Walden Flashcards
Painless chancre heals in 6-9 weeks, clean base well demarcated in indurated margins, white papules look like warts (condyloma Lata), maculopapular rash on palms and soles not pruritic, neurosyphilis gumma (soft tissue tumors) aneurysms, valvular damaged
Syphilis
RPR or VDRL screening tests if positive, confirm with FAT-ABS test
Syphilis Dx
benthazine-penicillin IM 1 dose, for late treatment- benthazine-penicillin once per week x 3 weeks, or doxycycline
Syphilis Tx
Bx1
Green colored, pelvic pain, vaginal discharge, penile discharge, dysuria, purulent mildly odorous, urethritis, cervicitis, proctitis, pharyngitis, endometritis, salpingitis, epididymitis,
- Dx NAAT testing,
- Tx ceftriaxone IM and Azithro, annual screenings, co treat with syphilis
Gonorrhea urethritis
C-Az
- Tx ceftriaxone, azithro
Sexual assault
C-Az
- Tx ceftriaxone, azithro
Chancroid
C-Az
- Tx ceftriaxone, doxy, flagyl
Epididymitis
C-D-F
- Tx ceftriaxone, azithro, doxy
Cervicitis
C-Az-D
Atypical bacterium, treponema pallidum, internal infection not on labia.
Chlamydia
Asymptomatic, mucopurulent, vaginal discharge, bleeding
Fitz-Hugh syndrome
- Dx gold standard, nucleic acid amplification test NAAT, gen probe, antigen detection (swab), urinalysis, wet prep >20 WBC
Fitz-Hugh syndrome
- Tx Azithro 1 dose or doxycycline for 7 days annual screenings
Fitz-Hugh syndrome
Az-D
Chlamydial/gonorrhea infection of liver capsule extensive scarring scars look like violin strings complication of PID
Fitz Hugh-Curtis syndrome
- Tx azithro, doxy
Nongonococcal Urethritis
Az-D
- Dx Thayer- Martin
- Tx ceftriaxone, azithro, doxy
Pharyngitis
C-Az-D
Risk factors history of PID, age 25 or younger, adnexal tenderness, cervical motion,
uterine tenderness, lastly temp >101.f,
- Dx NAAT
- Tx ceftriaxone, doxy, flagyl
PID
C-D-F
Yellow-greenish discharge with dyspareunia, pelvic exam reveals
strawberry patches on cervix,
- Dx is wet mount/prep, flagella, partner needs treated too
- Tx flagyl PO for 7 days
Trichomoniasis
Fx7
Asymptomatic, grayish white milky, watery discharge, unpleasant fish odor,
BV
- Dx wet mount clue cells (mature squamous epithelial cells with numerous bacteria on cell
borders, surfaces edges are coated with bacteria), gram stain,
BV
- Tx flagyl PO for 7 days
BV
Fx7
- Dx herpes viral culture or RPR assay (more
sensitive) - Tx acyclovir 7- 10 days, famciclovir 5 days
Herpes
HSV1 is oral
HSV2 is genital
Ac7-F5
Used as adjunct for evaluation herpetic infections, positive smear will show large abnormal nuclei squamous epithelial cells, (Giant cells)not commonly used
Tzanck smear
HPV strain 16/18 are carcinogenic, soft painless flesh colored warts,
- Tx podophyllum resin, trichloroacetic acid- causes acetowhite changes, cryotherapy, Imiquimod, laser CONTRAINDICATED IN PREGNANT WOMEN OR MECHANICAL METHODS
Human papilloma virus
- Tx permethrin
Scabies lice
Thick white curdy discharge
- Dx wet mount,
- TX clotrimazole, miconazole
Candidiasis
CM
- Tx clotrimazole, nystatin, miconazole
Yeast
CNM
Cervical cells that appear slightly abnormal but not
precancerous
Low grad Intraepithelial lesions
Precancerous cells not cancer HPV
testing and refer to colposcopy
High grade squamous intraepithelial lesions
Identified CD4 t lymphocyte count <200,
AIDS
S/S oral candidiasis, fever wt. loss diarrhea,
SOB, purple to bluish red bumps on skin (Kaposi sarcoma). Pneumocystis jirovecii
AIDS
- Tx Bactrim is infection that causes most deaths with HIV
AIDS
- Dx HIV1/HIV2 antibodies test and P24 antigen, step 2 HIV1/HIV2 antibodies differentiation immunoassay if indeterminate HIV RNA Prophylaxis is Bactrim
HIV
- Tx Antiretroviral therapy ART, HIV women take AZT (zidovudine)
Goal- prevent therapy for PCP, pneumocytis pneumonia jiurevisitis
HIV
Flu like or mono like infection, symptoms in persons infected within 2-4 weeks, HIV antibodies detected 3 months after exposure
- Dx HIV RNA, PCR test
Acute HIV
Can detect HIV infection in 7-28 days
NAAT
Detects HIV antibodies
Elisa/Western blot
Petechial or pustular lesions on hands sole, swollen, red, tender joints, asymmetrical joints, signs of STD Urethritis, cervicitis, pharyngitis
with green purulent sputum
Disseminated Gonococcal disease
- Tx Bactrim or Macrobid, spermicide increase risk
UTI
BM
Scotch tape, early morning
Enterobiasis (pinworms)
(balanitis xerotica) whitish patches on genitals, lesions chronic affect
vulva/anal in elderly patients, risk for cancer
Lichen sclerosus