Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CM III Exam III > STI's > Flashcards

STI's Flashcards

1
Q

Frothy gray or yellow-green vaginal DC, pruritis or cervical petechiae

A

Trichomonas vaginalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Thick white, curdy, cottage cheese like vaginal DC. Vulvar pruritis, erythema, irritation. External dysuria

A

Candida albicans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Malodorous vaginal DC that is reported more commonly after sexual intercourse or menses

A

Bacterial vaginosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Dysuria, muccopurulent DC, abd pain, intermenstrual bleeding, whitish or clear DC from penis

A

Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Dysuria, white, yellow or green DC, mucopurulent DC

A

Gonorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is normal vaginal DC like?

A

Clear to white, odorless, high viscosity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Normal vaginal pH?

A

3.8-4.2. Lactobacilli helps maintain this.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why is such an acidic environment okay for the vagina?

A

Acidic environment and other host immune factors inhibits the growth of bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Three most common types of vaginitis

A

Bacterial Vaginosis
Vulvovaginal candidiasis
Trichomoniasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Of the three most common types of vaginitis, which is most common?

A

Bacterial vaginosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Second most common form of vaginitis?

A

Candida. Affects most females during their lifetime.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Most prevalent non-viral STI?

A

Trichomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Major bacteria in bacterial vaginosis?

A

Gardnerella vaginalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pathogenesis of bacterial vaginosis

A

Overgrowth of bacteria normally present in vagina paired with a decrease/loss of protective lactobacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pathogenesis of vulvovaginal candidiasis?

A

Overgrowth of Candida albicans, a normal flora of the skin/vagina. Symptomatic clinical infection occurs w/ excessive growth of yeast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What predisposes you to candidiasis?

A

Disruption of the normal vaginal flora (doucheing) or host immunity will predispose you to vaginal yeast infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What;s the only protozoan that affects the genital tract?

A

Trichomonoas vaginalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

RF for bacterial vaginosis

A 
AA
>2 partners in last 6 mo
Douching
NO CONDOMS
absence/lack of lactobacilli
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

RF for candidiasis

A 
DM
IC
Abx
UNDERWEAR (EAT SHIT EVERYBODY)
Douching
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

RF for trich

A

Multiple partners
Being poor
Hx of STI
NO CONDOMS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Classic sx of bacterial vaginosis

A

Asymp!
Malodorous or fishy smell
Pruritic DC
thin, milky white, sometimes grey DC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Classic sx of candidiasis

A

Pruritic discomfort
Dysuria
Thick cottage cheese DC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Classic sx of trich

A

Asymp!
Pruritic DC sometimes green, yellow-green, frothy
Strawberry cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Vaginal pH <4.5?

A

Candidiasis or normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Vaginal pH >4.5?

A

BV or trich

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What would bacterial vaginosis show on a wet prep slide?

A

Clue cells! Few/no WBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What would candidiasis look like on a wet prep?

A

Few to many WBC. Other stuff is seen on the KOH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Trich on a wet prep?

A

Motile flagellated protozoa, many WBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is a KOH test?

A

Wet prep + 10% KOH prep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What will a KOH show on candidiasis?

A

Yeast psuedohyphae and budding yeast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What’s a fun test for BV?

A

Whiff test. Stick it up to your nose, “does this smell fishy”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which type of vaginitis uses the Amsel Criteria?

A

Bacterial vaginosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Best mode of diagnosing Trich

A

NAAT- Nucleic acid amplification. Aptima? Dunno, it was bolded. Done via swab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Best mode for diagnosing candidiasis

A

KOH, Hx and PE. Mostly a clinical diag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Best mode for diagnosing BV

A

Whiff test and Amsel Crit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Layout the Amsel Criteria

A

At least 3 of the following:

1) Basic vagina (>4.5)
2) Presence of clue cells on wet mount
3) Positive whiff test
4) Homogenous, non-viscous, milky white discharge that’s adherent to vaginal walls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Recurrence rate of BV and why

