STIs

Question 1

Chancroid is an STI caused by a gram ______ bacilus ___________ _____________

Answer 1

Chancroid is a sexually transmitted infection caused by the gram-negative bacillus Haemophilus ducreyi.

Question 2

Chancroid manifests clinically with…

Answer 2

-Multiple purulent lesions 1-2cm in size w/greyish necrotic base
-painful
-painful inguinal lymphadenopathy

Question 3

You have a woman coming in with a hx of inconsistent condom use, multiple small demarcated painful purulent lesions with a greyish necrotic base. What is at the top of your diff?

Answer 3

Chancroid caused by Haemophilus ducreyi.

Question 4

You have a patient that comes in with a painless genital ulcer (typically solitary) with indurated borders. What is at the top of your diff?

Answer 4

Syphilis Chancre (NOT CHANROID which is painful)

Question 5

Low-grade fever, myalgias, and a diffuse maculopapular rash involving the palms and soles are features of _____________syphilis.

Answer 5

SECONDARY:
Low-grade fever, myalgias, and a diffuse maculopapular rash involving the palms and soles are features of secondary syphilis.

Question 6

A patient comes in with a painless chancre. The nurse does a swab of the lesion. Would a culture be indicated?

Answer 6

Chancre is consistent with SYPHILIS. Although bacterial cultures are used to detect a wide variety of pathogens, they cannot be used in the diagnosis of syphilis. Treponema are obligate intracellular organisms that can only survive in mammalian cells and cannot be cultured in the laboratory.

Question 7

Condylomata lata is a manifestation of what?

Answer 7

Secondary Syphilis

A manifestation of secondary syphilis that causes broad-based, wart-like, papular erosions in the anogenital region, intertriginous folds, and oral cavity.

Question 8

Clinical features in combo with a positive RPR and treponemal ab test are diagnostic of….

Answer 8

SECONDARY Syphilis

Question 9

What is our mainstay tx option for gonorrhea in pregnancy?

Answer 9

Ceftriaxone

Question 10

Punctate hemoorrhages on the cervix with green-yellow malodorous discharge is highly concerning of…

Answer 10

Trichomonas vaginalis

Question 11

What symptoms may present in a patient with trich?

Answer 11

pruritus and dysuria, speculum exam will help you dx with a strawberry cervix and green yellow smelly discharge

Question 12

You see this on wet mount, what is the likely organism if this was found in a sexually active 21 yo female with pruritis and dysuria?

Answer 12

Trichomonas vaginalis

Question 13

What happens to vaginal pH with trich?

Answer 13

It raises to above 4.5

Question 14

What is first line therapy for a person dx’d with trich?

Answer 14

metronidazole for both partners

Question 15

Clue cells on wet mount are highly suggestive of…

Answer 15

bacterial vaginosis with gardnerella vaginalis

Question 16

Motile organisms/ flagellated protozoa on wet mount are highly suggestive of what organism?

Answer 16

Trichomonas vaginalis

Question 17

What would you see on wet mount for a yeast infection?

Answer 17

pseudohyphae

Question 18

What are the signs of disseminated gonorrhoeae?

Answer 18

Fever, migratory polyarthralgia, tenosynovitis.

Question 19

What is the hallmark presentation of primary syphilis?

Answer 19

painless chancre

Question 20

What is the hallmark presentation of secondary syphilis?

Answer 20

fever, diffuse maculopapular rash, lymphadenopathy, condylomata lata

Question 21

what is the hallmark presentation of tertiary syphilis?

Answer 21

tabes dorsalis, aortitis, and gummas

Question 22

What is our mainstay tx for chlamydia?

Answer 22

azithromycin or doxycycline