STI/epididymitis/VVC Flashcards

1
Q

what is the most common cause of testicular pain?

A

epididymitis, 80%

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2
Q

when do you treat with fluoroquinolones?

A

age > 35 or hx condomless anal insertive sex

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3
Q

what are some causes of chronic epididymitis?

A
trauma
prolonged sitting
prior scrotal/inguinal hernia
immunosuppresion
vasectomy
Bechet's disease
travel to a place w/ mumps or bucellosis 
amiodarone
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4
Q

what specific examination might support the dx epididymitis?

A

+ prehn’s

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5
Q

acute vs chronic epidimimytis

A

< 6 weeks

> 6 weeks

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6
Q

Red Flags (or ddx not to miss) for epididimytis

A

Systemic symptoms
Incarcerated hernia
Fournier’s gangrene (necrotizing fasciitis of perineum: acute scrotal pain, severe pain in anterior abdo wall spreading to gluteal muscles, scrotum, penis)
pain unrelieved with elevation (testicular torsion)
Testicular cancer

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7
Q

tx epididymitis for age < 35 and no insertive anal sex

A

GC/CT w/ cefixime or ceftriaxone X 1 dose and doxy X 10-14 days

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8
Q

tx for epididymitis for insertive anal sex

A

cefixime X 1 and levofloxacin X 10-14 days

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9
Q

tx for epididymitis > 35 years and no condomless sex or no risk factors for GC/CT

A

levofloxacin

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10
Q

common organism in BV (polymicrobial)

A

gardnerella vaginalis

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11
Q

BV is higher prevalence in what population?

A

WSW

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12
Q

risk factors for BV

A

IUD
smoking
new sexual partners, etc

NOT associated w/ DM or immunosuppression

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13
Q

what bacteria normally prevent overgrowth of microbes that cause BV?

A

lactobacilli

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14
Q

what percentage of BV are asymptomatic

A

50-75%

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15
Q

recurrent BV is defined as:

A

2+ 4 weeks

4+ one year

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16
Q

s/s trich

A

dyspareunia, pruritis, not a lot of d/c, vulva can look inflamed…. really it’s QUITE similar to BV or yeast

17
Q

amsel’s criteria for BV

A
3 or more: 
pH > 4.5 
moderate-profuse grey-white non-clumping d/c
\+ KOH whiff
Lab smear + for clue cells 

DCPW (discharge, clue cells, pH, whiff test)

18
Q

treat asymptomatic pts if:

A

pregnant
having gyne surgery/abortion/D+C
PID

19
Q

tx for BV

A

flagyl gel!!! -.75% (5g) daily X 5 days
clinda 2% (5g) daily X 7 days
** oil based will weaken condoms!!

20
Q

STI age highest prevalence

A

15-29

21
Q

LVG

A

lymphogranuloma venereum

22
Q

define multiple partners

A

> 2 in last 12 months

23
Q

LGV 3 stages

A

1) primary = painless small papules that ulcerate
2) 2nd within 2-6 weeks = lymphadenopathy, proctitis… may have systemic symptoms (fever/chills/malaise)
3) chronic inflammatory lesions

24
Q

Duration of tx for LGV

A

21 days

25
Q

Incubation for CT and GC

A

CT 2-3 weeks
GC 2-7 days
** consider window period for post-exposure testing!!

26
Q

GC TOC

A

persistent sx, reinfection, pregnant or chest feeding, pharyngeal infections, tx w/ 2nd line, PIDm etc… NAAT 2-3 weeks, culture 3-7 days (post completion of treatment)