Week 8 - STIs Flashcards
Symptoms of HPV and Genital warts
- HPV often asymptomatic
- Bumps to vaginal introitus, vulva, labia or anus
Treatment for genital warts
- Podofilox, imiquimod, sinecatechins- applied topically by the patient
- Cryotherapy in the office
- Surgical removal
- Trichloroacetic acid
- Bath in oatmeal solution, dry area with hair dryer
- Wear cotton underwear and loose fitting clothing
S/S genital herpes
- May be asymptomatic
- Assess for general viral symptoms – malaise, fever, headache, myalgias,
- vulvar pain, dysuria, itching, or burning at the site of infection, and painful genital lesions that heal spontaneously are very suggestive of HSV infection
How is genital herpes diagnosed?
PCR test
Treatment for genital herpes
- PO - acyclovir, valacyclovir, or famciclovir
- Oral analgesics for pain
- Warm sitz baths
- Drying lesions with hair dryer on cool setting
- Cotton underwear/loose clothing
- Apply cold milk or witch hazel to lesions followed by aloe vera gel or burrows solution
- Minimize foods containing arginine - coffee, grains, chicken, chocolate, corn, dairy products, meat, peanut butter, nuts, and seed
- Suppressive therapy to prevent spread to partners
Chancroid
bacterial STI uncommon in the US
Symptoms of chancroid
- painful macule on the external genitalia that rapidly changes to a pustule and then to an ulcerated lesion. May develop enlarged unilateral or bilateral inguinal nodes.
Treatment for chancroid
Azithromycin 1 gm orally in a single dose
Pubic lice treatment
1% permethrin cream rinse, apply daily and rinse off after 10 minutes – failure after 1 week then drug resistance malathion cream or PO ivermectin.
Trichomoniasis
A common sexually transmitted infection caused by a parasite.
S/S Trichomoniasis
- Asymptomatic
- yellow to greenish, frothy, mucopurulent, copious, malodorous discharge
- Inflammation of the vulva, vagina, or both may be present
- irritation, pruritus, dysuria, or dyspareunia
Treatment for trichomoniasis
Metronidazole 2 gm orally in a single dose or tinidazole 2 gm orally in a single dose
Chlamydia
Bacterial STI
S/S of chlamydia
- Usually asymptomatic
- vaginal spotting or postcoital bleeding
- mucoid or purulent cervical discharge
- urinary frequency
- dysuria
- lower abdominal pain
- Dyspareunia
Treatment for chlamydia
- Azithromycin 1 gm orally in a single dose
Gonorrhea
Bacterial STI
S/S Gonorrhea
- May be asymptomatic
- Dyspareunia
- a change in vaginal discharge
- unilateral labial pain and swelling
- lower abdominal discomfort.
- Later in the course of infection, women may describe a history of purulent, irritating vaginal discharge or rectal pain and discharge. Menstrual irregularities
Treatment for Gonorrhea
- Ceftriaxone 250 mg IM in a single dose
Pelvic inflammatory disease
Infection of the female reproductive organs. It most often occurs when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes or ovaries.
o includes endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis
o Caused by a variety of bacterial pathogens common in the vagina
S/S of Pelvic Inflammatory Disease
abrupt onset of acute lower abdominal pain following menses
may have mild, nonspecific symptoms
abdominal, pelvic, and low back pain
abnormal vaginal discharge
intermenstrual or postcoital bleeding
fever; nausea and vomiting
urinary frequency
Pelvic pain exacerbated by the Valsalva maneuver, intercourse, or movement
Diagnosis of PID
often made based on findings of pelvic organ tenderness and signs of lower genital tract infection, including mucopurulent cervicitis and cervical friability
Treatment for PID
- Ceftriaxone 250 mg IM in a single dose PLUS Doxycycline 100 or Metronidazole 500 mg orally two times/day for 14 days
- Analgesia for pain
- Many need hospitalization for severe symptoms
Syphilis
Bacterial STI
S/S of Syphilis
o periods of active symptoms and periods of asymptomatic latency.
o primary lesion, or a chancre, which often begins as a painless papule at the site of inoculation and then erodes to form a nontender, shallow, indurated, clean ulcer that is several millimeters to a few centimeters in size.
o Secondary – fever, pruritic rash
Treatment for Syphilis
- Benzathine penicillin G 2.4 million units IM in a single dose
Hepatitis B
a vaccine-preventable liver infection caused by the hepatitis B virus (HBV).
S/S Hepatitis B
arthralgias, fatigue, anorexia, nausea, vomiting, fever, abdominal pain, clay-colored stools, dark urine, and jaundice
may be asymptomatic
Treatment for Hep B
- Women with a definite exposure to hepatitis B should be given hepatitis B immunoglobulin IM in a single dose as soon as possible, and preferably within 24 hours after exposure.
- There is no specific treatment for acute hepatitis B; recovery is usually spontaneous
Hep C
an inflammation of the liver caused by the hepatitis C virus. The virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness to a serious, lifelong illness including liver cirrhosis and cancer.
Symptoms of Hep C
fatigue, fever, abdominal pain, nausea, vomiting, anorexia, jaundice, dark urine, or clay-colored stool.
Treatment for Hep C
- combination of interferon and ribavirin with or without protease inhibitors
HIV
HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system.
Symptoms of HIV
- fever, malaise, rash, myalgias, lymphadenopathy, sore throat, and headache
Diagnosing HIV
ELISA tests
Treatment for HIV
Antiretroviral therapy
