Term
| What are some important things to consider when a patient presents with a possible STD? Notes |
|
Definition
Determine sexual practices
identify very high risk populations
Remember that there could be multiple infections present
Determine if partner needs treatment |
|
|
Term
| What is the most common STD cause of nongonococcal urethritis? Notes |
|
Definition
|
|
Term
| What is the classic situation of nongonococcal urethritis? Notes |
|
Definition
| clear watery discharge, dysuria, frequency, post-mictural sensation to void, no fever, etc. U/A doesn't show anything - where is the expected UTI? |
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|
Term
| If nongonococcal urethritis is known to be cause by chlamydia, what drugs do you use to treat? Notes |
|
Definition
| Clindamycin or sulfisoxazole |
|
|
Term
| What is the treatment for nongonococcal urethritis? Notes |
|
Definition
1 large dose of Azythromycin
may add another abx to cover gonococcal just to be safe |
|
|
Term
| Between Trichomoniasis, Candidiasis, and Bacterial vaginosis, which is the least itchy? Notes |
|
Definition
|
|
Term
| Between Trichomoniasis, Candidiasis, and Bacterial vaginosis, which has the greatest odor? Notes |
|
Definition
|
|
Term
| Describe symptoms of Trichomoniasis, Candidiasis, and Bacterial vaginosis in relation to menses. Notes |
|
Definition
Trichomoniasis - inc. after menses
Candidiasis - inc. before menses
Bacterial vaginosis - unaffected |
|
|
Term
| Rank amount of discharge between Trichomoniasis, Candidiasis, and Bacterial vaginosis. Notes |
|
Definition
Most - trichomoniasis
middle - bacterial vaginosis
least - candidiasis |
|
|
Term
| Describe the discharge in Trichomoniasis, Candidiasis, and Bacterial vaginosis. Notes |
|
Definition
trichomoniasis - thin, purulent; white, yellow, green
candidiasis - thick, adherent; white cottage cheese-ish
bacterial vaginosis - thin, adherent; grayish white |
|
|
Term
T/F - Notes
The pH is elevated in Trichomoniasis, Candidiasis, and Bacterial vaginosis. |
|
Definition
| False, it is not elevated in candidiasis (4.5) |
|
|
Term
| What type of flora are Trichomoniasis, Candidiasis, and Bacterial vaginosis? Notes |
|
Definition
trichomoniasis - rods/coccobacilli
candidiasis - rods, yeast
bacterial vaginosis - coccobacilli |
|
|
Term
T/F
PMNs are present only in trichomoniasis (not candidiasis or bacterial vaginosis). |
|
Definition
| False -they are highly present in trichomoniasis, but they may also be present in candidiasis |
|
|
Term
T/F
There are clue cells in Candidiasis. |
|
Definition
| False - clue cells are seen in bacterial vaginosis. |
|
|
Term
| What is the treatment for trichomoniasis? Notes |
|
Definition
|
|
Term
| What is the treatment for candidiasis? Notes |
|
Definition
|
|
Term
| What is the treatment for bacterial vaginosis? Notes |
|
Definition
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|
Term
| Name 8 risk factors for gonorrhea. Notes |
|
Definition
1. black race
2. adolescent
3. multiple, casual sexual partners
4. new sexual partners
5. related drug use
6. lower socioeconomic status
7. inner city
8. Southeastern states |
|
|
Term
| What is the clinical presentation of a pt with gonorrhea? Notes |
|
Definition
| prurulent discharge from urethra, rectum, or endocervix; vaginal discharge without urgency or frequency, and vaginal bleeding. Anorectal - pain, pruritis, tenesmus, D/C, bleeding. Pharyngeal is usually asymptomatic. |
|
|
Term
| What are 4 risk factors for Pelvic Inflammatory Disease (PID)? Notes |
|
Definition
< 20 years old
Previous PID
Douching
Bacterial vaginosis |
|
|
Term
| What are the signs and symptoms of PID? Notes |
|
Definition
| variable pain in low abdomen, fever, peritonitis |
|
|
Term
| What are some other presentations of gonorrhea? Notes |
|
Definition
infertility
Fitz-Hugh-Curtis Syndrome (perihepatitis)
arthralgia
aysymptomatic polyarthritis - septic arthritis
dermatitis (pustules) - typically on lower legs
in children over 1 year - think sexual abuse |
|
|
Term
T/F
Gonorrhea can cause PID. |
|
Definition
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|
Term
| What lab tests do you run on a patient with suspected gonorrhea? Notes |
|
Definition
| Thayer-Martin culture, Gram stain (diplococcus, negative), DNA probe and ligase chain reaction |
|
|
Term
| What is a good treatment for gonorrhea? Why? Notes |
|
Definition
Azithromycin 1 g single dose
because it treats both gonorrhea and chlamydia |
