Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Women's Health 1 > STDs > Flashcards

STDs Flashcards

1
Q

etiology of chlamydia

A
  • chlamydiaceae trachomatis

- obligate intracellular w/ gram negative like cell wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

MC infected w/ chlamydia

A

AA females 15-24 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

different serotypes of chlamydia

A
  • A, B, C: trachoma (eye)
  • D-K: mucosal surfaces
  • L1, L2, L3: lymphogranuloma venerum (LGV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

lymphogranuloma venerum (LGV)

A
  • small, often asx genital skin lesion then regional lymphadenopathy in groin/pelvis
  • Lesions heal with scarring, can have persistent sinus tracts
  • Severe proctitis if aq. via anal sex
  • Same dx testing as general
  • Tx: Doxy 100 mg PO BID X 21 days or erythromycin 500 mg PO QID X 21 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Transmission of chlamydia

A
  • Mucosal contact: vag, oral, anal sex
  • Highly contagious (partner infection rate >50%)
  • Can pass sexual (genital) or vertical (perinatal)
  • Perinatal: neonatal conjunctivitis or pneumonia
  • Increases risk of acquiring HIV d/t mucosal inflammation
  • Sig asymptomatic carriers
  • Reinfection common
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Chlamydia screening

A

yearly if sexually active and <25 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

S/S of chlamydia in women

A
  • Cervicitis: clear to thick yellow discharge and abnl vag bleeding
  • Urethritis: dysuria-pyuria (but no wbc), abd pain, fever

(80% asymptomatic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

S/S of chlamydia in men

A
  • > 50% asx
  • Urethritis MC: clear, yellowish, white discharge. Dried secretions at urethral meatus
  • Proctitis, dysuria, urinary freq or urgency
  • Complications: epididymitis and reactive arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

PE of chlamydia

A
  • Female: thick, mucopurulent discharge in cervical os

- Male: mucoid/watery urethral discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Labs for chlamydia

A

Nucleic acid amplification tests (NAATs) PCR DNA probe

  • urine or bodily fluid
  • MC used, very accurate

Culture/gram stain

  • Culture swab from site of infection
  • Tx empirically, can take 24-48 hrs for results

ELISA

  • looks for antigens to pathogen
  • less accurate than culture but second most specific
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tx of chlamydia

A
  • Azithromycin: 1 g once (not for QT prolongation, meds for arrhythmia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Special points to note about chlamydia

A
  • Must report to health dept
  • If exposed or you think positive, treat!
  • Treat all sex partners if have had sexual contact during 60 days preceding onset of sx/dx
  • Abstain from sex 7 days after last day of tx
  • Check for gonorrhea – 40%F and 20%M co infected
  • Retesting recommended 3 mos after therapy d/t high rates reinfection
  • MSM screened annually for urethral or rectal infection
  • MSM + HIV or risky behavior = 3 month screening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PID associated with chlamydia

A
  • from ascending infection
  • Chronic abd pain d/t adhesions of ovaries and fallopian tubes
  • Inc chance of ectopic preg X7-10
  • Untreated = fertility
  • Fitz-Hugh-Curtis sx: (inflammation of liver capsule, RUQ pain, abnl LFTs)
  • Reactive arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Reiter syndrome / reactive arthritis d/t chlamydia

A
  • 2 to immune-mediated response to chlamydia
  • Sx: asymmetric polyarthritis, urethritis, conjunctivitis
  • RF/HLA-B27 negative
  • “can’t see, can’t pee, can’t climb a tree”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

etiology of gonorrhea

A
  • neisseria gonorrhoeae
  • gram neg. diplococci
  • incubation 1-14 days or 2-5 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MC infected w/ gonorrhea

A

15-24 yo F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

transmission of gonorrhea

A
  • Mucosal contact during vaginal, oral, anal sex
  • can affect any part of body/organs/mucous membranes
  • Easy transmission: single encounter with infected partner = infection 50-70% of the time!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

screening of gonorrhea

A

Annual if sexually active & <25 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

S/S of gonorrhea in female

A
  • most asx
  • urethritis
  • cervicitis
  • thin, purulent**, mild odor discharge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