A

Recurrence of 20-40% one month after tx. This can be a result of the BV-causing pathogens persisting, or just the normal lactobacilli failing to recolonize.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Avoidance education: BV

A

Condoms, avoid douching.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Avoidance education: Candidiasis

A

Avoid douching & unnecessary abx (keep it natural)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Avoidance education: Trich

A

Condoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

How is transmission of G/C

A

Sexual or vertical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What’s more common G or C

A

C is the most common infection worldwide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

RF for G/C

A 
Multiple partners
Young age <25
Minority
Low education/socioeconomic
RxAx
Hx of other STI
MSM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Complications of G/C

A

PID- infertility goes with that
Fitz-Hugh Curtis (adhesions)
Neonatal conjunctivitis
Inc risk of HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Gonorrhea specific complication

A

Disseminated gonococcal infection (DIC)

Arthritis, tenosynovitis, dermatitis (from disseminated G)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Chlamydia specific complication

A

Reactive arthritis (Reiters syndrome)
Lymphogranuloma
Neonatal pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is Reiter’s Syndrome

A

Joint pain & swelling triggered by an infection in another part of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Difference between G/C symptoms in women

A

Nothing! They’re exactly the same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Women G/C Symptoms

A 
*Can be asymp*
Dysuria
Mucopurulent dc
Tender uterus
PID sx
Cervicitis in 85% of pts ****
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Men G symptoms

A

Dysuria

White/yellow/green dx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Men C symptoms

A

Mucoid or watery urethral dc. Oftentimes only seen when milking the penis. Can also have LA, ewie

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Pharyngeal G sx

A

Sore throat. Ick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Women’s GC cervix w/ cervicitis

A

Red/friable cervix on internal exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Preferred method of testing for G/C

A

NAAT. Done with a vaginal swab or a urine culture for men. NAAT can be used as a screening tool as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Who gets screened for G/C

A 
Sx and/or partner w/ STI
High risk behavior (prostitute)
Hx of STD
Pregnant
MSM 
Military service
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Recommended Regimen for Txing Gonorrhea

A

Ceftriaxone 250mg IM AND Azithromycin 1g PO single dose.

No azithromycin? Doxycycline 100mg PO BID for 7 days works too

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Txing Gonorrhea when Ceftriaxone is not available

A

Cefixime 400mg PO one dose AND azithromycin 1g PO one dose.

***since you’re not getting the ideal coverage you need a test of cure in a week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Txing Gonorrhea when pt has a ceph allergy

A

Azithromycin 2g PO single dose

***since you’re not getting the ideal coverage you need a test of cure in a week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

When do you need test of cure for gonorrhea

A

When you’re not getting the exact ideal management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Recommended Management for Chlamydia

A

Azithromycin 1g PO single dose.

No azith? Can use Doxy 100mg PO BID for 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What are some other drug regimens we can use for chlamydia

A

Sweet jesus don’t bother remember the doses. It’s just not worth it.

Erythromycin
Ofloxacin
Levofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

When is test of cure recommended?

A

If non-ideal regimen is used, compliance is in question, symptoms persist or suspected reinfection. And if you’re pregnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Repeat testing in pregnant women

A

Test via NAAT 3 weeks after completion of therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

When do we recommend repeat testing in normal (non pregnant) pop

A

3-4 months after treatment. Especially in adolescents. All patients will be screened at their next health care visit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What microbe(s) cause PID

A

It’s polymicrobial!

Gonorrhea, Chlamydia trach or both!

66
Q

How do you get PID?

