Dz Flashcards
(266 cards)
1
Q
In which zone does BPH occur?
A
transition zone
2
Q
In which zone does prostate cancer occur?
A
peripheral zone
3
Q
What is the purpose of DRE?
A
to check for nodules/cancer
4
Q
Is DRE helpful for detecting BPH?
A
NO
5
Q
What are the type of BPH?
A
obstructive and irritative
6
Q
What is obstructive BPH? ie?
A
mechanical obstruction
ie) Bladder outlet obstruction
dynamic component
ie) adrenergic tone - muscle tone is causing obstruction
7
Q
What is irritative BPH?
A
detrusor muscle hypertrophy/hyperplasia
the BLADDER is irritated
8
Q
How may a pt with BPH come in looking like?
A
swollen abdomen/bladder
9
Q
When should peds get imaging done on their kidneys/bladders?
A
male <2yo
GU anaomolies
recurrent (3+/yr)
10
Q
What labs should be done for BPH?
A
Serum creatinine
UA
11
Q
Serum creatinine would be elevated or decreased in BPH? What next?
A
elevated
US
12
Q
UA in BPH? What next?
A
hematuria
CT urogram
refer to urology
13
Q
What imaging if considering cancer?
A
cystoscopy
14
Q
BPH mild - tx?
A
mild: nothing
15
Q
BPH mod- severe - tx?
A
selective alpha 1a-receptor blocker (not lungs) -tamsulosin (flomax) -alfuzosin (uroxatrol) nonselective alpha blockers (lungs) -terazoin (hytrin) -doxazosin (cardura)
16
Q
BPH w/ large prostate + hematuria?
A
5 alpha-reductase inhibitors
6mo until benefit
ADD W/ ALPHA BLOCKER
17
Q
BPH when to refer?
A
failed tx cannot urinate recurrent UTI recurrent hematuria renal insufficiency
18
Q
BPH surgery gold standard?
A
Transurethral resection of the prostate (TURP)
19
Q
What does PSA measure?
A
NOT cancer
protein that is measured in the blood –> if elevated may indicate: infxn, cancer, enlarged prostate
–further eval would be needed
20
Q
Hypospadias?
A
failure of the urethral folds to close at the tip of the penis
benign
21
Q
Hypospadias -refer?
A
if infant has a strong pee
22
Q
Hypospadias - tx?
A
nothing - unless bothersome
23
Q
Urethral stricture/meatal stenosis?
A
narrowing of the urethra
24
Q
Complication from uncircumcised penis?
A
phimosis pearly penile papules balanitis smegma HPV
25
Decrease urine stream, spraying/double stream, postvoiding dribbling?
urethral stricture/meatal steonsis
26
Phimosis?
chronic infxn from poor hygiene
| SQUAMOUS CELL CARCINOMA UNDER FORESKIN
27
Phimosis - tx?
abx
28
Paraphimosis?
foreskin gets stuck when retracted behind the glans
29
Paraphismosis - sx/pe?
edema d/t venous congestion
| arterial occlusion and necrosis may occur
30
Paraphismsis - tx?
firmly squeezing glans for 5min to decrease tissue edema
skin can be drawn forward over glans
abx
31
Curvature of the penis of the painful erection but NO pain when not erected?
peyronie's dz
32
Penis is rigid but NOT painful?
nonischemic priaprism
33
Nonischemic priapism -tx?
observe/self limiting
34
What should sickle cell pts be aware of?
ischemic priapism
35
What is happening in ischemic priapism?
venous drainage circulation gets cut off --> build up of viscous and poorly oxygenated blood in copora cavernosa
36
What drug can cause ischemic priapism?
trazodone
37
Ischemic priapism - tx?
analgesia + alpha agonist
corporal aspiration
surgical shunt
38
If pt has sickle cell and ischemic priapism?
treat the underlying sickle cell dz - O2, hydration, transfusion
39
Where does LH and FSH come from?
anterior pituitary
40
LH?
leydig --> synthesize testosterone --> secondary characterisitcs
41
FSH?
sertoli cell --> spermatogensis
42
Fails at testes?
primary hypergonadotrophic hypogonadism
43
Primary hypergonadotrophic hypogonadism- LH and FSH?
