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IDMM > STI's and other genital tract infections > Flashcards

STI's and other genital tract infections Flashcards

1
Q

STI risk factors

A 
known contact with STI
anonymous sex
<25 y.o
new partner
multiple partner
no barrier contraception
drugs, alcohol, IDU
sex workers/ survival sex
sexual assault
Hx of STI
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2
Q

Urethritis/cervicitis

-S/S

A

Men:
Burning or pain during urination
Discharge from penis

Women:
Vaginal discharge/Abnormal bleeding
Pain during sex
Dysuria
***can be asymptomatic***
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3
Q

Urethritis/cervicitis

-etiology

A

Neisseria gonorrhea

Chlamydia trachomatis

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4
Q

How to diagnose gonorrhea or chlamydia

A

Swab the urethra/cervix and culture
OR
Send first-catch urine to lab for NAAT

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5
Q

Gonorrhea management

A
  • Cefixime or IM ceftriaxone (but resistance is growing)
  • contact tracing (reportable)
  • test for other STIs
  • determine vaccination status of HBV and HPV
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6
Q

Chlamydia management

A
  • doxycycline or azithromycin
  • contact tracing (reportable)
  • test for other STIs
  • determine vaccination status of HBV and HPV
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7
Q

Pelvic Inflammatory Disease

-definition

A

infection of the female upper genital tract (uterus, fallopian tubes, ovaries

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8
Q

Pelvic inflammatory disease

-etiology

A

Usually polymicorbial:

STI+ endogenous

(STI: gonorrhea/chlamydia)
(endogenous is local flora, aerobic and anaerobic)

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9
Q

Pelvic inflammatory disease

  • S/S
  • complications
A

Abdominal pain
Fever
cervical motion tenderness
adnexal tenderness

Complications: infertility, ectopic pregnancy, chronic pelvic pain

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10
Q

Pelvic inflammatory disease

-management

A
  • Antibiotics to cover STI and endogenous (aerobic and anaerobic)
  • report any confirmed STIs
  • test for other STIs
  • determine vaccination status of HBV and HPV
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11
Q

Genital ulcer disease

-etiology

A
  • usually HSV-2, HSV-1

- sometimes syphilis (Treponema pallidum)

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12
Q

HSV course of infection

A

Primary infection:

  • painful vesiculoulcerative lesions
  • fever
  • lymphadenopathy
  • rarely: urethritis/cervicitis or meningitis

Then infects the sacral sensory ganglion and becomes latent.

Reactivation has a prodrome of burning/itching/tingling.

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13
Q

Diagnosis of HSV

A

Viral swab of open vesicle

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14
Q

Management of HSV

A 
Oral antiviral:
-valacyclovir
-famciclovir
-acyclovir
NOT REPORTABLE
Test for other STIs
Determine HBV and HPV vaccination status
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15
Q

Primary syphilis

-S/S

A

-painless chancre of mouth/penis/rectum

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16
Q

Diagnosis of syphillis

A
  • RPR (rapid plasma reagin) serology test
  • PCR on fluid from chancre
  • Special stain on fluid from chancre
17
Q

Management of syphillis

A
  • IM benzathine penicillin
  • Contact tracing (reportable)
  • Test for other STIs
  • Determine HBV and HPV vaccination status
18
Q

Causes of vaginal discharge

A

1) bacterial vaginosis
2) vulvovaginal candidiasis
3) Trichomonas vaginalis infection

19
Q

How to find out what’s causing vaginal discharge

A 
Take a vaginal swab, gram stain, smear.
Look at the type of discharge:
-White clumpy (candidiasis)
-watery white/grey, copious (bacterial vaginosis)
-frothy white or yellow (Trichomoniasis)
20
Q

Management of vulvovaginal candidiasis

A
  • OTC antifungals or fluconazole PO
  • Eliminate risk factors like Ab use
  • NOT REPORTABLE
21
Q

Management of Trichomonas

A
  • metronidazole for patient and partner

- NOT REPORTABLE

22
Q

Bacterial vaginosis

A
  • metronidazole of clindamycin PO/topical for patient only

- NOT REPORTABLE

23
Q

Prostatitis

-S/S

A

Fever, chills, pain in rectum, dysuria

tender, boggy prostate on exam

24
Q

Prostatitis

-etiology

A

Gram-negative bacilli (e.g. E. coli)

Sometimes gonorhhea or chlamydia (but not usually)

25
Q

Prostatitis

-diagnosis

A
  • physical exam
  • urine microscopy
  • urine culture
  • blood culture
26
Q

Prostatitis

-management

A
  • Ab that cover G(-) bacillin
  • ciprofloxacin
  • TMP-SMX
  • Report only if due to STI
27
Q

All pregnant women should be screened for:

A 
HIV
HBV
Chlamydia
Gonorrhea
Syphilis
28
Q

HPV serotypes and what they cause

A

HPV 1,2,3,4- skin warts
HPV 6, 11- genital warts
HPV 16,18- cervical cancer and other cancers

29
Q

Prevalence of HPV

A

75% of sexually active adults

IDMM (33 decks)

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