A

Ascending spread of microorganisms from the vagina/cervix up to the endometrium, fallopian tubes, ovaries and pelvic peritoneum

67
Q

Evolution of PID

A

Cervicitis ->
Endometritis ->
Salpingitis/oophoritis/tuboovarian abscess ->
Peritonitis

68
Q

Is there a national surveillance of PID

A

Nah. But there’s been a modest decline in hospitalizations/new cases

69
Q

RF for PID

A 
Hx of PID
G/C
Douching
IUD insertion
BV
OCP
Demographics
70
Q

PID Complications

A

Ectopic pregnancy
Infertility
Chronic PP

71
Q

“Must haves” for PID diagnosis

A

Uterine tenderness OR
Adnexal tenderness OR
Cervical motion tenderness (exquisite pain on speculum exam)

72
Q

Not “must haves” but are nice to have for diagnosing PID

A 
Fever
Abnormal mucopurulent dc
WBC on wet slide
ESR
CRP
73
Q

When to consider admitting PID

A 
Pregnant
Non responsive to PO tx
Cannot take PO
Severe illness
Abscess
Cannot exclude surgical emergencies
74
Q

PID Recommended Tx

A

Ceftriaxone (250 IM) and Doxy (100mg PO BID x14days)

WITH OR WITHOUT FLAGYL

75
Q

When should PID pts start improving

A

72 hours post abx

76
Q

When to do repeat testing for PID in women who have G/C

A

3-6 months after tx

77
Q

What kind of testing should be offered to women with PID?

A

HIV

78
Q

Male partners of women with PID show what kind of symptoms?

A

None! They may be G/C pos, but totally asymptomatic. Should be txed empirally for both

79
Q

Two types of HPV

A

Low risk and High risk

80
Q

Low risk HPV is associated with ____

A

genital warts and mild pap abnormalities

81
Q

High risk HPV is associated with ____

A

Moderate/severe pap abnormalities, cervical dysplasia/cancer

82
Q

Which types of HPV are low risk

A

6 and 11

83
Q

Which types of HPV are high risk

A

16 and 18

84
Q

Does having high risk HPV mean you’ll get cancer?

A

Nope. In fact, most women with high risk HPV have totally normal paps and never develop any cellular changes or cancers.

85
Q

What is HPV clearance dependent on

A

Your immune system.

86
Q

Is HPV a DNA or RNA virus

A

DNA

87
Q

Most important RF for cervical dysplasia

A

Persistent oncogenic HPV infection

88
Q

___% of infections clear in 2 years

A

90%

89
Q

___% of sexually active men and women acquire HPV at some point in their lives

A

100% Penis

90
Q

Since pap screening programs, cervical cancer rates have dropped by __%

A

75%

91
Q

Most genital HPV infections are…

A

Transient! Totally asymptomatic without any clinical symptoms or consequences… PPEINS

92
Q

Genital HPV transmission

A

Sex

93
Q

HPV RF

A

Young age
Sex
Not being circumcised
IC

94
Q

HPV Sx

A 
Asymptomatic usually***
Dyspareunia
Pruritus
Burning
Bleeding on defecation (anal warts) &amp; PENIS... PENIS
95
Q

HPV PE findings

A

Genital warts
Positive Paps
Usually just asymptomatic though

96
Q

Types of genital warts

A

Condylomata acuminata (cauliflower)

Smooth papules
Flat papules (usually on internal structures)
Keratotic warts

97
Q

Two types of mild cervical changes on pap (Bethesda criteria-pathology speak)

A

ASC-US and ASC-H

98
Q

Which type of mild cervical change is more likely to be precancerous

A

ASC-H

99
Q

(Bethesda Criteria) Pathology-speak for moderate change on pap smear

A

Low grade squamous intraepithelial lesion (LSIL). These are our Low risk HPV’s

100
Q

Bethesda Criteria pathology speak for significant changes on pap

A

High Grade squamous intraepithelial lesion HSIL. These are our persistent HPV

101
Q

How to diagnose HPV

A

It’s a clinical diagnosis. But there’s also a role for acetic acid and (rarely) a wart biopsy

102
Q

Recommended Patient-Applied genital warts tx

A

Podofilox (condilox) 0.5% gel or solution.

103
Q

Dosing instructions for patient-applied podofilox

A

Apply solution w/swab or gel& finger BID for 3 days, then do 4 days of no tx.

