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Clin Med III > STDs > Flashcards

STDs Flashcards

1
Q

vaginitis

A
  • general term for vaginal infection, inflammation or change in vaginal flora
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2
Q

sx of vaginitis

A
  • discharge- change in volume, color
  • pruritis
  • odor
  • dyspareunia
  • dysuria
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3
Q

normal vaginal flora

A
  • mainly lactobacilli
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4
Q

normal vaginal pH in premenopausal women

A
  • 4.0 - 4.5
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5
Q

normal vaginal pH in premenarche or postmenopasual

A
  • 4.7
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6
Q

normal vaginal discharge

A
  • d/c is normal
  • is an issue when it causes sx like itching, pain, odor
  • normally clear or whiteish
  • odorless
  • more during mid cycle and pregnancy
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7
Q

things that can impact vaginal discharge

A
  • estrogen- progesterone contraceptives
  • diet
  • sexual activity
  • medications
  • stress
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8
Q

bacterial vaginosis

A
  • shift in vaginal flora: decreased lactobacilli and more diverse bacteria
  • increased production of amines by new bacteria
  • rise in pH > 4.5
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9
Q

what is the most common cause of discharge in younger women

A
  • bacterial vaginosis
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10
Q

major bacterial responsible for BV

A
  • gardnerella vaginalis*
  • prevotella spp
  • prophyromonas spp
  • bacteroides spp
  • produce amines
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11
Q

risk factors for BV

A
  • sexual activity
  • STD
  • AA
  • smoking
  • hygiene use i.e. douching
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12
Q

clinical manifestations of BV

A
  • asymptomatic
  • discharge*- thin, off white
  • fishy odor*
  • more noticeable after intercourse or during menses
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13
Q

dx of BV

A
  • thin gray- white d/c
  • pH > 4.5
  • pos whiff test- drop of KOH on discharge -> fishy odor
  • clue cells
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14
Q

treatment for BV

A
  • flagyl* PO or intravaginally
  • clindamycin or tinidazole
  • vaginal boric acid suppository X 30 d (recurrent)
  • flagyl gel intra vag 2X a week X 4-6 mo (recurrent)
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15
Q

candidiasis

A
  • common cause of vaginal itching and discharge
  • due to inflammation of candida spp
  • present in normal flora of 25% of women
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16
Q

types of candida that cause yeast infections

A
  • candida albicans- majority of cases
  • candida glabrata- milder sx
  • NOT assoc with reduction in lactobacilli
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17
Q

risk factors for candidiasis

A
  • diabetes
  • abx
  • increased estrogen levels
  • immunosuppression
  • diaphragms, sponges, IUDs
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18
Q

clinical manifestations of candidiasis

A
  • vulvar pruritis**
  • burning, soreness, irritation
  • dysuria
  • dyspareunia
  • erythema, vulvar excoriation
  • discharge is white, thick, adherent
  • normal cervix
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19
Q

diagnosis of candidiasis

A
  • microscopy of vaginal d/c
  • pH usu 4-4.5
  • KOH on discharge -> hyphae and budding
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20
Q

management of simple uncomplicated candidiasis

A
  • fluconazole (diflucan)
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21
Q

management of complicated candidiasis

A
  • fluconazole 2-3 doses 72 hours apart

- 7-14 days topical cream

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22
Q

management of candidiasis in pregnancy

A
  • no PO options

- clomitrazole, miconazole intravag X 7 days

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23
Q

trichomonas

A
  • due to protozoa trichomonas vaginalis
  • most common non-viral STD world wide
  • may be asymptomatic
  • usu self limited in men
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24
Q

