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Flashcards in 7 - STD's Deck (33)
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1

What is the most common STD in Western countries?

Chlamydia trachomatis (CT) is 3-5 x more common than gonorrhea

2

True or False: GC (gonorrhea), CT, and syphilis all have routes of transmission that include both sexual contact and perinatal.

true

3

CT usually manifests as what 3 problems in men?

1) urethritis
2) proctitis
3) epididymitis
(true for GC as well)

4

CT usually manifests as what 5 problems in women?

1) urethritis
2) endocervicitis
3) proctitis
4) PID
5) perihepatitis (shoe string adhesions)
(true for GC as well)

5

What tests will you typically run to dx CT?

1) clinical exam (yellow discharge)
2) PCR/NAAT

6

What is the drug of choice to tx CT?

Azithromycin 1000mg single dose

7

If your patient comes to you for a severe sore throat that seems to be resistant to treatment, what might you want to consider?

gonorrhea (GC)

8

What should you consider in your DDx for joint infections that occur in sexually active patients?

disseminated gonorrhea

9

Disseminated gonorrhea can commonly present as arthritis or ________________

dermatitis

10

How will you dx GC?

1) clinical exam
2) PCR/NAAT

11

What is the treatment of choice for gonorrhea?

Ceftriaxone + Azithromycin

12

If GC goes untreated, what are the long term consequences?

infertility, ectopic, chronic pelvic pain

13

What STD has the highest prevalence in urban blacks and Hispanics and includes primary, secondary, latent, and tertiary stages?

syphilis

14

What is the pathogen responsible for syphilis?

treponema pallidum

15

What is the screening lab test for syphilis?

VDRL or RPR (basically same thing)
(and retest after 6 mo to get baseline)

16

What is characteristic of primary syphilis?

painless chancre (genitalia or cervix)

17

What is characteristic of secondary syphilis?

condyloma latum, flat plaques

18

What is characteristic of late/tertiary syphilis?

destructive gummas, aortic valve problems and CNS manifestations

19

What are the CNS manifestations of tertiary syphilis?

dementia, foot slapping (tabes dorsalis), pupil abnormalities (Argyle Robertson)

20

In what stage of syphilis is a diagnosis usually made?

Latent stage as part of a screening test.

21

How can syphilis affect a fetus?

1) death
2) growth restriction
3) multiple anomalies which can be immediately apparent at birth or delayed

22

What is the tx of choice for syphilis?

1) PCN!! Especially when pregnant
2) Doxy, Tetra, Cetriaxone also used...but if patient is pregnant USE PCN, even in presence of an allergy.

23

True or False: You cannot get HSV 2 on/around the mouth, as it is the genital strain of herpes.

False. Both types can occur and be transmitted at both oral and genital sites

24

How do you dx HSV?

1) clinical exam
2) PCR

25

If you need to collect a specimen from a lesion you suspect is HSV, what kind of lesion would yield the best test results?

a vesicular lesion with clear fluid, once "unroofed" will be most virulent.

(start as raised red bumps, then vesicular, then pustular, then ulcers, finally scabs)

26

How can you tell the difference between HSV and primary syphilis?

HSV is painful and syphilis chancre is not

27

What is the drug of choice for HSV?

Acyclovir (or Valacyclovir...but more expensive)

28

Can women with active HSV lesions proceed with a vaginal birth?

No. C-section

29

Which of the following STD's cannot use the PCR as a diagnostic test?
a) chlamydia
b) gonorrhea
c) syphilis
d) HSV

c) syphilis -- VCRL/RPR

30

Azithromycin alone is used to treat ___________

chlamydia