S/S of gonorrhea in male

A
  • most sx urethritis: burning on urination, purulent/mucopurulent discharge
  • Acute epididymitis: unilateral testicle pain/swelling, prostatitis, cystitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

other sx associated w/ gonorrhea

A
  • Rectal: often asx. Rectal pain, pruritis, tenesmus, rectal discharge. Bloody diarrhea. Rectal infection
  • Oropharyngeal: often asx, can cause mild-severe dysphagia and discomfort
  • Eye: most often unilateral if 2 to self-inoculation, purulent discharge, conjunctivitis, can = blindness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Labs for gonorrhea

A

same as chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

tx of gonorrhea

A

Dual therapy:

  • Rocephin 250 mg IM once + Azithromycin 1 gm PO once
  • Alt: cefixime + azithromycin
  • pain relief for epididymitis, PID, DGI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

special points to note about gonorrhea

A
  • Must report to health department
  • If exposed or you think positive, treat!
  • Screen if asx but partner known infection
  • Untreated can lead to accessory gland infection (Bartholin, skene)
  • PID
  • Fitz-Hugh-Curtis sx (inflammation of liver capsule, RUQ pain, abnl LFTs)
  • Test of cure not necessary with dual treatment, is recommended if used alt meds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Disseminated Gonorrhea Infection (DGI)

A
  • d/t untreated gonorrhea that spreads to blood
  • arthritis, tenosynovitis, dermatitis + any of the following:
    • Fever
    • Skin change: rash on torso, limb, palm, sole. Abscess formation
    • Joint: polyarthralgia, purulent arthritis (knee MC)
    • CNS: meningeal sx, decreased mental status
    • Cardiac: murmur, tachy, endocarditis, embolic lesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Tx of DGI

A

Ceftriaxone 1 g IM and Azithromycin 1 g PO daily X 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Etiology of trichomonas

A
  • T. vaginalis
  • oval shaped, flagellated protozoa (swimming football)
  • Incubation days to weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

screening for trchomonas

A

Screen all positive pts for other STIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Transmission of trichomonas

  • F
  • M
A
  • Women: vagina, cervix, urethra, bladder, Bartholin and Skene glands
  • Men: anterior urethra and prostate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

S/S of trich in women

A
  • 70% sx
  • copious, frothy, watery, yellow-green vag discharge
  • dysuria
  • vag irritation
  • Vulvar edema
  • +/- abd pain
  • Strawberry cervix**
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Labs for trich

A
  • Wet mount prep: visualize T. vaginalis on slide
  • Culture
  • NAAT
  • DNA probe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Tx of trich

A
  • Metronidzaole 2 g PO Once (avoid etoh)
    Alternatives:
  • Metro 500 mg PO BID X 7 days
  • Tinidazole 2 g PO once
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Special points to note about trich

A
  • Complications: PID
  • Pregnancy: 30% more likely to deliver preterm or low birth weight infant. Avoid metronidazole in first trimester (teratogenic risk)
  • Recommend retest sexually active women 3 months after treatment
  • Up to 53% women with HIV also have t. vaginalis. Screen at initial HIV visit, cure rate better with Metro 500 mg BID x 7 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

etiology of syphilis

A
  • Treponema pallidum
  • spirochete bacterium (corkscrew-shaped)
  • Must use dark field microscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

transmission of syphilis

A
  • Dz progresses in stages
  • Congenital transmission = congenital syphilis
  • MSM are majority of new cases, higher rates of abx resistance
  • Enters body via abrasions on skin/mucous membranes during sexual contact OR transplacentally during pregnancy
  • Disseminates via circulatory system (incl. lymph)
  • CNS invasion may occur in any stage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

primary syphilis infection

A
  • Ulcer or chancre on penis or vagina
    • Painless, indurated, clean base. Can have multiple lesions
    • Highly infectious but heals spontaneously within 3-6 weeks
  • Most contagious stage (primary and secondary)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

secondary syphilis infection

A
  • Secondary lesions several weeks after primary chancre, may persist weeks to months
  • Mucocutaneous
  • Manifestations
    • Skin rash – nickel/dime sized, generalized over body, palms/soles
    • Lymphadenopathy 50-80%
    • Malaise, alopecia
    • Condylomata lata***
  • Serologic tests usually highest titer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Tertiary (late) syphilis infection