HIGH
| NO negative feedback because testes are broken --> continuos LH and FSH is made but NO testosterone
44
Secondary hypogonadotrophic hypogonadism?
fails at the gonads
45
Secondary hypogonadtrophic hypogonadism - LH and FSH?
low LH and FSH --> LOW testosterone
46
Secondary hypogonadtrophic hypogonadism PE-before puberty?
before puberty- nothing
47
Secondary hypogonadtrophic hypogonadism PE-after puberty?
after puberty - NO secondary characteristics (hair, narrow shoulders, gynocomastia)
48
Secondary hypogonadtrophic hypogonadism PE-later in life?
later in life - erectile dysfxn, poor libido, mood changes (depression), low energy
49
Normal range for testosterone?
300-1,000
50
What do to if lower than 300 testosterone level?
suspect androgen deficiency
51
What do you a LH and FSH lab test for those w/have small testes?
to distinguish between primary hypergonadtrophic and secondary hypogondatrophic hypogoandism
52
When do you tx for hypogonadism?
testosterone is <300
| AND 3 sx (erectile dysfxn, poor libido, mood changes, fatigue)
53
How long do you monitor hypogonadisim tx? What else do you monitor?
after 3 mo + q 3 mo
| consider prostate screening, hct, lipids
54
What are contraindications for testosterone replacement?
```
incr Hct
sleep apnea
CHF, MI, unstable angina
hx of prostate cancer, breast cancer
severe lower urinary tract sx
```
55
What form does testosterone replacement come in?
```
oral
buccal
patch
gel
IM
```
56
What are DIs for testosterone replacement?
anticoag
antidiabetic
corticosteroids
ACTH
57
What are the benefits of testosterone replacement?
better mood --> depression
better libido --> libido
decrease erectile dysfunction --> erectile dysfunction
more muscle strength and endurance --> fatigue
58
What are the treatments for hypogonadism?
testosterone replacement
| gonadotropins
59
Premature gonadal failure vs "andropause"?
premature gonadal failure: ABNORMAL decrease of testosterone in YOUNG males
andropause: NATURAL decrease of testosterone w/age
60
What are the diff types of testicular dysfxn?
```
Klinefleter
cryptorchidism
trauma/torsion
mumps/infxn orchitis
radiation
```
61
What is Klinefleter?
XXY
62
What is cryptorchidism?
incomplete dropping of the testes
63
Cryptorchidism -tx?
correct before 2yo - surgery
64
Cryptorchidism - complication?
Bilateral > unilateral
increase risk for testicular neoplasm
increase risk for inguinal hernias
65
What is testicular torsion?
twisting of the testes
66
Testicular torsion - cx?
trauma
growth spurt
tumor
HX OF CRYPTOCHIDISM (complication)
67
Testicular torsion - population?
<25yo
68
Testicular torsion - sx/pe?
```
"bellclapper"
testes move freely in the tunica vaginls
ACUTE pain
swelling
asymmetric scrotum
```
69
What is the timeframe for testicular torsion saving?
sx w/ 6+hrs = risk of losing testes
70
What haps if you lose one testes?
other will kick into gear - not a prob
71
Testicular torsion - test?
cremastric reflex
72
Testicular torsion - tx?
surgery
| manual detorsion
73
Erection?
parasympathetic
S2-S4
blood flow increases --> presses down on the veins --> blood accumulates --> erection
74
Ejaculation?
sympathetic
T10-L2
needs both pudendal nerve and skeletal muscle
1) seminal emission
2) projectile ejaculation
--needs both pudendal nerve and skeletal muscle
75
How to tx premature ejaculation?
- behavioral therapy: stop stimulation just prior to climax and hold base of penis anterior to posterior to prevent emission (kind of like desensitizing)
- SSRI: d/t increase in serotonin
- reduce penile sensitivity: condomn, topical anesthetizing cream
76
What can cx delayed oragsm?
SSRI
| opiates
77
What is retrograde ejaculation?
backflow of semen into the bladder
78
Cx of retrograde ejaculation?
```
after TURP (d/t BPH)
alphablockers for BPH
```
79
Tx for retrograde ejaculation?
alphasympathomimetics (benadryl)
| remove alphablockers
80
Erectile dsyfunction-types?
organic
| psychogenic
81
What is organic erectile dysfunction?
having the desire but not able to physically get the penis erected
82
What is pychogenic erectile dysfunction?
not having the desire to get an erection
83
What must be ruled out before erectile dysfunction?
neurological disorder
- brain lesions
- peripheral neuropathy (diabetes)
84
Pt comes in erectile dysfunction - what is important to take note of/review?
