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Women's Health > STIs > Flashcards

STIs Flashcards

1
Q

Which PID complication?

-RUQ pain and violin string adhesions of liver…

A

perihepatitis/Fitz-Hugh Curtis Syndrome

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2
Q

Patient presents with:

low abdominal pain during/shortly after menses

dyspareunia

cervical motion/adnexial tenderness

purulent discharge

A

acute symptomatic PID

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3
Q

workup for PID…

A 
urine preg
d/c microscopy for WBCs
NAAT
STI/HIV screens
UA
CBC
ESR
CRP
Pelvic US
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4
Q

Tx for mild/moderate PID

A

ceftriaxone 250mg IM + Doxy 100mg BID x 14 days

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5
Q

When should f/u occur with PID Tx?

A

48-72 horus

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6
Q

The below are indications for what tx of PID?

Pregnancy
Refractory
noncompliance
NPO/N/V
high fever
complications/abscess
surg. emergency can't be excluded
A

hospitalize

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7
Q

What abx can be added to ceftriaxone and doxy for PID?

A

+/- metro 500mg PO BID x 14 days

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8
Q

What is an alternative to doxycycline for PID tx?

A

azithro 1gm q weekly x 14 days

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9
Q

This condition confers increased risk for ectopic pregnancy, infertility, hydrosalpinx and chronic pelvic pain

A

PID

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10
Q

When can PID patients resume sexual intercourse?

A

complete therapy, sxs resolved, partners treated

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11
Q

Who should have repeat testing in 3 mo after PID?

A

(+) for GC or chlamydia

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12
Q

MC STI worldwide transmitted thru infected skin/mucosa that can infect anogenital region

A

HPV

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13
Q

MC HPV types and oncogenic potential…

A

6 and 11, low oncogenic

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14
Q

Patient presents with:

soft, flesh colored plaque

cauliflower like lesions on anogenital region

A

HPV

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15
Q

If uncertain dx of an anogenital lesion, what diagnostic can be used?

A

bx

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16
Q

cyto destructive tx for HPV…

A

podofilox

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17
Q

Immune-mediated tx for HPV (2)

A

imiquimod, sinecatechins

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18
Q

Surgical tx for hpv (4)

A

cryo, laser, cautery, excision

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19
Q

how is HPV prevented?

A

vaccine

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20
Q

Patient presents with:

painful genital ulcer

inguinal LAD

can be asymptomatic

A

HSV/genital herpes

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21
Q

incubation for HSV after exposure is…

A

2-12 days

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22
Q

Which class of HSV tests is preferred?

A

virologic (cx, PCR)

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23
Q

Viral cx for HSV has highest dx yield when?

A

early stages

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24
Q

is PCR more or less sensative than viral cx for HSV?

A

more sensitive

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25
Q

presence of HSV-1 Abs can indicate what forms of disease?

A

anogenital or orolabial

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26
Q

is regular herpes screening indicated for general population?

A

no

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27
Q

first episode of HSV tx…

A

7-10 days antivirals

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28
Q

episodic tx of hsv outbreak

A

1-5 day regimen antivirals (acyclovir, etc.)

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29
Q

suppression tx for hsv

A

QD-BID dosing

30
Q

Screening for which diseases would occur in sexually active women < 25 and older women w. risk factors?

A

GC chlamydia

31
Q

Screening for _____ should be added to GC and chlamydia where prevalence is high.

A

trichomonas

32
Q

repeat testing should occur with what diseases?

A

GC, chlamydia, trich

33
Q

5 Ps of Sexual Hx

A

Partners (in last year, last sexual contact)

Practices (sites)

Preg Prevention

Protection (STI, condom use)

Past Hx STI (pt. and partners)

34
Q

who accounts for 1/2 of all new STIs?

A

youth

35
Q

This is a d/o of vagina caused by infx, inflammation, change in vaginal flora

A

vaginitis

36
Q

3 MC causes of vaginitis

A

candida, BV, trich

37
Q

Is candidiasis considered STI? Do partners need to be tx?

