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First Aid Step 3 Infectious Disease 5
GU Infections
29
Medical
Professional
12/25/2013

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Cards

Term
What are the sx/exam of cystitis?
Definition
Dysuria, urgency, and frequency of urination are the most common complaints.
Term
What is the DDX of cystitis?
Definition
Urethritis and cervicitis in sexually active patients
Renal stones may present with colicky pain and dysuria.
Term
How do you diagnose cystitis?
Definition
Check UA for the presence of bacteria, WBC, leukocyte esterase, and nitrites.
Term
How do you treat cystitis?
Definition
TMP-SMX or a fluoroquinolone for uncomplicated cases
Nitrofurantoin for pregnant women.
IV Ceftriaxone and fluoroquinolone for complicated (Foley related, hospital acquired, recently treated)
Term
What are the sx/exam for pyelonephritis?
Definition
Similar to UTI, but patient's are more ill.
Check for CVA tenderness, fever, tachycardia, and hypotension.
Term
How do you diagnose pyelonephritis?
Definition
Check UA for significant bacturia, pyuria, and occasional WBC casts. Urine culture should be sent.
Get Blood cultures on admission as 15-20% will be bacteremic.
Term
How do you treat pyelonephritis?
Definition
IV fluoroquinolone
If no clinical response, look for intrarenal or perinephric abscess or foreign bodies such as renal calculi with CT or US.
Term
What are the Sx of prostatitis?
Definition
Spiking fevers, chills, dysuria, cloudy urine, and even obstructive symptoms.
In patients with chronic prostititis, low back pain or perineal/testicular discomfort may be present.
Term
How do you diagnose prostatitis?
Definition
Urine cultures before and after a prostatic massage to look for G- rods.
Term
How do you treat prostatitis?
Definition
TMP-SMX or fluoroquinolone x 14 days.
Chronic: Fluoroquinolone x 1 month; or TMP-SMX x 3 months.
Term
What is primary syphilis?
Definition
Develops within several weeks of exposire; involves one or more painless, indurated, superficial ulcerations.
Term
What is secondary syphilis?
Definition
After initial ulceration has resolved, patients may develop malaise, anorexia, headache, diffuse lymphadenopathy, or rash (mucosal surface, palms and soles).
Term
What is tertiary syphilis?
Definition
Includes cardiovascular, neurologic, and gummatous disease (general paresis, tabes dorsalis, aortitis, meningovascular syphilis.)
Term
How do you diagnose primary,syphilis?
Definition
Do a nontreponemal serologic test (RPR or VDRL). Darkfield microscopy of the lesion's exudate will show the spirochetes. Direct antigen tests MHA-TP or FTA-ABS are used for confirmation
Term
How do you diagnose tertiary syphilis?
Definition
Perform LP when neurologic or ophthalmic signs and symptoms are present; in the setting of treatment failure; or with VDRL of >=1:32 correlate with cardiovascular, neurologic and systemic symptoms.
Term
How do you treat primary and secondary syphilis?
Definition
Penicillin G 2.4MU in a single IM dose.
Alternatives include doxycycline or erythromycin x 14 days.
IF disease is >1 year, treat with three doses of PenG IM a week apart.
Term
How do you treat neurosyphilis?
Definition
Penicillin G IV x 14 days
Term
What are genital herpes?
Definition
Painful grouped vesicles in the anogenital region. Caused by HSV; usually type 2.
Term
What are sx/exam of genital herpes?
Definition
Frequently associated symptoms include tender inguinal lymphadenopathy, fever, myalgias, headaches, and aseptic meningitis. Symptoms are usually more pronounced during the initial episode and grow less frequently with recurrences.
Term
How do you diagnose genital herpes?
Definition
Confirmed by viral PCR of the vesicle fluid.
Term
How do you treat genital herpes?
Definition
Acyclovir x 7-10 days (primary infx). Tmx should begin within 1 week of sx onset.
Severe recurrences may need repeat treatment wiht either acyclovir or valacyclovir x 5 days. Daily suppressive therapy can be used for frequent recurrences.
Term
What organisms generaly are involved in STD cervicitis or urethritis?
Definition
Chlamydial
Gonococcal
Mycoplasma genitalium
Term
What are the sx/exam of STD cervicitis or urethritis?
Definition
Dysuria, dyspareunia, and mucopurulent vaginal discharge are complaints in women.
In men, dysuria and purulent penile discharge predominate.
Term
How do you diagnose STD cervicitis or urethritis?
Definition
+endocervical or urethral culture OR
+urine PCR for chlamydia/gonorrhea
Term
How do you treat chlamydia and gonorrhea?
Definition
Treat Both together (always!)
Chlamydia: single dose of axithromycin
Gonorrhea: single dose of ofloxacin or cipro OR Im dose of ceftriaxone
Term
What is Pelvic inflammatory disease?
Definition
An upper genital tract infection in women that is usually a complication of chlamydia and or gonorrhea infection.
Term
What are the sx/exam of PID?
Definition
Pelvic pain
dyspareunia
vaginal discharge
fever
menstrual irregularities
lower abd tenderness
adnexal tenderness
cervical motion tenderness
Term
How do you diagnose PID?
Definition
>10WBC on low-power field on gram stain and endocervical smear is consistent with PID. Rule out pregnancy before treatment.
Term
How do you treat PID?
Definition
2nd gen cephalosporin IV and doxycycline IV.
If pt doesn't improve, consider US to eval for tubo-ovarian abscess that may need drainage.
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