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Women's Health - GYN > STI > Flashcards

STI Flashcards

1
Q

Most common STI in U.S.? Most commonly reported STI?

A

HPV

Chlamydia

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2
Q

Symptoms of HPV in females

A

genital warts that cause dyspareunia, pruritus, burning

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3
Q

Pap smear cytology results of HPV

A

cervical cell changes present:
LSIL - all subtypes
HSIL - 16 > 18

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4
Q

> 90% of ________ associated with HPV.

A

cervical cancer

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5
Q

When is HPV DNA testing NAAT done?

A

Triage ASC-US

Adjunct to pap screen for cervical cancer in women > 30

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6
Q

Treatment of HPV on genitals

A

Podofilox 0.5% solution or gel (Condylox)

Imiquimod 5% cream (Aldara)

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7
Q

What should be done next if HPV signs on cervical?

A

colposcopy, then possibly a biopsy

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8
Q

Gold standard of HSV diagnosis?

A

viral culture of lesions

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9
Q

Treatment of HSV

A

self-limiting, 10-12 days

Episodic:
Acyclovir 800 mg PO TID x 7-10 d OR
Valacyclovir 1000 mg PO BID x 7-10 d OR

Suppressive (+1 episode per month):
Acyclovir 400 mg BID for up to 5 years

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10
Q

Painful clustered vesicular lesions on genitals that are cause itching, dysuria, and vaginal discharge.

A

HSV - genital or cervical herpes

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11
Q

Who has annual screening for chlamydia and gonorrhea?

A

sexually active patients 25 and under

> 25 with risk factors

pregnant women in 1st trimester

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12
Q

Chlamydia sx’s based on location

A

cervicitis: mucopurulent opaque dc, cervical bleeding, friability
urethritis: dysuria, pyuria, freq

Bartholinitis: swelling of gland

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13
Q

Dx of chlamydia and gonorrhea

A

NAAT by swab or dirty urine

culture

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14
Q

Treatment of Chlamydia

A

Azithromycin 1 g orally in a single dose (or doxy if allergic, unless pregnant use amoxicillin)

Add ceftriaxone for gonorrhea

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15
Q

Partner management for patient’s with dx’d STI

A

eval and treat all partners within 60 days or last partner if > 60 days

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16
Q

Sequelae of GC, Chlamydia, PID in women

A

infertility, ectopic pregnancy, chronic pelvic pain

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17
Q

Disseminated gonorrhea

A

rare! Systemic, women>men, bacteremia without urogenital sx

skin lesions, arthralgia, tenosynovitis, arthritis, hepatitis, myocarditis, endocarditis, meningitis

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18
Q

Gonorrhea treatment

A

Ceftriaxone 250 mg IM

Add Azithromycin 1 gram po x 1 to treat Chlamydia

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19
Q

Etiologies of Pelvic Inflammatory Disease

A

Chlamydia and Gonorrhea (25-75% co-infected)

Other bacteria (E. coli, Bacteroides, streptococcus, etc.), endometritis, salpingitis, tubo ovarian abscess

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20
Q

What can pap smear thin prep test for?

A

HPV, GC, Chlamydia

21
Q

mucopurulent vaginal dc, pelvic pain, dyspareunia. DDX?

A

Chlamydia, Gonorrhea, PID (+/-)

22
Q

Risk factors for PID

A 
Risky sexual behavior
cervical ectopy (adolescence, OCP)
h/o STI
Douching
IUD
Bacterial vaginosis
23
Q

Hallmark findings of PID

A

Positive cervical motion tenderness

Uterine or adnexal pain

24
Q

gray vaginal discharge =

A

Gonorrhea

25
Q

Treatment of pelvic inflammatory disease

A

Treat with broad spectrum coverage to capture GC/CHL plus other vaginal organisms

Subclinical/Mild to mod: Ceftriaxone 250 mg IM in single dose + Doxycycline for 14 days
*Must follow up in 2 days; if worse admit for IV tx

Severe: admit; Cefotetan 2g IV q 12 hrs

26
Q

The risk of ________ is increased 6 to 8 fold after PID.

A

ectopic pregnancy

27
Q

Signs of severe PID that needs admission?

A

systemic finding: F/C, N/V, high WBC count

purulent vaginal discharge, severe pelvic pain

28
Q

Etiology of Syphilis

A

Treponema Pallidum

29
Q

What next if RPR/VDRL positive?

A

FTA-ABS

30
Q

Signs of secondary syphilis

A

mucocutaneous rashes on palms and soles

Titers highest in this stage

31
Q

Signs of primary syphilis

A

Chancre = painless indurated ulcer

32
Q

Signs of tertiary syphilis

A

gummatous lesions, aneurysms, aortic regurg, iritis. aortitis

33
Q

Signs of latent syphilis

A

No symptoms

+ serologic tests

34
Q

Syphilis labs if Chancre seen?

A

Darkfield microscopy and RPR/VDRL

35
Q

Syphilis labs if no chancre or lesion to test?

A

RPR/VDRL and FTA-ABS

36
Q

Lab results of neuro syphilis

A

+ serology
+ VDRL of CSF
elevated proteins in CSF

37
Q

Primary, secondary, and early latent syphilis treatment

A

penicillin G 2.4 million units IM in a single dose

38
Q

Late latent and tertiary syphilis treatment

A

penicillin G 7.2 million units total

3 doses of 2.4 million units IM each at 1-week intervals

39
Q

early vs late latent syphilis

A

early < 1 year

late > 1 year or unknown

40
Q

If HIV+ with syphilis, then how is treatment adjusted?

A

more freq and longer course of follow up due to increased likelihood of treatment failure

41
Q

Treatment of neurosyphilis

A

Aqueous crystalline penicillin G

42
Q

Reaction to anti-traponemal therapy with fever, malaise, N/V

A

Jarisch-Henheimer Reaction

43
Q

Syphilis follow up management

A

f/u at 6 and 12 months

extend f/u to 18 and 24 months for latent or tertiary

44
Q

Test for ____ infection to prevent syphilis.

A

HIV

45
Q

How is syphilis partner management different than other STI’s?

A

all partners exposed within 90 days instead of usual 60 are treated

46
Q

Symptoms of Trichomoniasis

A

foul smelling, grayish green vaginal discharge, strawberry cervix

47
Q

How is Trich dx’d?

A

wet mount for motile protoza
culture
NAAT
high vaginal pH

48
Q

Trichomonas treatment

A

Metronidazole 2g in single dose

  • No alcohol for 24 hrs

Women's Health - GYN (12 decks)

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