A

not STI, no partner tx

38
Q

The below are RFs for…

DM, Abx, Increased Estrogen, Immunosuppression

A

candidiasis

39
Q

Patient presents with:

Pruritis

curd-like adherent white thick d/c

A

vulvovaginal candidaisis

40
Q

dx for candidiasis can be made via

A

10% KOH Wet Mount

41
Q

uncomplicated vulvovaginal candidiasis can be tx by…

A

fluconazole 150mg PO x 1 dose

OR

clotramazle topical x 1-3 days

42
Q

Complicated (4+ yearly or comorbidities) vulvovaginal candidiasis tx

A

fluconazole 150 mg PO q 72 hours x 2-3 doses

OR

topical azole x 7-14 days

43
Q

Pregnant vulvovaginal candidiasis tx…

A

clotramazole or miconazole topical x 7 days

44
Q

MC cause of vaginal d/c in women of childbearing age

A

BV

45
Q

is BV an STI?

A

no

46
Q

what percent of BV presents asymptomatically?

A

50-75%

47
Q

Patient presents with…

thin, off-white vaginal d/c

fishy odor

this is suspicious for…

A

BV

48
Q

Amsel’s criteria for BV requires 3 of what 4 signs?

A

thin, white homogenous d/c
clue cells wet mount
pH > 4.5
(+) whiff test

49
Q

3 dx options for BV

A

Amsel’s criteria, gram stain, DNA probe

50
Q

Tx for BV only needs to occur with patient, not partners. What are the tx options?

A

metro 500mg PO BID x 7 days

metro 0.75% gel intravaginally QD x 5 days

51
Q

What can’t be ingested when taking metronidazole for fear of disulfiram like reaction?

A

etoh

52
Q

What is a major complication of BV?

A

preterm delivery

53
Q

This is the MC non-viral STI

A

trich

54
Q

Patient presents with…

a. Purulent, malodorous, frothy, thin d/c
b. Burning, pruritus, dysuria, dyspareunia
c. Post-coital bleeding

A

Trich

55
Q

What physical exam sign is often found with trich infx?

A

strawberry cervix: punctate hemorrhages on vagina/cervix

56
Q

Gold Standard Dx for trich…

A

Vaginal/cervical/urine NAAT

57
Q

trich wet mount may show…

A

motile organism

58
Q

Tx for patient and partner with Trich…

A

metro 2g PO x 1 dose

no sex for 7 days after tx

59
Q

Trich tx if N/V?

A

metro 500 mg BID x 5-7 days

60
Q

The below are complications for…

a. PID, urethritis, cystitis
b. Cervical neoplasia
c. Infertility
d. Increased HIV risk
e. Pregnancy complications (preterm delivery)

A

trich

61
Q

when should repeat trich testing take placE?

A

3 mo after tx

62
Q

This is the MC reportable bacterial STI, it has high prevelance in 24 yo and younger

A

Chlamydia

63
Q

Patient presents with…

a. Cervicitis: change in d/c, intermenstrual or post-coital bleeding
b. Urethritis: dysuria, frequency

a. Mucopurulent endocervical d/c
b. Cervix friability, erythema, edema

A

Chlamydia or GC

64
Q

Gold standard Dx for chlamydia?

A

vaginal swab NAAT

65
Q

Tx options for patient and partner for chlamydia

A

azithro 1g PO x 1

OR

doxy 100mg PO BID x 7 days

66
Q

Tx for chlamydia if pregnant…

A

azithro

67
Q

when can you have sex after chlamydia tx?

A

7 days after completed tx and no sxs

68
Q

Preferred dx for GC?

A

vaginal/endocervical swab NAAT

69
Q

If resistant GC is suspected, what diagnostic should be used?

A

Cx

70
Q

Tx for partner and pt w. GC?

A

avoid sex, STI test

Ceftriaxone 250mg IM + Azithro 1g PO x 1 dose

Women's Health (10 decks)

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