trichomonas sx in women

A
  • varied sx
  • prurulent, malodorous thin d/c
  • burning, pruritis
  • dysuria
  • frequency
  • lower abd pain, dyspareunia
  • 70-85% are asymptomatic but will eventually dev sx
  • erythema of vulva and vaginal mucosa
  • strawberry cervix*
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25
trichomonas sx in men
- 75% asymptomatic - spont resolution within 10 d but can persist for months - mucopurulent urethral d/c - dysuria, burning - mild pruritis
26
diagnosis of trichomonas
- microscopy shows jerky/ spinning protozoa - pH > 4.5 - NAAT- gold std
27
management of trichomonas
- flagyl or tinidazole 2g single dose - treat partners - abstain from sex X 7 days
28
gonorrhea
- 2nd most commonly reported communicable disease/ STI - cervicitis in women - urethritis in men - extragintal infections- pharynx and rectum
29
risk factors for gonorrhea
- recent new sex partner, multiple partners - unmarried - young age - minority - low education - low SES - substance abuse - hx of gonorrhea, HIV
30
clinical manifestations of gonorrhea in women
- cervicitis* - urethritis- more in men - 70% asymptomatic - pruritis - mucopurulent d/c - pain is atypical unless PID
31
clinical manifestations of gonorrhea in men
- urethritis - mucupurulent d/c - dysuria - epdidymitis will dev if not treated - majority of men are symptomatic
32
diagnosis of gonorrhea
- genital swab in females - urine cx in men - NAAT- quicker but does not test susceptibility
33
treatment for gnorrhea
- ceftrixone PLUS azithromycin
34
chlamydia
- most commonly reported bacterial infx in U.S. - causes cervicitis and urethritis - mostly asymptomatic - 2X more common in women
35
risk factors for chlamydia
- age < 25 - new partner or more than 1 partner in last mo - hx of prev chlamydia or STIs - inconsistent condom use - ethnic groups - special pops
36
screening for chlamydia
- sexually active women 25 and under annually - over 25 based on risk - pregnant women - MSM- annually - men entering jail - military - new partner
37
clinical manifestations for chlamydia in women
- cervix affected - majority asymptomatic - nonspecific sx - change in vaginal d/c - cervical bleeding - frequency, dysuria - UA pos, Cx neg
38
clinical manifestations for chlamydia in men
- urethritis - mucoid or watery d/c - dysuria
39
diagnosis of chlamydia
- vaginal swabs in women - urine for men - NAAT
40
treatment of chlamydia
- azithromycin | - doxy
41
pelvic inflammatory disease
- acute infection of upper genital tract in women - uterus - ovaries - fallopian tube - endometrium - intiated by sexually transmitted agent
42
what disease causes more severe PID
- gonorrhea
43
risk factors for PID
- multiple sex partners - younger age - partners with STI or prev hx of STI - prev hx of PID - AA and black caribbean
44
clinical manifestations of PID
- usu acute onset - sx vary from mild vague pelvic sx to tubo-ovarian abscess - rarley fatal intra-abd sepsis - liver inflammation- perihepatitis - lower abd or pelvic pain, worsens with intercourse - onset of pain during or shortly after menses
45
dx of PID
- pelvic organ tenderness - CT if uncertain dx or complications - US - presumptive dx is enough to warrant empiric tx due to reprod sequelae - temp > 101 - abnormal d/c - WBC on microscopy - documentation of GC/ chlamydia infection
46
what causes syphilis
- treponema pallidium | - spirochete
47
how is syphilis transmitted
- direct contact with infectious lesion | - crosses placenta -> fetal infection
48
stages of syphilis
- early- occurs weeks to months after infection - early subdivided into primary, secondary, or early latent - late- untreated pts that go onto dev complications - late subdivided into tertiary or late latent
49
clinical manifestations of early syphilis
- chancre- painless ulcer | - bilateral LAD
50
secondary sx of early syphilis
- fever, HA - LAD - malaise, anorexia, weight loss - sore throat - rash*- maculopapular on soles of feet and trunk
51
clinical manifestations of late syphilis
- CV syphilis- esp aortitis - gummatous syphilis- nodular lesions - CNS paresthesias- tabes dorsalis
52
tertiary syphilis
- late who are sympomatic with CV or gummatous disease
53
latent syphilis
- asymptomatic but still infected | - not considered infectious
54
who to test for syphilis
- painless genital ulcer - rash on palms and soles - neuro sx without alternative etiology - partner with early syphilis - MSM - HIV infected - high risk sexual behavior - incarceration - sex workers
55
what are the tests for syphilis
- nontreponemal - treponemal - both are serum tests
56
non-treponemal test
- initial screening for syphilis in asymptomatic pts - non-specific, measures antibodies - reported as titer - can be used to monitor tx - RPR, VRDL, TRUST
57
treponemal test
- used as confirmatory test when non-treponemal is positive - reported as reactive or nonreactive - usu remain positive for life - FTA-ABS, TP-EIA
58
treatment of syphilis
- early= pen G IM X 1 - late= pen G IM X once weekly X 3 weeks - prednisone X 3 days if CV syphilis
59
treatment for neurosyphilis
- pen G IV q 4 hours 10-14 days or as cont infusion - cefriaxone - doxy
60
HPV cutaneous types
- types 1 and 2 | - assoc with plantar and common hand warts
61
HPV mucosal types
- types 6, 11, 16, or 18 | - assoc with genital warts, precancerous or cancerous lesions
62
risk factors for HPV
- sexual activity - increased number of partners - vaginal and anal intercourse - MSM higher risk for anal infection - heterosexual men higher risk oropharyngeal infection
63
vaccines for HPV in kids 11-12
- 2 shouts 6-12 mo apart
64
vaccines for HPV in kids over 14
- 3 shots over 6 mo
65
diagnosis of HPV
- pap smear to look for abnormal/ cancerous cells - HPV test to look for virus - women < 21 no testing - women 21-29 PAP q 3 years - women 30-65 and HPV cotesting q5 years
66
clinical manifestations of HPV
- most asyptomatic - abnorm pap or pos HPV test may be first sign - vulvar/ vaginal warts - itchy and painful - most strains that cause cervical cancer dont cause warts
67
management of HPV
- no tx for virus | - monitor with PAP smears
68
diagnosis of herpes
- active lesions can be unroofed and sent for viral cx and PCR - serologic testing not commonly done - screening not recommended
69
who needs chronic suppressive therapy for herpes
- 6+ episodes per year
70
who needs episodic therapy for herpes
- 5 or less episodes per year

Clin Med III (26 decks)

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