Urology & STI

Question 1

asymptomatic bacteriuria

Answer 1

screen and treat: all pregnant women

Question 1

most common UTI bacteria

Answer 1

e. coli

Question 2

Uncomplicated UTI definition

Answer 2

cystitis/bladder infection/UTI
low risk pt
no systemic symptoms

Question 3

complicated uti definition

Answer 3

lower or upper (kidneys)
high risk pt
systemic symptoms

Question 4

UTI Symptoms

Answer 4

dysuria
urgency
frequency
incomplete emptying sensation
suprapubic/back pain
gross hematuria
foul smelling urine

Question 5

midstream urine culture infection definition

Answer 5

midstream- >100,000 organisms
catheter- >1,000 organisms

Question 6

Nitrites in urine

Answer 6

infection

Question 7

nitrates in urine

Answer 7

normal in urine

Question 8

leukocyte esterase in urine

Answer 8

usually indicates UTI
tests for enzyme produced by WBCs

Question 9

first line treatment for UTI

Answer 9

nitrofurantoin

Question 10

uncomplicated uti treatment

Answer 10

nitrofurantoin x3-6 days

Question 11

dysuria treatment with UTI

Answer 11

antispasmodic (phenazopyridine or flavoxate)

Question 12

complicated uti symptoms in older adults

Answer 12

fever
fatigue
falls
flaky

Question 13

complicated uti treatment length

Answer 13

treat 7-14 days

Question 14

UA with WBC cast indicates

Answer 14

pyelonephritis

Question 15

outpt pyelonephritis tx

Answer 15

5-14 days (f/u 48 hours)
fluoroquinolones are preferred

Question 16

urinary incontinence lifestyle treatment

Answer 16

etoh
carbonation
coffee/tea
citrus
artificial sweetener

Question 17

urinary incontinence behavioral therapy

Answer 17

weight loss
regular voiding
pelvic floor exercise
minimize fluids

Question 18

Gonorrhea treatment

Answer 18

ceftriaxone

Question 19

chlamydia treatment

Answer 19

doxycycline

Question 20

trichomoniasis treatment

Answer 20

metronidazole

Question 21

PID outpatient treatment

Answer 21

ceftriaxone in single dose PLUS
doxycycline x14 days PLUS
metronidazole x14 days

Question 22

HIV screening

Answer 22

routine screening all ages 13-64
all pregnant women
if TB, STI

Question 23

never give these to HIV infected adults

Answer 23

live/attenuated vaccines

Question 24

BV is

Answer 24

sexually associated, not sexually transmitted

Question 25

BV

Answer 25

Asymptomatic in about 50% of women * Profuse grayish-white malodorous vaginal discharge * Unpleasant, fishy, or musty vaginal odor * Increased odor after intercourse * Pruritus and burning of vulvovaginal area

Question 26

Amsel’s criteria for BV diagnosis requires 3 of the following signs and systems:

Answer 26

 Homogenous white discharge coating vulva/vagina  Vaginal pH of >4.7  Fishy odor of vaginal discharge before or after addition of KOH (“whiff test”)  Clue cells on microscopic exam, 1 or more epithelial cells coated with bacteria, obscuring borders

Question 27

BV treatment

Answer 27

metronidazole x 7 days NO etoh until 24h after last dose

Question 28

Chlamydia symptoms

Answer 28

Assessment Findings * Mucopurulent cervicitis * Edematous, congested, friable cervix * Vaginal discharge * Cervical motion tenderness * Dysuria/urethritis * Salpingitis * Proctitis, epididymitis * Abnormal vaginal bleeding

Question 29

Gonorrhea symptoms men

Answer 29

Purulent urethral discharge  Dysuria  Testicular pain  Asymptomatic

Question 30

gonorrhea symptoms- females

Answer 30

 Often asymptomatic  Endocervical discharge  Dysuria  Bartholin’s gland abscess  Abnormal vaginal bleeding  Abdominal/pelvic pain  Adnexal tenderness  Cervical motion tenderness

Question 31

PID criteria

Answer 31

 Lower abdominal pain and/or tenderness  Cervical motion tenderness, +/- mucopus  Adnexal tenderness

Question 32

trichomoniasis symptoms- female

Answer 32

 Asymptomatic (sometimes for decades)  Vaginal discharge: frothy, yellow-green (often variable)  Vulvar irritation  Dysuria  Cervical petechiae = “strawberry cervix”

Question 33

trichomoniasis symptoms male

Answer 33

 Asymptomatic  Urethral discharge  Dysuria  Epididymitis  Prostatitis

Question 34

trichomoniasis tx

Answer 34

metronidazole

Question 35

primary syphilis

Answer 35

 Chancre at site of inoculation begins as papule, then ulcerates with hard edge and clean, yellow base; indurated and painless; usually on genitalia; solitary or multiple; persists for 1-5 weeks, heals spontaneously  Chancre may go unnoticed in women  Regional lymphadenopathy

Question 36

secondary syphilis

Answer 36

 Rash that is bilaterally symmetrical, polymorphic, nonpruritic, frequently on soles and palms, and usually persists for 2-6 weeks, then spontaneously resolves  Condyloma lata: moist, pink, peripheral warty lesions present on glans, perianal, vulval areas, and intertriginous areas

Question 37

syphilis screening test

Answer 37

EIA, CIA then reflex rpr/vdrl testing

Question 38

syphilis tx

Answer 38

benzathine PCN

Question 39

asymptomatic bacteruria could precipitate this in pregnancy

Answer 39

pre term labor

Question 40

sti increases risk for acquiring hiv if exposed

Answer 40

HSV 2

Question 41

indications for herpes testing

Answer 41

if sti <10 partners hiv + genital lesion

Question 42

initial hiv testing should be

Answer 42

ELISA

Question 43

sti increasing esp in women

Answer 43

syphilis

Question 44

EIA, CIA used to screen for

Answer 44

syphilis

Question 45

most frequent sti in america

Answer 45

chlamydia

Question 46

sti associated with positive chandelier test

Answer 46

PID