Women's Health- STI's Flashcards
Estradiol
- Estrone
- Estriol
Estradiol Predominent estrogen during reproductive years – Most potent 80x that of estriol
• Estrone Predominant during menopause
• Estriol Predominant during pregnancy
• Hypoactive sexual desire disorder
Deficient (or absent) sexual fantasies and desire for sexual activity
• Female sexual arousal disorder
Inability to attain or maintain until completion adequate lubrication-swelling response of sexual excitment
Female organismic disorder
Delay in or absence of orgasm following a normal sexual excitment
Vaginismus:
involuntary contraction of the penile muscle due to something going in
Untreated G and C lead to
Infertility.
Untreated Syphilis leads to
what if + during preg?
brain CV and organ damage
if + during perg baby will be + too
what are the 5 Ps of protection
Partmeners, Prevention of pregnancy, protection from STDs, Practices, Past hx of STDs
what STIs are infected from the urethra or vaginal sections
G, C, trich
what STIs are infected from the surface/ skin?
Herpes, Syphilis, chancroid, HPV
what is one of the most affective methods for preventing the transmission of STDs
pre exposure vaccinations.
HPV
HEP B- everyone
Hep A and B ( recommended for MSM and Injecion drug users)
There are 2 HPV vaccinations what are they and who are they recommended for?
Gardasil and cerviarix
Girls 13-26
Boys: 13-21
Male Condoms
Helpful in the privation of:
-
May be helpful in the prevention of:
Heterosexual
• Helpful in prevention
– Pregnancy, GC, HIV, hepatits, chlamydia and
trichomonas
• May be helpful in prevention of (data is limited)
– HSV, HPV and syphilis
• Heterosexual relationships
– HIV negative partners likely to become HIV infected compared to similar rela+onships without condom use
what type of lubricant can you use with condoms?>
only water based, not oil based.
Female Condoms
Effective : Viruses, HIV, Semen
may be better at preventing HPV skin transmission
Male circumcision reduces the risk of what?
HIV and STDs in heterosexulal men
is there a post exposure prophylaxis for HIV and STD?
Antivital therapy (ART)
what STIs are reportable to the state?
C&G, Syphilis, chancroid, HIV and AIDs
rates of what STDs are highest in adolescents?
Chlamydia, HPV and hERPES
What STI is common in WSW?
BV
what is pelvic inflammatory disease?
Ascending genital infection of the fallopian tubes.
C&C aerobic and anaerobic
what are some PE findings for PID?
Cervical Motion Tenderness (Chandelier sign)
Mucopurulent cercitis
Adenexal tenderness
what is the treatment for PID?
Out pt: Rocephin Ceftriazone and Doxycycline
In:
Clindamycin and gentamicin IV
CAUSES INFERTILITY!
All patients who have genital, anal or perianal ulcers should be evaluated with a serologic test for:
in the US what are the most common causes for genital ulcers?
Syphilis and Genital Herpes
Chancroid, herpes and syphilis
in the setting where chancroid is + a test for _________ should also be performed
Haemophilius ducreyi
For genital, anal and perianal warts when do you start treatment?
RIGHT away!
Chancroid
what does it look like?
Painful genital ulcer and tender suppurative ingulinal adenopathy
Vesiculo pustule that breaks down to form a painful, soft ulcer with necrotic base
how do you dx charncroid?
Tx:
Identification of H. Ducreyi
Azithromycin, F/U in 3-7d should see improvement in 3 days
Herpes Simplex II ( Genital herps)
cause:
presentation
transmission
dx:
Tx:
Herpes simplex virus
Multiple vesicular lesions in anogenital region, wil assoicated puritis, dysuria, vulvitis
sexual contact
clinical findings, confirm via viral culture of unroofed vesicle, tzank smear
Blood: HSV II antibody
Tx: Acyclovir
HSV-II
highest rates in:
More common among:
Young white teenager
females than males
Syphilis
Causative agent
Presentation
Primary
Secondary
Tertiary
dx
- Treonema pallidum
- Papular lessons that ulcerate to painless genital oral or anal lesions.
Primary: Chancre (PAINLESS)
Secondary: Rash (Copper Pennies) malase, mucocutaneous lessions and lympadenopathy
tertiary: Neurologic, cardiac, opthalmic and auditory Neurosyphilis
Dx: VDRL, if + then confirm with FTA-ABS of lesion
If you suspect neurosyphilis you must perform what?
a LP with VDRL
Gonorrhea:
Highest among who
causative agent:
presentaion:
F:
M
Dx
tX:
Complications
M
F
MSM
Neisseria gonorrhoeae
F: Vaginal D/c lower ab pain, cervical motion tenderness and fever
Males: Experience dysuria and yellowish white penile D/C
DX: swab
Tx: Rocephin
PID
Epidiymitis
Chlamydia:
Most common
dx
-Preg:
Reported Infectious disaese in the US ( 9th -12 th grade most common)
NAAT
Tx: Azithtomycin
Preg: Amox or azithro
Asherman syndrom:
define:
symptoms:
Tx:
Scaring of the uterus, most after D &C
Symptoms: Amenorhhea, repeated miscarriage
Tx: Sxr
HPV
most of the time
The system fights off HVP within 2 years- if not treated causes most cancers of the anus vagina and penis and about 1/3 of ca in the oral pharynx
Genital warts
Causative agent:
Clinical presentation
Visible:
Strong link to cervical ca: 1
HPV
Soft fleshy growths on genital area
Visible: types 6 and 11
Strong link to cervical ca: 16, 18, 31, 33, 35
Genital warts Dx:
Tx
Provider applied:
Patient applied:
Stain with Acetic acid and PAP smear
Provider applies:
Trichloroacetic acid or Podophylline resin or Cryo
Patient applied:
Condylox or aldara
what is Sub clinical gentital HPV without exophytic warts?
+ for HPV with no warts
Trichamonas: causative agent: Presentation Dx T
Tichomonas Vagnialis
Frothy yellow/ green malodorous discharge with strawberry cervix
Microscopic exam and wet mount
Metronidalzole
BV Causative agent: presentation dx Tx
Gardnerella vainalis
Fishy odor grey dc
DX: Clue cells and wiff test
tx: Metronidazole
Molluscum Contagiosum
Cantharidlin solution .