A
  • approx. 30% untreated progress within 1-20 years
  • Rare bc of abx
  • Mannifestations:
    • Gummatous lesions***
    • Cardiovascular syphilis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Latent syphilis infection

A
  • Host suppresses infection, no lesions clinically apparent
  • Only evidence is positive serologic test
  • Occurs between 1 and 2 stage, between 2 relapses, after 2 stage
  • Early latent < 1 year duration
  • Late latent ≥ 1 year duration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Neurosyphilis infection

A
  • Invasion of CNS
  • Can occur at any stage, may occur decades after infection
  • Can be asx
  • Tabes dorsalis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Congenital syphilis

A
  • May = stillbirth, neonatal death, infant disorder (deaf, neuro impairment, bone deformities)
  • May occur during any stage of syphilis, risk higher during primary and secondary
  • Fetal infection can occur at any trimester
  • Spectrum of severity
    • Only severe cases clinically apparent at birth
    • Early lesions (MC): <2 yo, usually inflammatory
    • Late lesions: >2 yo, usually immunologic and destructive
  • Hutchinson teeth, palate deformities
42
Q

Dx of syphilis

A
  • Hx and PE
  • Biopsy: direct visualization of spirochete from lesion exudate or tissue
    via dark field microscopy
  • Tertiary: LP with VRDL
43
Q

Blood tests for syphilis

A
  • treponemal
  • RPR
  • VDRL
  • FTA-ABS
  • MHA-TP
44
Q

treponemal test for syphilis

A

qualitative, measures ab vs. T. pallidum ag

45
Q

RPR blood test

A
  • faster than VDRL
  • detects ab vs cardiolipin-lecithin-cholesterol antigen**
  • NOT specific for T. pallidum
  • positive or negative screen
    • within 7 days of exposure
  • Titer decrease with time +/- tx
46
Q

VDRL blood test

A
  • slower than RPR
  • stndrd for CSF testing
  • same ab as RPR
  • reported as ratio (1:4)
  • 4 rise = active infection***
  • failure of titer to dec 4X is new infection or tx failure
47
Q

FTA-ABS or MHA-TP tests

A
  • very specific, confirms positive RPR or VDRL

- Neg test of CSF excludes neurosyphilis

48
Q

Tx of primary, secondary and early latent syphilis

A
  • Benzathine penicillin G 2.4M units IM once
  • Penicillin allergic:
    • Doxy 100 mg PO BID X 14D
    • Tetra 500 mg PO QID X 14D
49
Q

Tx of late latent and tertiary syphilis

A
  • Benzathine penicillin G 2.4M units IM once weekly X 3 weeks
  • Penicillin allergic:
    • Doxy 100 mg PO BID X 28D
    • Tetra 500 mg PO QID X 28D
50
Q

Tx of neurosyphilis

A
  • Aqueous crystalline penicillin G IV q 4hr or continuous IV infusion 10-14D
  • compliance ensured: procaine penicillin IM daily X 10-14D + Probenecid 500 mg PO QID X 10-14D
51
Q

Jarisch-Herxheimer Rxn

A

self-limited rxn to antitreponemal therapy

  • fever, malaise, nv, chills, exacerbation of secondary rash
  • within 24 hrs of tx
  • NOT allergic rxn to penicillin
  • MC after tx with penicillin and tx of early syphilis
52
Q

infection/etiology of chancroid

A
  • Haemophilus ducreyi: Gram-neg streptobacillus
  • Bacteria via sexual contact
  • incubation: 1-2 days after intercourse
  • Small bump – ulcer in one day
  • uncommon in US
  • MC developing countries, low socioeconomic areas, commercial sex workers
53
Q

S/S of chancroid

A
  • Painful ulcer
  • 3-50 mm diameter
  • Shaft penis/labia
  • M – once ulcer
  • F – multiple ulcers
  • tender suppurative inguinal adenopathy
  • soft edges
  • base covered with gray or yellowish-gray material
  • bleeds easily if scraped
54
Q

Dx of chancroid

A
  • Culture lesion: definitive dx
  • Combo of painful genital ulcer and tender suppurative inguinal adenopathy suggests dx of chancroid
  • r/o syphilis:
    • t. pallidum with darkfield microscopy
    • Neg serologic tests
  • Neg HSV PCR and HSV culture if ulcer
55
Q

Tx of chancroid

A
  • Azithromycin 1 g PO once
  • Ceftriaxone 250 mg IM once
  • Ciprofloxacin 500 mg PO BID X 3D
  • Erythromycin 500 mg PO TID X 7D
56
Q

Special points to note about chancroid

A
  • f/u 3-7days after tx initiation
  • Tx partners regardless of sx (all pt 10 days before lesion appeared)
  • Can scar
  • No documented adverse rxn while pregnant
  • Common in HIV pts, if dx chancroid, test for HIB
57
Q

in comparing chancre vs. chancroid, what characteristics do they share?

A
  • Pustules at site of inoculation, progress to ulcerated lesions
    1-2 cm diameter
  • Appear on genitals of infected pts
  • Present at multiple sites and with multiple lesions
58
Q

in comparing chancre vs. chancroid, how do they differ?

A

Chancre:

  • Painless
  • Non-exudative
  • Hard (indurated) edges
  • Heal spontaneously w/in 3-6 weeks, even w/o tx

Chancroid:

  • Painful
  • Grey or yellow purulent exudate
  • Soft edge
59
Q

infection/etiology of genital herpes

A
  • Herpes simplex virus 1 and 2
  • leading cause of genital ulcer dz
  • HSV-1: MC cold sore/fever blister
  • HSV-2: MC genital herpes
    • but either can cause lesions in all locations!
  • Chronic, life-long
  • Can xmit from asx host
60
Q

Risk factors for genital herpes

A 
Genital HSV-2:
- F>M, AA, older age
- Higher with more sexual partners
Genital HSV-1:
- Young women (college students) 
- MSM
61
Q

transmission of genital herpes

A
  • Close contact with person shedding virus at mucosal /epithelial surface or genital/oral secretions
  • genital:genital, oral:genital, genital:oral
  • HSV2: MC asymptomatic shedding, often person unaware infected
62
Q

S/S of herpes

A
  • Often asx
  • Primary infection/outbreak 2D to 2W after intercourse
  • Primary outbreak most diffuse and painful
  • Considered primary if infected with HSV1 or 2 and NO ab of either type
  • Ab appear 12 weeks after
  • Decr appetite, fever, malaise, musc ache, groin lymphadenopathy
63
Q

S/S of primary genital herpes

A
  • Severe, multiple, bilateral genital ulcers
  • Prodrome before outbreak
  • Blisters break, leave painful, shallow ulcer. Crust over and heal 7-14D
  • dysuria
  • Vag/urethra discharge
  • Tender inguinal adenopathy
  • F: shedding from cervix in 80-90% primary infections. Cervix appears abnl with ulcerative lesions, erythema, friable
  • Infection of urethra/meatus = clear
64
Q

S/S of non-primary genital herpes

A
  • HSV1 or 2 infection w/ pre-existing ab to the other strain
  • Milder than primary (cross immunity protection)
  • weeks to months after primary
65
Q

Dx of herpes

A
  • Viral culture
  • PCR for HSV DNA
  • IG testing for either strain
    IgG – old infection
    IgM – new infection
  • Tzanck Test
    Scrape vesicle base to look for Tzanck cells*** (giant cells with multiple nuclei). Stain with Wright’s stain
66
Q

Tx of primary herpes

A
  • Acyclovir 400 mg PO TID X 7-10D
  • Acyclovir 200 mg PO 5 times a day X 7-10 days
  • Famciclovir 250 mg PO TID X 7-10D
  • Valacyclovir 1 g PO BID X 7-10D
  • extend tx if no improvement in 10 days
67
Q

