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Dermatology > STDs > Flashcards

STDs Flashcards

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Dermatology Board Prep flashcards
1
Q

Trichomoniasis

  • definition
  • etiopathogenesis
A
  • infection (vulvovaginitis) caused by trichomonas vaginalis –> 90% urethral infection
  • trichomonas enters through vagina or urethra
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2
Q

Trichomoniasis

-clinical features

A

females

  • asymptomatic course 50%
  • foul smelling, yellow-green, frothy, purulent discharge
  • 2% - strawberry cervix - erythematous with petechia

-pruritus, burning sensation, redness of external genitalia, dyspareunia, frequent and painful urination

males

  • asymptomatic
  • urethritis
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3
Q

Trichomoniasis

  • diagnosis
  • treatment
A

-direct microscopy, culture, pH of vaginal discharge >4.5

  • metronidazole - first choice
  • treatment of partners
  • avoid sexual intercourse during treatment
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4
Q

Bacterial vaginosis - not an STI

  • definition
  • etiopathogenesis
  • risk factors
A
  • vulvovaginitis
  • normal vaginal flora has changed –> lactobacilli are replaced by anaerobes and aerobes –> vaginal pH increased
  • pregnancy, contraception, frequent sexual intercourse, multiple sexual partners, immunosuppression, acquired immunodeficiency, smoking
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5
Q

Bacterial vaginosis

-clinical features

A
  • asymptomatic 50%
  • grayish - whitish homogeneous discharge
  • unpleasant “fishy smell”
  • probably itching, but usually no pain or pruritus
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6
Q

Bacterial vaginosis

  • diagnosis
  • treatment
A
  • direct microscopy: absence of lactobacilli, presence of clue cells
  • 3 of 4 Amsel’s classification: whiff test, vaginal pH >4.5, no leukocytes, clue cells
  • first choice: metronidazole
  • oral probiotics
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7
Q

Gonorrhea

  • definition
  • etiopathogenesis
A

-sexually transmitted infection caused by Neisseria gonorrhoeae

  • facultative intracellular microorganism, survives only in host cells using its energy
  • invades cylindrical epithelium - detected in: cervix, urethra, rectum, conjunctiva, pharynx
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8
Q

Gonorrhea

  • epidemiology
  • risk factors
A
  • most common STI, 15-24 y.o

- multiple sexual partners, low socioeconomic status, lack of protection

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9
Q

Gonorrhea

  • diagnosis
  • treatment
A
  • anamnesis, molecular diagnostics, discharge microscopy (PMN leukocytes with gonorrhea diplococci), culture
  • third generation cephalosporins: ceftriaxone
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10
Q

Gonorrhea

-clinical features

A

-polyuria, dysuria, dyspareunia, purulent (yellow) odorless discharge

women:
-cervicitis, urethritis, pelvic inflammatory disease, bartolinitis (vulval edema, pain, discharge)

men:
-urethritis, epididymitis, proctitis

complications: pharyngitis, conjunctivitis (usually in newborns)

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11
Q

Urogenital chlamydiosis

  • epidemiology
  • risk factors
A
  • most common STI among adolescent up to 25 y.o

- multiple sexual partners, low socioeconomic status, lack of protection

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12
Q

Urogenital chlamydiosis

  • diagnosis
  • treatment
A
  • anamnesis, molecular diagnostics, discharge microscopy (non-specific findings, leukocytes increased but usually normal!)
  • Doxycycline or Azithromycin (pregnant women)
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13
Q

Urogenital chlamydiosis

-clinical features

A

-polyuria, dysuria, dyspareunia, purulent odorless vaginal discharge

women:
-cervicitis, urethritis, pelvic inflammatory disease, peri hepatitis, pregnancy complications,

men:
-urethritis, epididymitis, prostatitis, proctitis

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14
Q

Syphilis

  • definition
  • infected through:
A

-systemic disease caused by Treponema pallidum

  • sexual contact, blood transfusion, direct contact with the pathogen in saliva/mothers milk/ semen/vaginal discharge, transmitted through the placenta 12-16 week
  • sweat, tears, urine –> not contagious
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15
Q

Syphilis

  • epidemiology
  • risk factors
A
  • male more than female

- unprotected sex

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16
Q

Syphilis

  • diagnosis
  • treatment
A
  • history, symptoms, direct T. pallidum identification, T. Pallidum Ab detection, biopsy
  • non-treponemal tests, treponemal tests, dark field microscopy, PCR, CSF examination
  • penicillin G
  • VDRL test every 3 months after therapy
17
Q