- meds: SSRI, opiates, non selective beta blockers, antishitamines, H2 blockers
- ETOH drinker
85
If pt is taking meds for the heart and is having trouble with erections, what drug can be used? avoided?
- change the beta blocker to alpha agonist
| - do NOT use sildenfil in case pt needs to take nitro
86
What pts should have labs done for erectile dysfunction?
ONLY if they are:
- depressed
- fatigue
- libido
87
Tx erectile dysfunction?
```
lifestyle changes
adjust meds (Beta blockers, SSRI)
drugs: PDE 5Is
transurethral therapy: alprostadil
vacuum pump device
intracavernous injection
penile implant
```
88
What adjustment to meds for erectile dysfunction?
Beta blockers --> alpha agonist
| SSRI --> bupropion/wellbutrin, drug holiday, reduce SSRI
89
What drugs can be used for erectile dsyfunction?
- sildenafil
- verdenafil
- tadalafil
90
When are the drugs for erectile dysfunction effective?
IF he is aroused
91
MOA of sildenafil?
increase cGMP levels --> vasodilation
92
Who may NOT respond to sildenafil?
DM
93
Sildenfil ADR?
```
HA
flushing
GI
vision (blue)
hypotensive
```
94
Sildenfil DI?
NO nitrites
alpha blockers
CYP450
95
Which tx of erectile dysfunction does NOT need sexual arousal?
intracavernous injection
96
What are the types of hernias?
```
groin --> inguinal and femoral
incisional
hiatal
ventral
umbilical
rectus diastasis
```
97
RF for hernias?
```
CHRONIC COUGH/CONSTIPATION
abdominal wall injury
HX OF CRYPTORCHIDISM
older age
male
caucasian
smoker
```
98
Hx of cryptorchidism can cx?
inguinal hernias
testicular torsion
cancer
sterility
99
Population for hernias?
50yo
100
Hernia hx/sx?
dull pain when NOT moving
| worse w/ moving, heavy lifting, coughing
101
Hernia PE?
bulge in groin but NON TENDER
102
Inguinal hernia: direct vs indirect PE?
direct: rounder
indirect: 'narrow'
103
Complication of hernia?
if painful:
| incarceration --> strangulation --> bowel obstruction
104
What is incarceration (hernia)?
the bowel gets stuck outside - pain
105
What is strangulation (hernia)?
bowel AND ischemia starts - blood flow compromised
106
What is bowel obstruction (hernia)?
BLOCKING of gas/stool - DIFFUSE abdomen pain
107
How to diff indirect and direct hernia?
US
108
When to use CT for hernia?
COMPLICATED
109
When to use MRI for hernia?
to check if strangulated
110
How to tx hernia uncomplicated w/ little sx?
watchful waiting
111
How to tx hernia uncomplicated w/ sx?
elective repair
112
How to tx ACUTE incarcerated hernia w/ no sx of strangulation?
manual reduction - trandelenburg w/ slow pressure
113
How to tx unreducible incarerated hernia +/-strangulation?
emergent repair
114
Congenital hernia vs acquired hernia?
congenital: processus vaginalus did NOT oblierate and internal ring did NOT close
acquired: trauma/damage to fibromuscular tissue of abdominal wall (cyclists, straining of the abdomen that increases pressure, etc)
115
What hernia is ABOVE the inguinal ligament?
indirect and direct inguinal hernia
116
What hernia is BELOW the inguinal ligament?
femoral hernia
117
What hernia is congenital?
indirect hernia
118
What hernia is acquired?
femoral hernia
119
What hernia can be both congenital and acquired?
direct hernia
120
Which hernia can be seen in children?
indirect hernia
121
Which hernia can be seen in adults?
direct hernia
| femoral hernia
122
Which hernia is the most common? least?
most: indirect
least: femoral but MORE complications
123
What is hap in indirect hernia?
goes THROUGH the inguinal ring
| LATERAL to the inferior epigastric artery
124
What is hap in direct hernia?
goes THROUGH the Hesselbach's triangle
LATERAL to inferior epigastric vessels
MEDIAL to rectus muscle
125
What is hap in femoral hernia?
goes THROUGH the empty space MEDIAL to femoral canal
| THROUGH the femoral ring
126
What is follicular/sebaceous cyst?
