, generally, is the treatment for HSV?

A

Acyclovir

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14
Q

When should women avoid sex with HSV positive partners?

A

In the 3rd trimester

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15
Q

What should be done if a woman has active HSV or prodromal s/sx and is close to being due?

A

C-section

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16
Q

How do you diagnose syphilis?

A

VDRL RPR

FTA testing

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17
Q

What are the s/sx of primary syphilis?

A

Painless chancre at site

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18
Q

What are the s/sx of secondary syphilis?

A

Rash and mucocutaneous LAD

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19
Q

What are the s/sx of tertiary syphilis?

A

Aortitis
Iritis
Auditory abnormalities
Gummas

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20
Q

What is the treatment for latent syphilis if early (contracted in last 12 months)? Late?

A 
Early = PCN 2.4 IM x1
Late = same but x3
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21
Q

How long should neurosyphilis be treated for? What should be used?

A

10-14 days

aqueous crystalline PCN 18-24 MU QD

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22
Q

How often should CSF be obtained for neurosyphilis?

A

q 6 months until cell count is normal

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23
Q

What is the Jarisch-Herxheimer reaction? What is the significance of this in pregnancy?

A

Acute, febrile reaction with HA, myalgias, w/in 24 hours of treatment of syphilis

May induce labor or cause fetal distress

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24
Q

When should partner treatment for syphilis be started? (2)

A

Exposure within 90 days

or greater than 90 days if no testing available or unsure f/u

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25
Q

True or false: if you have a patient that tests positive for syphilis, you should test them for HIV in 3 months

A

true

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26
Q

What should be done for patients who have neurological s/sx of syphilis? Eye?

A

LP for neuro s/sx

Ocular slit lamp for ophthalmic

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27
Q

How do you diagnose Chancroid?

A

Culture for H ducreyi

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28
Q

Although classically HSV-1 was an oral disease and HSV-2 was a genital disease, the difference is now 50/50. What is the significance of this?

A

HSV-1 has a lower risk of recurrence

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29
Q

When should patients who are treated for syphilis be reevaluated? What happens if they have persistent s/sx or a4 fold increase in titers?

A

6 and 12 months

Assume failure of treatment, and retreat with PCN

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30
Q

What is the second line abx for syphilis?

A

Doxycycline

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31
Q

What is the treatment for syphilis in pregnancy? How do you follow these patients?

A

PCN orally

28-32 wga follow titers, or monthly if high risk

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32
Q

If you begin treating syphilis within how many days of delivery is treatment most likely inadequate?

A

If within 30 days of delivery

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33
Q

What are the four US findings that can be seen with congenital syphilis?

A
  • Hepatomegaly
  • Ascites
  • Hydrops
  • Thickened placenta
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34
Q

Mega-placenta is usually seen with what congenital condition?

A

Congenital syphilis

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35
Q

How do you evaluate a newborn for syphilis?

A

RPR or VDRL

CSF analysis

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36
Q

What are the s/sx of congenital syphilis? (6)

A
  • Nonimmune hydrops
  • HSM
  • Jaundice
  • Pseudoparalysis of extremity
  • Rash
  • Rhinitis
37
Q

What is the characteristic nose with syphilis? What characteristic symptom does this cause?

A

Saddle nose

“snuffles”

38
Q

Hutchinson teeth = ?

A

Congential syphilis

39
Q

What are the s/sx of vaginitis?

A
  • Discharge
  • Malodor
  • Pruritus
  • Burning
  • Dysuria
  • Dyspareunia
40
Q

How do you diagnose vaginitis?

A
  • Vaginal pH
  • whiff test
  • KOH
  • DNA amp
41
Q

What is the usual ddx for cervicitis?

A
  • Chlamydia
  • Gonorrhea
  • Trichomonas
  • BV
  • Douching
42
Q

What is the most frequently reported infectious disease in the US?

43
Q

What are the s/sx of chlamydia?

A
  • Abnormal discharge
  • Cervicitis
  • Dysfunctional uterine bleeding
44
Q

What percent of pts with chlamydia are asymptomatic?

45
Q

When should annual screening begin for chlamydia?

A

Less than 25 years

46
Q

What are the sequelae of chlamydia?

A

PID
Ectopic prego
Infertility

47
Q

What is the treatment for Chlamydia?

A

Azithromycin

48
Q

What must patients who are being treated for chlamydia do?

A

Abstain from sex for 7 days from treatment, and until partner is treated

49
Q

Can you prescribe abx to patient’s partners without seeing them?

50
Q

When should you retest for chlamydia after a patient gets prego?

51
Q

What are the risk of neonatal chlamydia?

A

Conjunctivitis and pneumonia

52
Q

What are the characteristics of the cough associated with neonatal pneumonia 2/2 chlamydia infection? CXR findings?

A

Repetitive staccato cough w/ tachypnea

Hyperinflation and bilateral diffuse infiltrates

53
Q

True or false: if a patient tests positive for Gonorrhea, then you should test for chlamydia as well

A

True–commonly acquired together

54
Q

Why should patients with Chlamydia always have an additional gram of Azithromycin?

A

Decreases the resistance of gonrrhea

55
Q

What is the treatment for Quinolone resistant Gonorrhea?

A

Ceftriaxone + Az

56
Q

What are the s/sx of disseminated Gonococcal infections?

A
  • Petechial or pustular acral rash
  • Asymmetrical arthralgia
  • Tenosynovitis
  • Septic arthritis
57
Q

What are the ophthalmic complications from Gonococcal infections? How long does it take for this to manifest?

A

Perforation of the globe and blindness

Acute illness manifests 2-5 days after birth

58
Q

How do you diagnose PID? (3)

A
  • Pelvic/lower abdo pain
  • No other cause of pain
  • Cervical motion tenderness or adnexal tenderness
59
Q

True or false: PID is only caused by STDs

A

False-more common, but not necessary

60
Q

What is the PPD of clinical ssx for salpingitis in PID?

61
Q

What is the most specific test to obtain for PID diagnosis?

A

Embx with endometritis

62
Q

What are the US or MRI findings of PID? (2)

A
  • Fluid filled tubes

- Doppler studies with tubal hyperemia

63
Q

What is Fitz-hugh-curtis syndrome?

A

Rare adhesions between the uterus and the abdominal wall

64
Q

Is there any difference in reproductive outcomes if PID is treated as an inpatient vs an outpatient?

65
Q

What are the four organisms that you should cover when treating PID?

A
  • GC
  • CT
  • Anaerobes
  • BV
66
Q

What are the five criteria of admission for PID?

A
  • Surgical emergency
  • Pregnant
  • Non-compliant
  • Unable to tolerate PO
  • Tuboovarian abscess
67
Q

What is granuloma inguinale (donovanosis)?

A

Genital ulcerative disease caused by Klebsiella granulomatis

68
Q

What are the s/sx of granuloma inguinale (donovanosis)?

A

Painless, progressive ulcerative lesions without regional LAD

69
Q

How do you diagnose granuloma inguinale (donovanosis)?

A

Dark-staining donovan bodies

70
Q

What is the treatment for granuloma inguinale (donovanosis)?

A

Doxy for donovano

71
Q

Where is granuloma inguinale (donovanosis) usually found?

72
Q

What is lymphogranuloma venereum? What causes it/?

A

Painless ulcer with unilateral LAD (femoral/inguinal)

Caused by the invasive serovars L1, L2, L2a or L3 of Chlamydia trachomatis

73
Q

What are the HPV strains that cause condyloma? (2)

74
Q

What are the HPV strains that cause cervical CA? (5)

A 
16
18
31
33
35
75
Q

How do you diagnose HPV?

A

Mostly clinical, but biopsy if uncertain or unresponsive to treatment

76
Q

What is the screen for HPV?

77
Q

What is the potential complication of having a kid when you have HPV?

A

Respiratory papillomatosis—significantly rare

78
Q

Why do genital warts get worse with prego?

A

Slight immunosuppression

79
Q

What are the s/sx of trichomonas?

A

Diffuse, malodorus, yellow-green discharge with vulvar irritation

80
Q

How do you diagnose trichomonas?

A

Wet mount or culture

81
Q

What is the treatment for Trichomonas? What is the classic adverse effect of this medication?

A

Metronidazole

Disulfiram effect

82
Q

Strawberry cervix = ?

A

Trichomonas

83
Q

What is the treatment for lice?

A

Permethrin

84
Q

What is the treatment for scabies?

A

Permethrin cream

85
Q

What is Molluscum contagiosum? How is it acquired? Treatment?

A
  • Poxvirus that causes painless warts.
  • Commonly caused by skin contact
  • Self-limiting
86
Q

What is the classic sign of a molluscum?

A

Umbilicated center

87
Q

What are the four pathogens that classically cause UTIs?

A
  • E.coli
  • Proteus mirabilis
  • Klebsiella pneumoniae
  • Staph saprophyticus
88
Q

Why do UTIs become more common after menopause?

A

Tissue between the urethra and the vagina becomes thinner

89
Q

When can the nitrite test on a UA falsely show a positive result?

A

After eating beets

Infectious Disease (18 decks)

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