Syphilis

-classification

A

Acquired - early and late

  • stages: primary, secondary, early latent, late latent, tertiary
  • tertiary - gummatous, cardiovascular, neurosyphilis

Congenital

18
Q

Syphilis

-classification

A

Acquired - early and late

  • stages: primary, secondary, early latent, late latent, tertiary
  • tertiary - gummatous, cardiovascular, neurosyphilis

Congenital

19
Q

Syphilis - clinical features

-Primary stage (6)

A
  • infection site papule –> painless ulcus durum (fluid is rich in spirochetes)
  • resolves within 3-6 weeks, 10-14 days when treated
  • ulcus/ erosion with elevated border and cartilage with surrounding erythema and local lymphadenopathy
  • males - glands, foreskin
  • females - rarely detected - cervix, labia minora and majora, periurethral
  • oral mucosa, lips, rectum, nipples, ears, fingers
20
Q

Syphilis - clinical features

-Secondary stage

A
  • due to spirchetal multiplication and dissemination in the blood
  • asymmetric flat pink macula (roseola)
  • fever, headache, tonsilitis, nocturnal arthralgia, malaise
  • non- pruritic, copper red, symmetric rash –> in face, palms, soles, trunk, skin folds
  • around 3 months –> lesions become papular –> most infectious stage
  • condylomata lata - smooth, white, painless lesions - highly contagious
  • syphilitic alopecia
  • oral and genital mucosal involvement
  • generalized lymphadenopathy
21
Q

Syphilis - clinical features

-Secondary stage

A
  • due to spirchetal multiplication and dissemination in the blood
  • asymmetric flat pink macula (roseola)
  • fever, headache, tonsilitis, nocturnal arthralgia, malaise
  • non- pruritic, copper red, symmetric rash –> in face, palms, soles, trunk, skin folds
  • around 3 months –> lesions become papular –> most infectious stage
  • condylomata lata - smooth, white, painless lesions - highly contagious
  • syphilitic alopecia
  • oral and genital mucosal involvement
  • generalized lymphadenopathy
22
Q

Syphilis - clinical features

  • early latent stage
  • late latent stage
A
  • no clinical signs, serological positive
  • dormant, asymptomatic
  • no clinical signs, serological positive
  • can last a long time
  • spirochetes stays in organs and tissues
  • dormant, asymptomatic
23
Q

Syphilis - clinical features

-Tertiary stage (6)

A
  • symptoms can manifest up to 20 years following the infection
  • skin involvement - superficial (kidney shaped lesion) or deep (syphilitic gumma - round/oval painless, develops into deep ulcers)
  • cardiovascular involvement - asymptomatic murmur, aortitis, aneurysm
  • bone, muscle, internal organ (esophagus, stomach, liver) involvement
  • heals with scarring
  • neurosyphilis
24
Q

Syphilis - clinical features

-neurosyphilis

A

asymptomatic

symptomatic

  • acute meningeal syphilis
  • meningovascular syphilis - subacute stroke, cranial neuropathies
  • late neurosyphilis - general paresis, Argyll Robertson pupil, syphilis myelopathy
25
Q

Congenital syphilis

-etiopathogenesis

A

-vertical transmission - transplacental transmission from an infected mother

26
Q

Congenital syphilis

-clinical features - early congenital syphilis (5)

A
  • hepatomegaly and jaundice
  • rhinorrhea
  • maculopapular rash on palms and soles
  • skeletal abnormalities
  • generalized lymphadenopathy
27
Q

Congenital syphilis

-clinical features - late congenital syphilis (5)

A
  • saddle node, frontal bossing, short maxilla
  • Hutchinson teeth and mulberry molars
  • skin: gummas
  • “saber shins”
  • cranial nerve defects, hydrocephalus
28
Q

Congenital syphilis

-diagnosis

A
  • RPR or VDRL
  • dark field microscopy or PCR

fetus
-ultrasound examination showing –> placentomegaly, hepatomegaly, ascites, hydrops fetalis

29
Q

Congenital syphilis

  • treatment
  • prevention
A
  • penicillin G

- maternal screening in early pregnancy

Dermatology (10 decks)

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