BLOCKED sebaceous gland/hair follicle
127
Is follicular/sebaceous cyst - benign/malignant?
benign
128
"small dome-shaped skin-colored 'pearly' papules on the CORONAL margin"?
pearly penile papules
129
"benign dome shaped subcutaneous papules on SCROTUM"?
follicular/sebaceous cysts
130
"black/blue/dark red dome shaped papules on scrotum"?
angiokeratomas of fordyce
131
Which derm are reassurance and tx for cosmetics?
follicular/sebaceous cysts
pearly penile papules
angiokeratomas of fordyce
lichen planus unless lesions
132
Pearly penile papules vs herpes/warts?
pearly penile papules: ON THE CORONAL
133
What is psoriasis?
non infectious and of the GLANS
134
"Well demarcated scaly erythematous plaques"?
psoriasis
135
Psoriasis tx?
symptomatic: hydrocortisone
prevention: calcipoterine
136
Pt comes in with dilated thin walled venules and black/blue papules on scrotum - pt most likely has...?
passed puberty
137
"violet flat topped lesions" on...?
glans and shaft
138
Pruitic/painful lesions on glans and shaft?
lichen planus
139
Lichen planus tx?
papular lesions - topical corticosteroids
| erosive lesions - intralesional steroid injection
140
Pt is <5yo, uncircumcised, poor hygiene + early stages of red erosions on glans?
balanitis
141
Balanitis - later stages?
erythema
swelling
discharge
pain
142
Balanitis -tx?
abx
antifungal
steroid
143
Uncircumcised + old skin cells, oils, but NO skin irritation?
smegma
144
Smegma - tx?
retract foreskin
145
What is lichen sclorsis also called?
balanitis xerotica obliterans
146
What are the stages of lichen sclorsis?
early: atophic puritic white plaques/papules
progressing: dysuria, painful erection
later: phimosis, meatal stenosis
147
Tx for lichen sclorsis?
early: HD topical steroids
later: intralesional corticosteroids
148
What are the gonadal deficiency?
HIV, COPD, cancer, liver/kidney dz
obesity
age
drugs
149
What drugs can affect gonadal deficiency?
```
spirnolactone
ketecoonazole
steroids
ETOH
marijuana
opoids
pit. tumor
```
150
What is androgen insensitivity?
do not have secondary characteristics
151
How does an androgen insensitivity person look like?
genitally male (XX) but appearance is female
152
What is precocious puberty?
puberty comes on TOO fast
| <9yo
153
What is delayed puberty?
NO secondary characteristics by 14yo
154
Delayed puberty vs constitutional delay?
GnRH stimulation
155
What is officially gynecomastia?
bigger than 4cm
| GLANDULAR tissue NOT adipose
156
What is hydrocele?
fluid accumlating
157
Cx of hydrocele?
trauma
| infxn
158
What can hydrocele be associated with?
testicular:
- neoplasm
- torsion
159
Why do a US in hydrocele?
distinguish between simple (watch) vs complex (refer)
160
If young child has hydrocele?
normal d/t testes dropping
161
Spermatocele/epididymal cyst?
PAINLESS cyst that is MOVEABLE
| located AWAY from testes
162
Spermatocele/epididymal cyst -tx?
observe
163
"dilation of venous plexus and internal spermatic vein" - what would you expect?
bag full of worms
164
Which side is varoicele commonly found?
Left
Right --> refer
right is DIRECTLY connected to the IVC
165
Tx of varicocele?
surgery
166
What can cause infertility?
varicocele
| hx of cryptochiasm
167
Pt notices ONE blue dot that is hard and tender?
torsion of appendix testes
168
What is high and low risk in HPV?
high: 16, 18
low: 6, 11
169
How can HPV be transmitted?
skin to skin
| sexual contact
170
HPV incubation period?
2wks-8mo
171
HPV sx/pe?
asymptomatic
| genital warts: condylomata acuminata, flat genital, smooth papule
172
Do you bx HPV?
ONLY if pt is immunosuppressed, bleeding, ulceration
173
What STD has a vaccine?
HPV
174
What are the vaccines available for HPV?
Quadrivalent and bivalent
175
Age for vaccine HPV?
between 9-10yo; before 11yo
| men who have sex w/men: cut off is 26yo
176
HPV vaccine dosage?
1st --> 2) 2mo later --> 3) 6mo later
177
First line tx for HPV? dosage?
podofilox 0.5% GEL NOT solution
| 3x/daily x 4days for 4 cycles --> no change? suspect cancer
178
How does HSV1 present?
oral
| papules --> vesicles -->pustules --> ulcers --> crust
179
HSV1 on the nose?
be careful for ocular herpes/herpes keratits--> may cause blindness
test w/ Floursecein --> medical emergency
180
HSV1 and HSV2 present?
F/C/HA/Fatigue/dysuria
181
What can trigger HSV2?
sunlight
stress
burning and tingling
182
HSV dx? what is no longer used?
viral culture - gold standard
| Tzanck is no longer used
183
HSV tx for fist episdoe?
1) acyclovir 800mg TID
2) valacyclovir 1000mg BID
3) Famciclovir 250mg TID
x7-10days
184
HSV tx chronic suppressive if..?
1x/mo
185
HSV tx chornic suppressive?
acyclovir TID x3-5days
valacyclovir 1gx5days
famiciclovir 1g BID x1day
186
Complication for HSV2?
somatitis and pharyngitis
| neonatal herpes
187
if HSV is on the face?
aseptic meningitis
188
What is chlamydia assocaiated with?
gonorrhea
189
RF for chlamydia?
15-24yo
| AA
190
Chlamydia sx/pe?
```
WATERY discharge
oropharynx infxn - NO discharge
conjunctivitis
proctitis
dysuria
```
191
Chlamydia dx?
NAAT
192
When to culture for chlamydia?
if suspicion for child abuse
193
Chlamydia tx?
azithromycin 1g PO x 1 dose
194
IF pt is allergic to azithormycin-chlamydia?
doxycycline 100mg PO BID x7days
| levofloxacin 500mg PO daily x 7days
195
Pt education for chlamydia?
NO sex for 7 days after tx OR after 7days w/ abx
196
Trichomoniasis pe?
scant grayish green penile discharge
197
Trichomoniasis tx?
metronidazole 2g PO x 1dose
198
What to advise during tx for trichomoniasis?
do NOT drink ETOH
199
Pubic lice sx/pe?
pruitic reddish/bluish papules/wheals
200
Pubic lice tx?
permethrin RINSE 1% x10min
OR
permethrin CREAM 5% for 8hrs
201
Granuloma inguinale cx?
klebsiella
202
Where is granuloma inguinale found?
tropical
203
Granuloma inguinale sx/pe?
1) painless
2) painful - foul smelling purulent discharge
lesions WAIST down
204
Granuloma inguinale dx?
bx--> DONOVAN BODIES
205
Granuloma inguinale tx?
doxycylcline 100mg PO BID x3-4wks
OR
TMP-SMX DS Q12hrs x3wks
UNTIL ALL LESIONS HEAL
206
Which STI have bubos?
lymphogranuloma venereum
| Chancoid
207
Lymphgogranuloma venereum cx?
subset CHLYMADIA
208
Where is lymphogranuloma found?
tropical
209
Lymphogranuloma venereum sx/pe?
1) painless ulcer/papule
2) painful inguinal LYMPHADENOPATHY
3) BUBOS -purple
check partners w/in 60 days
210
Lymphogranuloma venereum tx?
doxycycline 100mg PO BID 3-4wks
| tx partners like chlyamdia b/c it is subset
211
What STI are txd with doxycylcine?
granuloma inguinale
lymphogranuloma venereum
chlyamdia if allergic to azithromycin
212
Chancroid found where?
caribbean
213
What is important to keep in mind for chancroid?
CO FACTOR FOR HIV
214
Chancroid sx/pe?
1) PAINFUL vesticulopustural lesion - red at the base and bleeds easily (friable)
2) bubos
INGUINAL CANAL
215
Chancroid tx?
```
ceftriaxone 250mg IM x1dose
OR
azithromycin 1g PO x1dose
MUST RTC 3-7DAYS
check parter w/in 60 days
```
216
Chlamydia associated?
gonorrhea
217
What are AA RF?
chlamydia
gonorrhea
syphilis
218
Chlamydia vs gonorrhea sx/pe?
chlamydia: water discharge, NO discharge from oropharynx
gonorrhea: PURULENT discharge and in oropharynx
219
What do BOTH chlamydia and gonorrhea have?
dysuria
| conjunctivitis
220
How dx chlamydia and gonorrhea?
NAAT
221
How to tx gonorrhea?