Tx of secondary herpes

A
  • Acyclovir 400 mg PO TID X 5-10D
  • Famciclovir 500 mg PO BID X 5-10D
  • Valacyclovir 1 g PO BID X 5-10D
68
Q

suppression tx of herpes

A
  • Acyclovir 400-800 mg PO BID-TID
  • Famciclovir 500 mg PO BID
  • Valacyclovir 500 mg PO BID
69
Q

Special points to note about herpes

A
  • Sexual transmission thought to be higher from M → F than F → M
  • Can be transmitted perinatally at time of delivery (mucosal or skin contact)
  • Fomite transmission is unlikely, autotransmission can occur from genital to other mucocutaneous sites, fingers, eyes’
  • Can get Herpetic whitlow (fingers)
70
Q

Severe HSV

A
  • Hospitalization + IV acyclovir if: severe, complications (disseminated infection, pneumonitis, hepatitis), CNS complications
  • Followed by outpt PO antivirals for min 10 days total therapy
71
Q

HSV counseling

A
  • Inform current and future partners
  • Can transmit during asx periods
  • Remain abstinent with uninfected partners when lesions or prodromal sx are present
  • Male latex condoms might reduce risk of transmission
72
Q

Pregnancy and HSV

A
  • Transmission is high if mom is infected at time of delivery (30-50%)
  • Transmission is low for moms with hx of HSV on suppression meds during delivery
  • 3rd trimester, abstain from sex with people known to be infected
  • CAN deliver vaginally w/o sx or prodrome
  • C-section if lesions at onset of labor
  • Acyclovir is drug of choice during pregnancy
73
Q

infection/etiology of HPV

A
  • Many sub types,
  • Type that causes warts ≠ the kind that causes cancer
  • Type 6 & 11 90% of warts
  • 27% sexually active people, 45% between 14-19 yo
  • Onset 4 mo after contact
74
Q

transmission of HPV

A
  • Highly contagious (contact = 70% chance will be infected)
  • Spread via skin-to-skin contact
  • Viral particles penetrate skin and mucosal surfaces through microscopic abrasions in genital area
75
Q

S/S of HPV

A
  • Occur in clusters
  • Very tiny to large masses (condyloma acuminate)
  • Look like small stalks:
    F: outside (MC)/inside vagina, cervix, anus
    M: tip of penis, shaft, scrotum, anus
    Rare: in mouth/throat
76
Q

Dx of HPV

A
  • PE
  • acetic acid turns condyloma white = positive
  • Biopsy
77
Q

Tx of HPV

A
  • $$ and not always effective
  • Podofilox cream – 1st line
  • Aldara – alt option
  • Liquid nitrogen cyrotherapy
  • Derm referall
78
Q

Cervical CA associated w/ HPV

A
  • Strains 16 & 18 cause about 70% of cancers.
  • 27,000 affected ea year
  • Cervical, vaginal, vulvar cancer in W, penile ca in men. Also anal and throat cancer
  • Almost all cervical cancer is caused by HPV
79
Q

HPV vaccine

A
  • Rec for preteen boys and girls 11-12, protection prior to virus exposure.
  • Series of shots over several months
    Gardasil:
  • HPV 6, 11, 16, 18
    Gardasil 9:
  • Same as Gardasil + high risk strains: 31, 33, 45, 52, 58
    Cervarix:
  • HPV 16 & 18
  • No coverage vs. genital wart strains
80
Q

what is the MC gyn complaint?

A

vaginosis

81
Q

MC causes of vaginosis

A
  • Trichomonas vaginalis
  • Candidiasis
  • Bacterial vaginosis
  • Atrophic vaginitis
82
Q

nl vaginal pH (postmenarchal and premenopausal)

A
  1. 8 - 4.2

* if disturbed = overgrowth of pathogens

83
Q

factors that alter the vaginal environment

A 
•	Fem hygiene products
•	Contraceptives
•	Vag medications
•	Abx
•	STIs
•	Sexual intercourse
•	Stress
- Recurrent infections → irritiation, excoriation, scarring → sexual dysfunction &amp; facilitation of transmission of other STIs
- Psychosocial/emotional stress common
84
Q

