Upper and lower Tract infections Flashcards
What are the screening guidelines for Ghonnorhea and Chlamidia?
Ghono and Chlam: Annual screen if Sexually active
Those with dev disabilities
Nucleic Acid amplification most sensitive
Self collected vaginal swab acceptible
What are the screening guidelines for Hep C?
One time testing if born from 1945-1965 and unknown status
What are the screening guidelines for HIV?
Screen at least once age 13-64 yrs
Annual screen based on risk factors
Opt out screening
What are the risk factors for STDs?
History of multiple partners Sexual contact with STI person Repeated STIs Attendance at clinic for STI Inconsistent condom use, sex work, drug use
How is a detailed sexual history obtained?
Open ended questions
Understandable language
Normalizing language
What is the best way to prevent STIs?
Delay Coitarche Limiting # partners Limiting exposure to risk patients Encourage immunization Increase condom usage Partner notification and treatment
What STIs are reportabe in ALL STATES?
Ghonorrhea, syphillis, chlamidia, HIV, AIDS
What are the considerations in HPV vaccine?
Protects against 6,11,16,18
6/11 cause wwarts
16/18 cause cervical cancer
What are the considerations in Hep A vaccine?
Postexposure prophylaxis up to 2 weeks after exposure
What are the considerations in Hep B vaccine?
Recommended for all unvaccinated uninfected persons evaluated for STD
What are the best type of condoms?
Latex
What is the proper use of male condoms?
Water based lubricant prevents breakage
New condom with each sex act
avoid teeth, nails
Which STDs should be re-tested in the 3rd trimester of pregnancy?
HIV
Syphilis
Chlamidia
Hep C
How is HIV screened for vs Confirmed?
Screen: Ez immunoassay
Rapid Test
WHat type of bacteria is Haemophilus ducrei?
G(-) Streptobacillus
What is the Tx of Chancroid?
Azithromycin or
Ceftriaxone IM or
Cipro BID
Erythromycin tid
How is herpesvirus infection diagnosed?
Culture
PCR
Serology
What are stages of Herpes Infection?
Primary
Non-primary first episode
Recurrent
How is systemic syphilis diagnosed?
Darkfield Exam
Direct Fluorescent Ab
VDRL, RPR
Fluorescent treponemal Ab
What are the stages of Syphilis and symptoms?
1) Chancre at site
2) Rash, mucocutaneous, LAN
3) Aortitis, iritis, uveitis, auditiry abn, Gummas
Latent)
How is neurosyphilis treated?
Aqueous crystalline PCN Daily
Procaine
Probenicid
Repeat CSF exam every 6 mon until cell count normal
What are the US findings of Congenital syphilis?
Hepatomegaly
Ascites
Hydrops
Thickened placenta
What are the S and S of Vaginitis?
Discharge Malodor Pruritis Burning Swelling Dysparunia Dysuria
How is Vaginitis diagnosed?
Vaginal pH Amine (whiff) test Saline Microscopy KOH microscopy DNA amplification Fungal Culture
What is the Tx of Chlamidia?
Azithromycin or Doxycycline Erythromycin Ofloxacin Levofloxacin
What is the Tx for Gonorrhea?
Ceftriaxone AND Azithromax
How is PID Treated?
Cover Ghon, Chlam, Anaerobes, Bact vaginitis
What is the criteria for Hospitalization in PID?
Surgical EM cant be excluded PReggo Non-compliant Unable to tolerate PO meds Tubovarian abcess
What causes Granuloma INguinale?
Klebsiella Granulomatosis
Tx with Doxycycline
How is HPV condyloma diagnosed?
Clinical Diagnosis uncertain Dx unresponsive to Tx Immunocomprimise Pigmented , indurated, fixed, bleeding, or ulcerated
WHat is recurrent respiratory papillomatosis?
HPV passed to infants and infects the airway
How is Trichomonas diagnosed?
Treatment?
Wet mount
Culture
Trich antigens
Metronidozole
How can molluscum contagiosum be diagnosed?
Umbilicated center of lesions
Self limited
What are the common microbes that cause Cystitis?
E Coli (75-95%)
Proteus Mirabilus
Klebsiella
Staph Saprophyticus
What is the Tx of Cystitis?
Nitrofurantoin
TMP-SMX
Fosfomycin
Fleuroquinolones
