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Found 6 > STI > Flashcards

STI Flashcards

1
Q
  • 85% of primary & secondary syphilis
  • 51% also w/ HIV
A

MSM

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2
Q
  • Most prevalent NON-VIRAL STI in United States?
  • MC presentation?
  • When do sxs occur?
A

Trichomoniasis

  • Asymptomatic
  • 1-4 weeks after exposure
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3
Q
  • urethritis
  • epididymitis
  • prostatitis
A

3 sxs of Trichomoniasis in men

(but men are usually asymptomatic)

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4
Q
  • Increased vag pH >4.5
  • Vag irritation, malodorous, frothy, yellow/green discharge
  • LOTS of discharge
  • Petechiae on cervix or vagina (what’s this called)?
  • Organism?
A

Trichomoniasis

  • Strawberry Cervix
  • Trichomonas vaginalis
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5
Q

Dx of Trichomoniasis

  • 60% accurate?
  • Most accurate?
A
  • 60% - wet mount w/ flagellated organisms
  • Swab –> culture (takes 7 days)
  • NAAT = fast and most accurate
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6
Q

Tx of what?

  • Metronidazole (oral)
  • Tinidazole (single dose)
  • Retest in __
  • Test of cure in ___ (for pregnant pts)
A

Trichomoniasis

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7
Q

Increases risk of premature rupture of membranes, preterm deliv, low birth weight

(but tx does NOT reduce risk)

A

Trich

(can tx pregnant women w/ Metronidazole)

(Lactating women should not breast feed 12-24 hrs after Metron single dose)

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8
Q
  • MC bacterial STI in United States
  • Organism?
  • Peaks in late teens/early 20s
  • Screening?
A

Chlamydia

  • Chlamydia trachomatis (gram -)
  • Women 25 or younger screened yearly
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9
Q
  • cervical dsch
  • vag bleeding
  • low abd pain
  • F/chills
  • adnexal tenderness
  • burning
  • SMALL amt discharge
A

Chlamydia sxs of women

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10
Q
  • Oral & Rectal infections are more common in Trich or Chlamydia??***
  • Possible in which other infection?
A

Chlamydia

  • Gonorrhea
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11
Q
  • 1st catch urine
  • NAAT
  • Pharynx/Rectal swab
  • Tx: Azithromycin single dose or Doxy x7 days
  • Don’t use which med in pregnant pts?? Cat D
A
  • Chlamydia
  • Doxy is Class D Preg
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12
Q
  • Increased risk of HIV
  • Untreated –> PID
  • Males –> epididymitis
A

Chlamydia & Gonorrhea

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13
Q
  • May lead to preterm delivery
  • Leading cause of MILD conjunctivitis and PNA in newborns (ophthalmia neonatorum)
A

Chlamydia

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14
Q
  • Severe conjunctivitis in newborns
A

Gonorrhea

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15
Q
  • sxs 1-14 days after exposure
  • Screen sexually act women under 25
  • NO recommendations for men or women over 25
A

Gonorrhea

(Neisseria gonorrhea = gram -)

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16
Q
  • Women:
    • Usually asymptomatic
    • cervical motion tenderness
  • Men:
    • urethritis, dysuria
    • white/yellow/green discharge
A

Gonorrhea

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17
Q
  • 1st catch urine
  • NAAT
  • Gram stain: PMN leuks w/ intracellular Gram-negative diploccoci**

(On exam)

A

Dx of Gonorrhea

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18
Q
  • IM Ceftriaxone + Azithromycin PO
  • or DOxy
A

Tx of Gonorrhea

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19
Q

Newborns: perforation of globe & blindness

A

Gonorrhea

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20
Q

MC cause of PID

A
  • STI organisms
    • Chlamydia & Gonorrhea
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21
Q

IUD within ___ of insertion can be cause of PID

A

3 weeks

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22
Q
  • Lower abd/pelvic pain
  • Cervical Motion Tenderness (Chandelier sign)
  • Uterine or adnexal tenderness
  • Cervical friability
A

PID

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23
Q
  • Get serum quant HCG
  • US to r/o ectopic
A

PID

24
Q

Outpatient regimen:

  • Cef
  • Doxy x 14 days
  • +/- Metronidazole x 14 days

Inpatient: IV

**FU in 48 hrs**

A

PID

25
Q

Hospitalize pts w/ ___ if:**

  • cannot r/o ectopic, appy, torsion
  • pregnant
  • Unresponsive to oral abx (48-72 hrs)
  • Tubo-ovarian abscess
  • Pt is VERY ill w/ 102.2F, N/V, looks sick
A

PID

26
Q

Main compliation of PID?

A

Infertility

27
Q

Fitz-Hugh -Curtis syndrome

  • What is it? / Which disease?
  • WHat 2 sxs?
A

PID

  • Perihepatitis
  • RUQ pain & Adhesions
  • Adhesions between liver & diaphragm
28
Q
  • Acyclovir
  • Valacyclovir
  • Famciclovir
  • Reduce dose if renal insufficiency
  • Initial outbreak: ___ days
  • Recurrent outbreak ___ days
A

Tx of Genital Herpes

  • initial: 7-10 days
  • recurrent: 1-5 days
29
Q

Transmission during vaginal delivery MC

C-section to reduce transmission

A

Genital Herpes

30
Q

MC syndrome of Neonate HSV from genital herpes

A

Localized Skin, Eye, Mouth (SEM disease) 4 weeks after birth

31
Q

MC STI overall?***

on exam

A

HPV

6&11 are sexually transmitted

32
Q
  • Most asymptomatic
  • Condyloma acuminata
  • flesh colored / soft
  • cauliflower
  • Persistence of this infection is MCC of ____
A

HPV

  • Cervical Cancer
33
Q

Pt applied therapy:

  • Imiquimod
  • Podofilox

Provider applied:

  • Cryotherapy
  • Surgical therapy
  • Trichloroacetic Acid (TCA)

(NO CURE of this)

A

HPV

34
Q

Vaccine for HPV?

A

9-valent HPV (Gardasil 9)

35
Q
  • Treponema pallidum
  • painless chancre
A

Syphilis

36
Q

Primary Syphilis

A

Painless Chancre

37
Q

Secondary Syphilis

A
  • Rash
    • diffuse, symmetric, macular/papular, NON-pruritic
    • Palms and soles of feet
    • Salmon colored lesions
38
Q

When is syphilis no longer sexually transmittable?

A

Latent

(asymptomatic)

39
Q

Late syphilis

A
  • 10-20 yrs after infection
  • Neuro deficits: blindness, dementia, damage to internal organs
40
Q

What type of syphilis can happen at ANY stage?

A

Neurosyphilis

41
Q

Dx of syphilis

A
  • Non-treponemal serological assays
  • RPR (MC used) = rapid plasma reagin
42
Q
  • Benzathine PCN G (IM)
  • If PCN allergy: oral doxy
  • retreatment: weekly Benzathine PCN G (IM x 3 weeks)
A

Tx of Syphilis

43
Q

Early Congenital Syphilis

  • Manifests prior to __ yrs

Late Congenital Syphilis

  • Manifests after __ yrs
A
  • 2
  • 2
44
Q
  • CNS syphilis
  • Long bone abnorm
  • PNA
  • Severe anemia
A

Early COngenital Syphilis

45
Q
  • Gumma Formation (granulomatous lesion)
  • Hutchinson Triad***??

(On exam)

A

Late Congential Syphilis

  • Hutchinson teeth
  • Interstitial keratitis
  • Sensorineural hearing loss
46
Q

Tertiary Syphilis

A
  • Multi-organ involvement
  • Gummatous syphilis (skeletal, spinal, mucosal)
  • CV syphilis: aortic regurg, CAS, aortitis
47
Q
  • Haemophilus ducreyi
  • Sporadic outbreak in US
  • Painful ulcer
  • fould discharge
  • buboes
  • Contact County Health Dept
A

Chancroid

48
Q
  • Chlamydia trachomatis
  • “groove sign”
  • rectal bleeding
  • Contact County Health Dept
A

Lymphogranuloma venereum (LGV)

49
Q
  • Pthirus pubis
  • Crab louse
  • Tx: Permethrin cream rinse
A

Pediculosis Pubis

50
Q

All pregnant women should be screened for what 3 things?

A
  • HIV
  • Syphilis
  • HBsAg
51
Q

Annual screenings for which 2?

A
  • Chlamydia
  • Gonorrhea
52
Q

Screen MSM annually for what 2?

A
  • HIV
  • Syphilis
53
Q

Screen 13-64 y/o

A

HIV

54
Q
A
55
Q

9-Valent HPV (Gardasil 9) vaccine for <15 y/o

A

2 doses

  • 0 months
  • 6-12 months
56
Q

9-Valent HPV (Gardasil 9) vaccine for 15+ y/o

A

3 doses

  • 0 months
  • 1-2 months
  • 6 months

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