S/s of vaginosis

A
  • Irritation of genital area
  • Discharge: white, gray, watery, foamy
  • Inflammation of labia minora/majora & perineal area
  • Dysuria
  • Dyspareunia
  • Foul/fishy vaginal odor
85
Q

infection/etiology of bacterial vaginosis

A
  • Gardnerella vaginosis MC

- NOT STI but caused by sexual intercourse

86
Q

RF for bacterial vaginosis

A 
- F partners of F with BC 80% chance of infection
•	Rough sex
•	Douching
•	Hot baths
•	Frequent intercourse
•	Change in sex partner
•	Cunnilingus
•	Concomitant STIs
•	Pregnancy
87
Q

S/S of bacterial vaginosis

A
  • Thin white or gray discharge
  • Foul fishy odor
  • Clue cells (globs of bacteria stuck to vaginal cell walls)
  • Dysuria, vaginal erythema, irritation, pruritis
  • Positive “whiff test” when vaginal discharge combined with KOH
  • Vag pH >4.5
88
Q

Dx of bacterial vaginosis

A

Saline wet mount (wet prep):

  • Vag discharge on slide with NaCL
  • Clue cells: vag epithelial cells with rods and cocci bacteria
  • decrease number lactobacilli
  • no WBCs***

KOH prep:

  • Vag discharge on slide with 10% KOH
  • Whiff test: fish odor dt release of amines = positive test
89
Q

Tx of bacterial vaginosis

A
  • Metronidazole
  • Clindamycin gel
  • Recurrent: standing orders
90
Q

infection/etiology of vaginal candidiasis

A
  • Candida species (MC C. albicans)

- NOT STI but seeded by a man

91
Q

RFs of vaginal vandidiasis

A
  • Oral contraceptive use
  • IUD
  • Young at first intercourse
  • Frequent intercourse
  • Cunnilingus
  • DM
  • HIV, immunocompromised-
  • Abx use
  • Pregnancy
92
Q

S/S of vaginal candidiasis

A
  • Vulvar/vaginal erythema/swelling
  • Burning and itching**
  • Curd-like vaginal discharge** (vomit)
  • Vulvar dysuria** – burning when urine in contact with vulva skin
  • Cervix appears nl
  • Dyspareunia
93
Q

Dx of vaginal candidiasis

A

Saline wet mount (wet prep):
- hyphae and budding yeast

KOH prep:
- budding yeast and hyphae easier to see bc KOH kills bacteria

94
Q

Tx of vaginal candidiasis

A
  • Diflucan 150 mg PO once

- repeat in one week of no improvement

95
Q

infection/etiology of PID

A
  • Orgs ascending to upper female genital tract from vagina/cervix
  • MC pathogens:
    Chlamydia trachomatis
    Neisseria gonorrhoeae
96
Q

prevention of PID

A
  • education/counseling
  • Change in sexual behavior
  • Use of prevention services
  • Effective dx, tx, counseling
  • Eval, tx, counseling of partners
97
Q

RFs for PID

A
  • Young
  • Multiple sex partners
  • IUD
  • Hx of PID
98
Q

complications of PID

A
  • Sepsis
  • Ectopic pregnancy
  • Tubal occlusion with infertility
  • Fitz-Hugh-Curtis sx
99
Q

S/S of PID

A
  • Abd pain
  • Vag discharge
  • Low back pain
  • Irregular vaginal bleeding
    Pelvic exam:
  • Cervical motion tenderness**
  • Mucopurulent cervical discharge
  • Uterine tenderness
  • Adnexal tenderness (bilateral)
  • Toxic sx: fever, nv, severe pain
100
Q

Dx. of PID

A

Urinalysis:
- r/o cystitis and pyelonephritis

Cultures:
- Gonorrhea and chlamydia

Pregnancy test:

  • Preg until proven otherwise
  • PID is MC incorrect dx of ectopic pregnancy
  • PID rare in pregnancy but can occur in first 12 weeks gestation

Wet prep:

  • PID rare without coexisting purulent endocervical infection
  • Look for numerous WBCs
101
Q

Tx of PID

A
  • Doxycycline
  • Azithromycin
  • If tubual/ovarian abcess – include clindamycin or metronidazole
  • Remove IUD if present

Women's Health 1 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions