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Infectious Disease
STD
69
Medical
Graduate
11/19/2009

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Cards

Term
What STDs are considered "drips" or discharges?
Definition
Gonorrhea, Chlamydia, Nongonococcal urethritis/mucopurulent cervicitis
Term
What STDs cause sores or ulcers?
Definition
Syphillus, Genital herpes, Lymphogranuloma venereum, Chancroid, Granuloma inguinale
Term
Is urethritis from gonorrhea more common in men or women? Peak age of incidence?
Definition
Equal. M: 20-24yo, F: 15-19yo, peak 15-29yo.
Term
What is the etiologic agent of Urethritis Gonorrhea?
Definition
N. gonorrheae
Term
What does N. gonorrheae infect anatomically?
Definition
mucous-secreting epithelial cells
Term
Where is there an endemic of quinolone resistant N. gonorrhae?
Definition
HI, CA, SE. Asia
Term
Sx of gonorrheal urethritis?
Definition
urethral d/c and dysuria
Term
What is a common complication of gonorrhea urethritis?
Definition
Epididymitis
Term
Name 6 uncommon sx of gonorrhea urethritis.
Definition
1) Inguinal lymphadenitis 2) Penile edema 3) Periurethral abscess 4) Urethral stricture 5) Balanitis 6) Prostatitis
Term
What is the primary site of infection of gonorrhea causing urogenital infxn in women?
Definition
endocervical canal, also colonizes the urethra
Term
Sx. of gonnorhea urogenital infxn in women?
Definition
50% asymptomatic, vaginal d/c, dysuria, labial pain/swelling, abd pain
Term
What are complications of gonorrhea urogenital infxn in women?
Definition
accesory gland infxn, PID, perihepatitis (Fitz-Hugh-Curtis Syndrome)
Term
Is disseminated gonococcal infection causing bacteremia more common in men or women?
Definition
women
Term
what is dermatitis-septic arthritis syndrome? What is it a clinical manifestation of?
Definition
Triad of dermatitis, polyarthritis, and tenosynovitis. Disseminated gonococcal infxn.
Term
Name 4 other clinical manifestations of disseminated gonoccal infection.
Definition
1) Hepatitis 2) Myocarditis 3) Endocarditis 4) Meningitis
Term
What is found on urine dipstick in gonorrhea?
Definition
(+) leukocyte esterase on first void urine
Term
What selective growth culture media is used to dx gonorrhea infxn?
Definition
Thayer-Martin chocolate agar
Term
What is the CDC rec. for tx of gonorrhea infxn since 2007?
Definition
Cefixime (suprax) or ceftriaxone + tx for chlamydia if not r/o
Term
What is the most common etiologic agent in the infxn of nongonococcal urethritis?
Definition
Chlamydia trachomatis
Term
What is the second most common etiologic agent for nongonococcal urethritis? Other causes?
Definition
Genital mycoplasmas. Occasionally Trichomonas vaginalis, HSV, or Candida. Unknown in ~50% of cases.
Term
Sx of nongonococcal urethritis?
Definition
mild dysuria and mucoid discharge
Term
Chlamydia trachomatis can be transmitted to the newborn during delivery, what does it cause?
Definition
conjunctivitis and pna
Term
Name 4 complications of Chlamydia trachomatis.
Definition
1) Epidymitis 2) PID 3) Perihepatitis 4) Reiter's syndrome
Term
What test has the ability to detect Chlamydia in the first void urine?
Definition
Ligase chain reaction (LCR)
Term
What is the standard lab test for Chlamydia?
Definition
tissue culture
Term
Tx for chlamydia trachomatis?
Definition
Azithromycin or Doxycycline
Term
What is the most common STD syndrome in women?
Definition
STDs characterized by Cervicitis
Term
Name 4 primary etiologic agents of cervicitis.
Definition
N. gonorrhae, C. trachomatis, HSV, HPV
Term
Name 6 sx of cervicitis.
Definition
1) Purulent cervical d/c 2) Cervical edema 3) Inc. menses 4) Dysmenorrhea 5) Dyspareunia 6) Dysuria
Term
Differentiate b/t cervicitis from C. trachomatis and HSV.
Definition
C. trachomatis - mucopurulent d/c, nonspecific abd pain, spotting w/ intercourse, 20-70% normal appearing cervix. HSV - mucoid d/c, lower abd pain, friable cervix w/ ulcers or gangrene.