Ceftriaxone 250mg IM x1dose
| AND cover for chlyamdia - azythromycin 1g PO x1dose
222
What is the diff between dipstick, microscopy, and culture?
UA is a screening tool
| microscopy can be used for dx
223
When to use culture?
when microscopy is positive for bacteria/WBC
224
When to suspect false positive for dipstick?
if the sticks have been exposed to air for a proglonged period of time
225
Sx/PE for acute bacterial cystitis?
foul smelling urine
226
Tx for acute bacteria cystitis?
bactrim or cipro (fluroquinolone) x 7days
227
What sx/PE acute bacterial cystitis, acute prostitis, and chronic prostitis have in common?
```
dysuria
hematuria
frequency
suprapubic pain
urgency
```
228
What is the difference between acute prostitis and chronic prostitis?
acute: fast, FEVER, PAINFUL DRE/prostate, can lead to septic
chronic: slow, afebrile, normal DRE
229
How to tell difference between acute bacterial cystitis vs prostitis?
prostitis has PERINEAL PAIN
230
Tx of acute prostitis?
bactrim or cipro x 4-6wks
231
Tx for chronic prostitis?
bactrim or cipro x 6wks-3mo
232
What are younger men likely to have-acute or chronic prostits? bug?
acute - e.coli
233
pt has scrotal pain?
epididmytis/orchitis
234
What other PE can epididmytis/orchitis have?
positive phren sign
| reactive hydrocele
235
How to tx epididmytis/orchitis?
50yo
| o Fluroquinolone PO x14days
236
RF for syphilis?
AA
| 25-29yo
237
How can syphilis be spread?
skin to skin
| sexual
238
Syphilis sx/pe?
ANYTIME! ANY rash!
239
What are the sub types of syphilis?
primary and secondary syphilis
latent syphilis: early latent and late latent
tertiary syphilis
240
Primary syphilis sx/pe?
chancre
| PAINLESS w/ CLEAN bse
241
Secondary syphilis sx/pe?
rash
| warts
242
When does chancre heal?
1-6wks
243
When does secondary syphilis sx/pe occur?
3-6wks
244
How can primary and secondary syphilis present?
THEY CAN OVERLAP
245
How does latent syphilis present?
NO lesions
246
When does latent syphilis occur?
between primary and secondary
secondary relapses
AFTER secondary stage
247
What is the criteria for early latent syphilis?
```
pos w/in 12mo
4 fold incr from previous titer test
sx w/in 12 mo
contact w/ someone who has syphilis (documented)
possible exposure w/in 12 mo
```
248
What is late latent syphilis?
same sx as early but more than 1 yr
249
PE for tertiary syphilis?
gummatous lesions - destruction of nasal bone/septum
| cardiovascular syphilis - aneurysms, aortic regurgitation, CAD
250
What is early neurosyphilis?
mo-yrs
cranial nerve dsyfxn
meningitis
altered mental status
251
What is late neurosyphilis?
tabes dorsalis
18-25yo
poor judgement skills
252
What labs should you run for syphilis? to be aware of?
partners should get VDRL
| note: if sx are early in primary syphilis - may be false negative
253
What is dx if pt has chancre?
darkfield microscopy + VDRL/RPR
254
What is dx if pt doe snot have chancre?
FTA-ABS + VDRL/RPR
255
How to tx primary, secondary, and early latent? F/u?
Benzathine penicillin G: 2.4million units IM x1dose
| f/u: 6-12mo
256
How to tx late latent and tertiary?
Benzathine penicillin G: 2.4million x3 doses (total 7.2)
| f/u: 6, 12, 18, 24mo
257
How to tx neurosyphilis?
aqueous crystalline penicillin G + admit
258
Complication from tx'ing syphilis?
Jarisch-Herxheimer Rxn
259
What is Jarisch-Herxcheimer rxn?
NOT an allergic rxn from the penicillin --> the bug dying int he body
usually occurs w/in 24hrs after therapy
260
"pearly, skin colored, umbilicated papules"?
molluscum contagiosum
261
Molluscum contagiosum - bug?
pox virus
262
How can molluscum contagiosum spread?
skin-skin
fomites
bathes/swimming pool
263
When is molluscum contagiosum the most contagious?
thick white paste
264
How to tx molluscum contagiosum?
imiquimod 5% 3x/wk for 1-3mo
265
Incubation period for chlaymdia?
7-10days
266
Incubation period for gonorrhea?
1-14days
