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Repro. Med 3 > STDs AHHH! > Flashcards

STDs AHHH! Flashcards

1
Q

___-___ y/o account for 50% of all new STD infections

A

15-24 y/o

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2
Q

What is the most common STD? 2nd most common? 3rd most common?

A

Most common: HPV

then HSV-2, then Trich

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3
Q

Disruption of ___ and ____ make the transmission of HIV much easier

A

epithelial and mucosal barriers

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4
Q

What factors facilitate HIV transmission?

A
  1. Increase the # of HIV target cells in the genital tract
  2. Increase expression of HIV co-receptors
  3. Induce secretion of cytokines (increase HIV shedding)
  4. HIV alters natural hx of some STIs
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5
Q

Where are people most likely to seek care for a STD?

Are men or women more likely to seek care?

A

PCP

Women

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6
Q

What STDs commonly present as sores?

A

Syphillis
Herpes (HSV1 or 2)

*uncommon in the USA–> Lymphogranuloma venereum, Chancroid, Granuloma inguinale

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7
Q

What STD commonly present w/ discharge?

A 
Gonorrhea
Chlamydia
Trichomonas vaginitis / urethritis
Candidiasis (not an STD)
Bacterial vaginosis (sexually associated, but not sexually transmitted!)

Other major concerns: genital HPV and caCAncer

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8
Q

Just as birds of a feather, flock together…. so do ____

A

STDs

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9
Q

What is the DDx of painful genital ulcers

A

Genital herpes simplex

Chancroid

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10
Q

What is the DDx of PAINLESS genital ulcers?

A

Syphilis

Lymphogranuloma venereum (caused by chlamydia)
Granuloma inguinale (a sexually transmitted version of Klebsiella)
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11
Q

What is the incubation phase for syphilis?

A

10-90 days (averge 3 weeks)

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12
Q

A ___ is a painless, indurated ulcer w/ a clean base and smooth, firm border

What STD if this associated w/?

A

Chancre

Syphilis

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13
Q

A chancre goes unnoticed in __-__ % of pts and resolves in ___-___ wks

A

Unnoticed in 15-30% of pts

Resolves in 1-5 weeks

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14
Q

T/F: A chancre makes syphilis very infectious

A

True

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15
Q

____ is the hematogenous dissemination of spirochetes that usually occurs 2-8 weeks after a chancre appears. S/s resolve in 2-10 weeks.

A

secondary syphilis

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16
Q

What are common findings w/ secondary syphilis? (x4)

A

Rash - whole body (includes palms/soles)
Mucous patches
Condylomata lata - HIGHLY INFECTIOUS
Constitutional sxs

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17
Q

What can you use to dx syphilis?

A

Darkfield

Serology

18
Q

What is the recommended tx for syphilis?

A

Benzathine PCN G (Bicillin), 2.4 million units IM x 1

19
Q

Transmission of HSV is through direct contact usually during (symptomatic/asymptomatic) shedding

A

asymptomatic

Shedding during the prodrome is common!

20
Q

The primary infection of HSV is commonly (symptomatic/asymptomatic)

A

Asymptomatic (mainly people dont know they have it)

21
Q

How do you dx HSV?

A

PCR
Cx
Serology (Type-specific; Western blot)

22
Q

How do you tx HSV?

A

Acyclovir
Valacyclovir
Famciclovir

23
Q

What is the dosing for acyclovir?

***MUST KNOW

A

400 mg PO q8hr for 7-10 days

or 200 mg PO q4hr while awake (5 times daily) for 10 days

24
Q

Tx is (longer/shorter) for primary infection and (longer/shorter) for recurrent infection

A

Longer

Shorter

25
Q

When may you consider chronic HSV suppression tx?

A

After 1 yr of infection (more likely to have recurrences at this time)

If the pt is having 4+ recurrences/year

26
Q

_____ is an effective tx against STIs. When treating gonorrhea, ureaplasma urealyticum and chlamydia, take a dose of 1000mg (two 500mg tablets).

When treating Mycoplasma genitalium, primary syphilis, and nonspecific urethritis, the dose should be increased to ____ mg

A

Zithromax

2000 mg

27
Q

What are the S/S of Gonorrhea in males?

A

“Drippy, Hurty PP”

Dysuria and urethral discharge (5% asymptomatic)

28
Q

What are the S/S of Gonorrhea in Women?

A

Majority are asymptomatic

may have…

  • vaginal discharge
  • dysuria, urination
  • labial pain/swelling
  • abdominal pain
29
Q

where is the primary site for urogenital infection in women with gonorrhea?

A

Endocervical canal

***70-90% also colonize urethra

30
Q

what is the incubation phase for gonorrhea in men?

A

1-14 days

women maybe 10 days

31
Q

what is the etiology (bacteria) for Nongonococcal Urethritis

A

Unknown in ~50% cases

20-40% C. trachomatis

20-30% genital mycoplasmas (Mycoplasma genitalium, Ureaplasma urealyticum)

32
Q

What are s/s of Nongonococcal Urethritis

A

Mild dysuria

mucoid discharge

33
Q

What is the clinical Manifestations for chlamydia

A

Mostly asymptomatic (50% of men, 75% in women)

cervicitis
urethritis
proctitis
lymphogranuloma venereum
PID
34
Q

how can you dx Chlamydia

A

NAAT

can gram stain

35
Q

how can you tx Gonorrhea?

A

Cefitriaxone 250 mg IM x 1
+
Azithromycin 1gm PO x 1 Or OR
Doxycycline 100mg PO BID x 7d

36
Q

what complications are caused during delivery for infected women with chlamydia and transmits it to newborn

A

Conjunctivitis

PNA

37
Q

Chlamydia is an ____ ____ bacteria that infects columnar epithelial cells and survive by ____ and results in the death of the cell

A

obligatory intracellular bacteria

replication

38
Q

How do you tx Chlamydia/NGU

**Know doses

A

Azithromycin 1gm po x 1 Or
Doxycycline 100mg po BID x 7d

Alternative:
Erythromycin base 500mg po QID x 7d Or
Erythromycin EES 800mg po QID x 7d Or
Levofloxacin 500mg po qd x 7d Or
Ofloxacin 300mg po BID x 7d
39
Q

___ is a Sexually transmitted parasite

A

Trichomonas Vaginalis

40
Q

Trichomonas Vaginalis has an estimated prevalence os
___% in the general female population
Prevalence (increases/decreases) with age
Highest rates in __ (populaiton)

A

3.1%
increases
AA

41
Q

How do you dx trich?

A

wet mount (fastest)

or OSOM test (trich rapid test)

42
Q

How do you treat Trich?

**know doses

A

Metronidazole 2gm PO x 1 dose Or
Tinidazole 2gm PO x 1 dose

Alternative:
Metronidazole 500mg PO BID x 7d

Repro. Med 3 (14 decks)

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