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gyn > STI > Flashcards

STI Flashcards

1
Q

Diagnose and treat Chlamydia

A

NAAT

Doxycycline 100 mg BID x 7 days

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2
Q

Diagnose and treat trichomoniasis

A

Naat or Wet mount

Metronidazole (Flagyl) 5000 mg BID x 7 days

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3
Q

Diagnose and treat Syphillis

A

FTA-ABS

Benzathine penicillin G 2.4 million units IM once

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4
Q

Diagnose and treat Gonorrehea

A

NAAT or culture on Thayer Martin media

ceftriaxone (Rocephin) 500 mg IM once

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5
Q

Diagnose and treat HSV

A

Viral culture/PCR or serum type specific

Acyclovir 400 mg po tid x 7 -10 days

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6
Q

Diagnose and treat Human Papilloma virus-condylomata acuminata

A

Visual observation, confirmed by biopsy if necessary

imiquimod 5% cream

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7
Q

Diagnose and treat HIV

A

Westernblot
Truvada 200/300mg 1 tab PO daily

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8
Q

Treatment for BV

A

metronidazole (Flagyl) 500 mg po bid x 7 days

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9
Q

Treatment for Candida

A

miconazole 2% vaginal cream 5 gm intravaginally x 3 days

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10
Q

5 P’s of sexual history

A

Partners

Prevention of Pregnancy

Protection of STIs

Practices

Past hx of STIs

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11
Q

Signs and sx of Chancroid

A

Single painful ulcer,
Erythematous,
Unilateral painful abscess
painful lymphadenopathy

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12
Q

signs and sx of chlamydia

A

Most will not report symptoms
May describe mucopurulent discharge
bleeding with intercourse
dysuria
Bartholin gland infection

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13
Q

signs and sx of Gonorrhea

A

Usually asymptomatic

Purulent Yellow/green discharge

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14
Q

signs and sx of nongonococcal urethritis (males)

A

Dysuria and urethral discharge

Mucoid penile discharge after milking penis

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15
Q

Signs and sx of syphillis

A

Primary-painless indurated ulcer at initial site with adenopathy

Secondary-maculopapular rash on palms and soles, flat wart-like lesions, adenopathy

Tertiary- cardiac neurological, auditory and gummatous lesions

Latent infection: No symptom

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16
Q

Signs and sx of HSV

A

Flu-like symptoms,
tingling before outbreak
painful vesicular lesions
white exudate centrally

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17
Q

Signs and sx of HIV

A

Fever
Malaise
adenopathy
rash in first few weeks
Blood diarrhea

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18
Q

signs and sx of HPV

A

May be asymptomatic
Fleshy
soft
pale-colored growths

19
Q

signs and sx of trichomonas

A

itching

yellow/green discharge

postcoital bleeding

intramenstrual bleeding

friable cervix
strawberry spots

20
Q

Treatment for molloscum contagious

A

cryotherapy with liquid nitrogen

21
Q

Signs and sx of molloscum contagious

A

light colored papules
umbilicate centers

22
Q

Retest for chlamydia

A

non-pregnant women should be retested in 3 months or at the next possible outpatient visit

Pregnant women should be should be retested no sooner than 3 weeks after tx
and
then rescreened again 3 months later or in the 3rd trimester

23
Q

Bacterial STI

A

Chlamydia (Chlamydia trachomatis)

Gonorrhea (Neisseria gonorrhoeae)

Syphilis (Treponema pallidum)

Chancroid (Haemophilus ducreyi)

Lymphogranuloma venereum (Chlamydia Trachomatis serovars L1, L2, L3

Granuloma inguinale (Klebsiella granulomatis)

Molluscum contagiosum

24
Q

Viral STI

A

Human Papillomavirus (HPV)

Herpes simplex virus (HSV 1 and HSV 2)

Human immunodeficiency virus (HIV)

Zika virus

25
Q

Protozoal and Parastic sti

A

Trichomoniasis (trichomonas vaginalis)

Pubic lice/crabs (phthirus pubis)

Scabies (Sarcoptes scabiei)

26
Q

STI presents with increased discharge

A

Chlamydia
Gonorrhea
Trichomoniasis

27
Q

STI presents with sores

A

Herpes
Syphilis
Chancroid
Lymphogranuloma venereum
Granuloma inguinale

28
Q

STI presents with lesions

A

Genital warts
Condyloma acuita (HPV)
Condylomata lata (Treponema pallidum)

29
Q

Gonorrhea retest

A

rescreen 3 months after tx for possible reinfection

or at next health care visit after 3 mo.

30
Q

Test for syphilis (info)

A

VDRL or RPR (these are non-treponemal tests)
they look for the NON-specific antibodies
that develop during syphilis
have a high false-positive rate
It is sensitive, not specific

Factors for false-positive:
pregnancy
autoimmune disorders
acute bacterial or viral infections

if no chancre is present, there may be a false-negative for 1st few weeks of infection.

31
Q

Next step if VDRL or RPR are positive to diagnose

A

if positive VDRL or RPR:
need a confirmatory treponemal test -

VERY important to confirm Diagnosis- Pos VDRL or RPR is a screen only

32
Q

What are the treponemal tests for syphilis

A

(FTA-ABS) fluorescent treponemal antibody absorption test

or passive particle agglutination assay (TP-PA)

or enzyme immunoassays (EIAs) or

chemiluminescent immunoassays (CLIAs)

33
Q
A

6 months to 1 year following tx,
VDRL or RPR (non-treponemal tests)
titers should decrease 4-fold with adequate tx

ex: 1:128 down to 1:32
an increase in titers following tx
indicates treatment failure or reinfection
offer HIV screening

tx all sexual partners from the last 90 days presumptively for syphilis

if the person has secondary or early latent syphilis,
previous sex partners in the last year may need to be notified

Reportable disease to the health department

34
Q

What is Lymphogranuloma Venereum

A

caused by C. trachomatis

different subtypes than those that cause chlamydial infection of the vagina

distinct disorder than Chlamydia

primarily an infection of the lymphatic system

35
Q

Subjective complains of Lymphogranuloma venereum

A

unilateral

painful inguinal lymphadenopathy or pelvic pain

about 1/3 of infected individuals recall having a nontender genital lesion

rectal infection is common

symptoms
–constipation, anal pain, tenesmus & bloody & mucoid anal discharge

36
Q

Clinical presentation for lymphogranuloma venereum

A

unilateral, painful, inguinal lymphadenopathy

lymph nodes may be fluctuant and rupture on compression

37
Q

Subjective sx of Granduloma Inguinale

A

painless beefy-red lesions that bleed on contact

genital lesions progressive
spread across the anogenital and inguinal areas

38
Q

objective findings for Granduloma Inguinale

A

ulcerative lesions that are red and bleed easily

39
Q

Treatment for Granduloma Inguinale

A

Azithromycin Z-pak 1 g orally /week once

40
Q

What are the main subtypes of HPV that causes genital warts

A

6, 11

causes 90% of genital wart

41
Q

Objective findings for genital wart (HPV)

A

on Physical exam
fleshy papules or pedunculated warty lesions
on the vulva, introitus, perineum, anus, cervix and vaginal walls
Large warts = condylomata acuminata
cauliflower-like appearance
may bleed when abraded

42
Q

Patient’s applied treatment for warts

A

Imiquimod

43
Q

Provider applied treatment for warts

A

Cryptotherapy with liquid nitrogen

44
Q

CDC recommendation for PID treatment f/u

A

within 72 hours

gyn (22 decks)

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