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Women's Health Clin med > STIs > Flashcards

STIs Flashcards

1
Q

What is the number 1 cause of vaginal discharge

A

Bacterial vaginosis

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2
Q

What is the number 1 cause of symptomatic bacterial infection in reproductive age women

A

bacterial vaginosis

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3
Q

What symptoms may someone have with bacterial vaginosis

A

Discharge will be milky with a fishy odor (after KOH prep)

worse after unprotected intercourse

non-irritating

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4
Q

How is a diagnosis of bacterial vaginosis made

A

Amsels criteria

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5
Q

What will be present with amsels criteria with bacterial vaginosis

A

Clue cells on microscopy
alkalotic pH
+ whiff test

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6
Q

What is the first line treatment for bacterial vaginosis

A

Metronidazole PO for 7 days
or intravaginal metronidazole
or
intravaginal clindamycin gel

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7
Q

What do you have to warn a patient when prescribing metronidazole

A

n/v with ETOH

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8
Q

What is the risk if BV goes untreated

A

Increase risk of STI (including HIV)
increased preterm delivery
risk of candidiasis s/p tx

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9
Q

What is the second most common reported STI

A

Gonorrhea

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10
Q

What age group has the highest incidence of gonorrhea

A

15-24
*higher in black patients

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11
Q

If symptoms are present with Gonorrhea, what will they be

A

White/green/yellow purulent discharge

friable cervix
vaginal bleeding
dysuria

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12
Q

What are possible extra genital infections occur with gonorrhea

A

Conjunctivitis
arthritis
disseminated

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13
Q

How do you diagnose gonorrhea

A

NAAT

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14
Q

How do you treat gonorrhea

A

Ceftriaxone IM single dose
+
azithromycin or doxy
*no intercourse for 7 days

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15
Q

What are some complications with Gonorrhea

A

PID
epididymitis
mom-to-baby transmission

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16
Q

What is the most frequent reportable bacterial STI

A

Chlamydia

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17
Q

What symptoms will a patient have with chlamydia

A

pyuria
increased urinary frequency
purulent discharge
friable cervix

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18
Q

How do you treat chlamydia

A

Doxy 100mg PO BID x 7 days

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19
Q

What is the most prevalent non-bacterial STI

A

Trichomonas vaginitis

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20
Q

How is trichomoniasis prevented

A

condom use

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21
Q

What symptoms will females have with trichomoniasis

A

Profuse, malodorous, frothy vaginal discharge

strawberry cervix

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22
Q

How do you diagnose trichomoniasis

A

wet mount (must do immediately post sampling)

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23
Q

What is the treatment for trichomoniasis

A

metronidazole for 7 days for females

1 day for males

24
Q

What are some associated risks for trichomonas

A

preterm labor
PROM
small gestational age
increased risk for cervical cancer

25
Q

How is candidiasis diagnosed

A

presence of budding yeast and hyphae on KOH wet mount
*culture is gold standard

26
Q

How do you treat candidiasis

A

OTC: clotrimazole/miconazole
RX: Fluconazole PO

27
Q

What are some complications from syphilis

A

Neurosyphilis
ocular syphilis
auditory syphilis

28
Q

How do you diagnose early syphilis

A

Darkfield microscopy
*ID spirochetes

29
Q

What is the lab workup for later stages of syphilis

A

Non-treponemal test
treponema test (confirmatory)

30
Q

When should syphilis screening be preformed

A

MSM every 6-12 months
High risk every 3 months
Pregnant at prenatal, 3rd tri, and delivery

31
Q

What is the treatment for syphilis

A

Parenteral Pen G is first line

doxy is second line
* no intercourse 7-10 days
*ID and treat contacts within last 3 months

32
Q

What is Jarisch-Herxheimer reaction

A

Fever and worsening clinical ssx
Starts within hours of tx
lysis of spirochetes

*associated with syphilis

33
Q

What is chancroid

A

rare STI seen in younger men and sex workers

cause by Haemophilus ducreyi

34
Q

What is the presentation for chancroid

A

Papule -> pustule -> ulcerations

  • painful, soft, irregular borders, friable
  • necrotic base with yellow/gray exudates

-swollen lymph nodes (unilateral) near the lesion

35
Q

How do you diagnose chancroid

A

lesion culture is gold standard

36
Q

How do you treat chancroid

A

Azithromycin 1g PO x1
or
ceftriaxone 250mg IM x1

37
Q

What is the most common cause of genital ulcers

A

Herpes simplex

38
Q

How will herpes simplex present

A

Tingling prodrome
macular/papular rash
vesicle on erythematous base
shallow painful ulcers
lesions are self limiting over 3 weeks

39
Q

How do you diagnose herpes simplex

A

clinical if vesicles are present
tzank smear
HSV PCR
Urine culture

40
Q

What is the first line treatment for herpes simplex

A

Acyclovir or valcyclovir
*lifelong disease

41
Q

What strain of HPV is related to genital warts

A

6 or 11

42
Q

What is the presentation of genital warts

A

flat pedunculated lesions near Introitus

43
Q

What is the definitive diagnosis of genital warts

A

Biopsy of a lesion

44
Q

What are the treatment options for genital warts

A

Cryotherapy
surgical excision
caustic agent

45
Q

What are patient applied genital wart treatment

A

imiquimod cream
podofilox gel
sinecatechins ointment

46
Q

What is PID

A

Inflammation of upper genital tract

*secondary to an ascending infection from lower genital tract

47
Q

What is the most common cause of PID

A

chlamydia or gonorrhea

48
Q

Who is at increased risk for PID

A

Multiple partners
age
previous PID
IUD
tubal ligation

49
Q

How will PID present

A

Abdominal or lower pelvic pain
vaginal discharge
dyspareunia
AUB

50
Q

How would you do an exam for suspected PID

A

Cervical discharge
cervical motion tenderness
uterine tenderness
adnexal tenderness
+/- pelvic mass

51
Q

What clinical criteria needs to be present to have a high suspicion for PID

A

cervical motion tenderness
uterine tenderness
adnexal tenderness

52
Q

How do you treat PID

A

IV or PO antibiotics
* should improve within 72 hours

53
Q

What are the indications for admissions with PID

A

-need to rule out other surgical emergency
-presence of tubo-ovarian abscess
- severe infection (Temp over 101)
-no response to PO tx

54
Q

What is the first line abx regimen for PID

A

Ceftriaxone 1g IM
+
Doxy 100mg PO
+
Metronidazole 500mg PO
*treat for 14 days

55
Q

What are complications associated with PID

A

Tubo-ovarian abscess
pelvic abscess
ectopic pregnancy
infertility
chronic pelvic pain

Women's Health Clin med (13 decks)

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