***This cycle may need to be repeated like 4 times

104
Q

Are any of the patient-applied tx for genital warts established to be safe in pregnancy?

A

Nah, there’s a few provider applied options that are though

105
Q

Recommended Provider-applied therapy for genital warts

A

Cryotherapy w/ liquid nitrogen or cryoprobe.

This will have to be reapplied every 1-2 weeks

106
Q

Other forms of provider-applied therapies

A

Resin, Trichloracetic acid, or surgical removal

107
Q

How long does it take for genital herpes to clear?

A

It doesn’t. This is a chronic, lifelong condition

108
Q

Two types of HSV?

A

HSV 1 and HSV 2

109
Q

What causes most cases of recurrent genital herpes in the US?

A

HSV 2

110
Q

HSV 2, more common in women or men?

A

Women :(

111
Q

How is HSV transmitted?

A

Sexually and perinatally

112
Q

Which type of HSV is more likely to recur?

A

HSV2

113
Q

Can HSV-2 be transmitted when not flaring?

A

YES. Most cases are transmitted when the carrier is asymptomatic. Asymptomatic shedding is huge. This virus can be latent indefinitely

114
Q

Why should we ask pregnant women if they have a hx of HSV

A

Because there’s a crazy high risk of transmitting it to the kiddo (30-50%)

115
Q

HSV likes to lay low for a long time, but what happens when it reactivates?

A

When it gets reactivated, we’ll see an outbreak of herpetic lesions and some viral replication. Even more virus will be shed

116
Q

Scary fun fact about HSV2

A

90% of patients who are seropositive for HSV ab have NOT been diagnosed with herpes

117
Q

When is most HSV-2 transmitted?

A

During asymptomatic shedding

118
Q

Effect of antiviral suppressive therapy on viral shedding

A

Dramatically reduces it, but does not completely eliminate

119
Q

Ab presence and sx during primary HSV infection

A

No antibody present! This is their first exposure to HSV1/2

Primary infection will have more severe sx than recurrent. Lesions will be severe and bilateral

120
Q

Non primary HSV infection Ab and Sx

A

This is when someone who was previously seropositive to an HSV gets another one.

Milder symptoms! These lesions will be moderate, since they have some form of ab coverage

This is technically a new infection, so it will take a few weeks/months for an appear

121
Q

Recurrent symptomatic HSV infection, Ab and sx

A

Ab is present, disease is mild and short in duration. It’s the same HSV your body is used to

122
Q

Asymptomatic HSV Ab and Sx

A

Serum ab is present

No sx

123
Q

Life cycle of genital lesions

A

Papules -> Vesicules -> Pustules -> ulcers -> crusts -> healed

124
Q

Sx of Symptomatic HSV

A

Numerous, bilateral, painful genital lesions.

Can also have GU sx like pain, itching, dysuria, dc and tenderness

125
Q

Sx of Symptomatic Primary HSV

IE What are the lesions like, how long does the illness last

A

Systemic complaints, like fever,HA,malaise.

The lesions are more severe and last longer.

Illness lasts 2-4wks. Avg is 11 days

126
Q

Sx of Symptomatic Recurrent HSV

What are the lesions like, how long does it last, what type of symptoms are unique to recurrent

A

Recurrent tends to have prodomal sx, like localized tingling/irritation beginning 12-24 hours before the lesions occur.

The lesions are much less severe than the primary infection.

Illness lasts 4-6 days

127
Q

Gold standard for diagnosing HSV and its one caveat

A

Viral culture. Must get the culture from an open lesion, if it’s already healing then its no good to you

128
Q

What test is more sensitive than a viral culture and preferred for detecting HSV in CSF

A

PCR!

129
Q

When to get HSV serology

A

1) Recurrent gential symptoms but negative HSV viral cultures
2) Clinical diag of genital HSV but no lab confirm
3) Partner has herpes
4) Part of comp. STD eval

130
Q

Use of antiviral chemotherapy in HSV (what does it do, what does it not do)

A

Partially controls the sx of herpes and lowers viral shedding.