Term
What is the etiologic agent in cervicitis if multinucleated giant cells with intranuclear inclusions are seen?
Definition
HSV
Term
Dx testing for cervicitis?
Definition
gram stain of endocervical mucus, cervical cytology, nonamplified and amplified tests
Term
What is the tx for recurrent/persistent urethritis/cervicitis?
Definition
Metronidazole PLUS erythromycin
Term
What bacteria causes syphilis?
Definition
Treponema palidum, spirochete
Term
What are the 2 painful genital ulcer diseases?
Definition
Genital HSV and chancroid
Term
What are the 3 painless genital ulcer diseases?
Definition
syphilis, lymphogranuloma venereum, and granuloma inguinale
Term
what is the most common cause of genital ulcer disease in North America and Europe?
Definition
Genital HSV
Term
what is the gold standard test for HSV?
Definition
viral culture
Term
What is seen on Tzank smear in HSV?
Definition
multinucleated giant cells
Term
Which rapid serology test can differentiate b/t HSV 1&2 and which can't?
Definition
Can - immunoflourescent staining. Can't - ELISA
Term
How is genital herpes tx?
Definition
Acyclovir OR Famciclovir OR Valacyclovir
Term
3 complications of genital HSV infections?
Definition
Aseptic meningitis, 2nd bacterial infxn, recurrence
Term
Which complication is more common in primary rather than recurrent infxn of genital HSV?
Definition
aseptic meningitis
Term
What is the 2nd most common cause of genital ulcer dz worldwide?
Definition
Syphilis
Term
Describe the ulceration in primary syphilis.
Definition
painless chancre, highly infectious
Term
When does secondary syphilis occur? What does it represent?
Definition
2-8 wks after chancre dev. Hematogenous dissemination of spirochetes.
Term
What are the clinical findings in secondary syphilis? (6)
Definition
Whole body rash, gen. lymphadenopathy, malaise, alopecia, mucous patches, condylomata lata
Term
What is condylomata lata?
Definition
Highly infectious patches of weepy pink or gray skin that appear in the moist areas of the body during secondary syphilis.
Term
Tx for syphilis?
Definition
Benzathinine Penicillin G
Term
Tx for syphilis w/ a penicillin allergy?
Definition
Doxycycline
Term
Tx for neurosyphilis? If allergy present?
Definition
IV aqueous crystalline penicillin G. Ceftriaxone.
Term
Etiologic agent of Chancroid?
Definition
Haemophilus ducreyi
Term
Clinical presentation of chancroid?
Definition
Painful genital lesions, painful lymphadenopathy
Term
What is seen on gram stain of Chancroid?
Definition
"school of fish" appearance
Term
Tx of Chancroid?
Definition
Azithromycin
Term
Etiologic agent of granuloma inguinale (donovanosis)?
Definition
Calymmatobacterium granulomatus
Term
Clinical presentation of granuloma inguinale?
Definition
Painless, ulcerative lesions w/ beefy red appearance that bleed easily on contact, no lymphadenopathy
Term
What is seen on darkfield microscopy of granuloma inguinale?
Definition
Donovan bodies (safety-pin shaped intracytoplasmic inclusion bodies)
Term
Tx of granuloma inguinale?
Definition
Doxycycline
Term
etiologic agent of lymphogranuloma venereum?
Definition
Chlamydia trachomatis serotypes L1, L2, or L3
Term
What is the most common clinical presentation of lymphogranuloma venereum?
Definition
unilateral, tender, inguinal and/or femoral lymphadenopathy
Term
Tx of lymphogranuloma venereum?
Definition
Doxycycline
Term
What genotype of HPV cause condyloma acuminatum (anogenital warts)
Definition
types 6 & 11
Term
What genotypes of HPV cause cervical infxn/neoplasia?
Definition
16, 18, 45, and 56
Term
How is HPV transmitted? What is the infxn rate of a single contact?
Definition
skin-to-skin. 65%
Term
What are 2 patient-applied tx for genital warts?
Definition
Podofilox or Imiquimod
Term
Name 4 provider-administered tx for HPV.
Definition
1) Cryotherapy 2) Podophyllin resin 3) Trichloroacetic or Bochloroacetic acid 4) Surgical excision
Term
Name 4 situations in which HPV lesions are resistant to tx?
Definition
1) Pregnancy 2) DM 3) Smokers 4) Immunosuppressed
Term
What type of CA is associated with HPV?
Definition
squamous cell cervical CA
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