|
|
Term
| What STD is called "The Great Imitator"? Notes |
|
Definition
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|
Term
| When should syphilis be considered? Notes |
|
Definition
| Any patient who has an ulcerative lesion in the genital region |
|
|
Term
| Describe primary syphilis. Notes |
|
Definition
single, painless, clean based ulcer
Begins 3 weeks after infection
Resolves in 4-6 weeks |
|
|
Term
| Describe secondary syphilis. Notes |
|
Definition
Maculopapular rash, generalized, including palms and soles
Fever, arthralgia, pharyngitis, lymphadenopathy
Develops 2-8 weeks after infection
Ultimately resolves |
|
|
Term
| Describe latent syphilis. Notes |
|
Definition
Early late - < 1 year after infected
Late latent - > 1 year after infected
Diagnosis made only be serologic testing |
|
|
Term
| Describe tertiary syphilis. Notes |
|
Definition
Neurosyphilis - attacks dorsal rami of spinal cord causing loss of sensory information
Cardiovascular - aortitis
Gumma
Manifest many years later (10, 20, 30, etc) |
|
|
Term
| What happens in aortitis caused by syphilis? Notes |
|
Definition
| causes separation of the layers of the thoracic aorta |
|
|
Term
| What happens in neurosyphilis? Notes |
|
Definition
| syphilis attacks the dorsal rami of the spinal cord which causes a loss of sensory information |
|
|
Term
|
Definition
extremely rare, soft, noncancerous growth
not infectious
indicative of tertiary syphilis |
|
|
Term
| What are Hutchinson's teeth and what do they indicate? Notes |
|
Definition
| Notched incisors that indicate that syphilis was contracted in utero |
|
|
Term
| What lab tests do you run for suspected syphilis? Notes |
|
Definition
VDRL and RPR - used for screening and to monitor patient's response to treatment
FTA-ABS - confirmatory test (because of false + VDRL)
MHA-TP (TP-PA) - equal to FTA-ABS in secondary and tertiary |
|
|
Term
| When might you get a false positive for VDRL and RPR? Notes |
|
Definition
Atypical pneumonia
malaria
other bacterial/ viral infections
autoimmune diseases
IV drug users
HIV
leprosy
aged |
|
|
Term
| What is the first line therapy for Syphilis? Notes |
|
Definition
|
|
Term
| What is a Jarisch-Herheimer reaction? |
|
Definition
A reaction that occurs when large quantities of toxins are released into the body as bacteria die
fever, chills, myalgia, headache
treat with aspirin (ASA) |
|
|
Term
| In what % of treated cases of syphilis does a Jarisch-Herxheimer reaction occur? |
|
Definition
|
|
Term
| Why is probenecid given to syphilis patients in addition to penicillin? Notes |
|
Definition
| It prevents penicillin from being excreted by the kidney and therefore keeps the drug in the body longer |
|
|
Term
T/F Notes
FTA-ABS usually remains positive for life. |
|
Definition
| True - it may revert to normal, though, so a negative test does not rule out past history |
|
|
Term
| When should you follow up with serologic titers for a treated patient with syphilis? Notes |
|
Definition
| 6 and 12 months - or sooner |
|
|
Term
| What is a common cause of blindness in the world? |
|
Definition
|
|
Term
| What is the most commonly reported STD? Noes |
|
Definition
|
|
Term
| What % of those with chlamydia are asymptomatic? Notes |
|
Definition
|
|
Term
| What are 3 possible sequelae of chlamydia infection? Notes |
|
Definition
| PID, infertility, ectopic pregnancy |
|
|
Term
| Name 4 risk factors for chlamydia infection. Notes |
|
Definition
1. 15-21 years old
2. single
3. new sexual partner
4. multiple sexual partners |
|
|
Term
| What laboratory tests would you run if you suspected Chlamydia? Notes |
|
Definition
| Swab specimen, PCR amplification, ligase chain reaction (to check for concurrent gonorrhea infection) |
|
|
Term
| How do you treat chlamydia conjunctivitis? Notes |
|
Definition
|
|
Term
| What treatments are there for chlamydia? Notes |
|
Definition
| Azithromycin (single dose) or doxycycline (7 days) |
|
|
Term
| What does Chlamydophila pneumoniae cause? Notes |
|
Definition
| may cause atherosclerosis and plaque instability |
|
|
Term
| What does human papilloma virus cause? Notes |
|
Definition
genital or venereal warts; moist warts
different serotypes cause warts on any part of the body
also cause changes that may lead to cancer |
|
|
Term
| What is the treatment for HPV warts? Notes |
|
Definition
Destruction
Also use vaccine to prevent (Guardisil) |
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