Does not eradicate the latent virus or affect risk/freq/severity of recurrences after d/cing drug.

131
Q

Two methods of tx in HSV

A

Episodic and supressive

132
Q

HSV First episode tx

A

Valacyclovir 1g PO BID for 7-10 days

133
Q

HSV Episodic tx (not first)

A

Valacyclovir 500mg PO BID for 3 days
OR
Valacyclovir 1g PO QD for 5 days

134
Q

HSV Supressive tx

A

Valacyclovir 1g QD PO

135
Q

HSV patient education key points

A

Potential for recurrent episodes, asymptomatic shedding and viral transmission

136
Q

Disease progression of syphilis

A

Primary ->
Secondary ->
Latent ->
Tertiary/Late

137
Q

Bug in syphilis

A

Treponema Pallidum

138
Q

Which stages of syphilis are the most contagious

A

Primary and secondary

139
Q

Syphilis transmission

A

Sexual and vertical (congenital syph)

140
Q

Major Sx of Primary Syphilis

A

Chancre lesion! It develops at the site of inoculation.

141
Q

Are chancre painful?

A

Nah. Totally painless

142
Q

Testing serology during early stages of syphilis?

A

May or may not be positive. This is not a reliable testing form

143
Q

Secondary Syph major sx. When do these occur?

A

Occurs several weeks/months after primary chancre. Can last for that long too.

Rash! Think palms and feet, but it sure as heck can be on your chest and back too. There’s other stuff too but it’s super vague. LA is a thing I guess. Think of syph when you see non resolving ulcerative skin lesions

144
Q

Serologic titers during secondary syph?

A

Wicked high. This is when the titers will be highest, serologically reliable at shit

145
Q

Only signs of latent syphilis

A

Positive serology! Their lesions will have gone away and they’ll have no clinically apparent signs

146
Q

When does latent syph occur

A

Anytime! Even in between secondary relapses

147
Q

Two categories of latent syph

A

Early Syph: <1 yr post intial infection

Late Syph: >1 yr post initial infection OR we just don’t know when the initial infection was

148
Q

Sx of tertiary syph

A

Gummatous lesions and CV syph

149
Q

Working up syph: PE

A 
Oral cav
LN
Skin-torso
Palms &amp; ankles
Genitalia and perianal area
Neuro exam
Abdomen
150
Q

Why is tertiary syph rare

A

Because we have abx now :)

151
Q

Can we diagnose syph based on one serologic test?

A

NO. Need to have multiple

152
Q

Three types of serologic testing for syphilis

A

1) Darkfield microscsopy
2) Non-treponemal
3) Treponemal

153
Q

Which kind of serologic testing is used to evaluate therapeutic effect and reinfection

A

Non treponemal

154
Q

Which serologic syph testing can be used as a confirmatory test

A

Non treponemal and treponemal

155
Q

What does treponemal testing measure?

A

Direct antibodies against T pallidium. These will stay positive for life.

156
Q

What does non-treponemal measure?

A

Reagin ab. Whatever that is

157
Q

What does darkfield microscopy measure?

A

It’s literally a wet slide performed immediately from the bugs in the lesion/ulcer. You look at all the little sphirocetes

158
Q

Diagnosing CNS Syph

A

1) Need to be serologically positive

2) Need a Positive CSF WU.

159
Q

Positive CSF Syph WU

A

1) CSF for pleocytosis (>5WBC)
2) Inc Protein conc (>45)
3) Positive VDRL and/or FTA-ABS

160
Q

What is VDRL

A

Blood test for syph (venereal disease research lab)

161
Q

Tx for syph

A

Everything but tert/late-latent:
Benzathine PCN G 2.4 mill units IM

Tert/late-latent:
Benzathine PCN G 7.2 mill units given as 3 doses IM at one week intervals

CM III Exam III (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions