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Flashcards in Genital Tract Infections Deck (46)
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What are the 2 most common bacterial STIs?

1. Chlamydia
2. Gonorrhea

1

What are the 2 most common viral STIs?

1. HPV
2. HSV

2

What are the symptoms of Urethritis in men?

1. Dysuria
2. Discharge from the penis

3

What are symptoms of Urethritis/cervicitis in women?

1. Vaginal discharge
2. Abnormal vaginal bleeding or spotting
3. Dyspareunia
4. Dysuria
5. Could be asymptomatic

4

Which pathogens can cause Urethritis/cervicitis?

1. Chlamydia
2. Gonorrhea

5

What comprises a relevant Hx for genital tract infections?

1. New partners?
2. Multiple partners?
3. High-risk partners?
4. Type of exposure: men, women, both?
5. Anal, vaginal, oral?
6. Frequency of condom use
7. Past STIs

6

What methods are available for the Dx of STIs?

1. Clinical
2. Microscopy (Gram stain)
3. Culture
4. Ag detection
5. NAAT
6. Serology

7

Dx method for Gonorrhea and Chlamydia

1. NAAT - can be done on urine
2. Can also do Gram stain and culture

8

Tx for Gonorrhea

1. Increasing resistance
2. Cefixime or IM Ceftriaxone + azithromycin

9

Tx for Chlamydia

1. Doxycycline or azithromycin

10

What else is involved in the Tx of STIs besides drugs?

1. Reportable infection?
2. Partner notification
3. Counselling
4. Test for other STIs
5. Check vaccination status for Hep B and HPV

11


What is PID?



PID = Pelvic Inflammatory Disease Infection of the female upper genital tract (endometrium, Fallopian tubes)


12

What causes PUD?

1. Polymicrobial infection (STI + endogenous flora)

13

What are the S/S's of PUD?

1. Abdominal pain
2. Fever
3. Lower abdominal tenderness
4. Cervical motion tenderness
5. Adnexal tenderness

14

What is the Tx for PUD?

Antibiotics to cover STI + endogenous flora

15

What complications arise from scarring due to PUD?

1. Infertility
2. Ectopic pregnancy
3. Chronic pelvic pain

16

What elements are involved in the Dx of PUD?

1. Clinical
2. Test for Gonorrhea/Chlamydia
3. Imaging
4. Possible OR

17

What are characteristics of Genital Ulcer Disease (GUD)?

1. Ulcers, erosive, vesicular
2. Lymphadenopathy

18

What causes GUD?

1. HERPES SIMPLEX VIRUS (HSV-1 or HSV-2)
2. Syphilis - less common (Treponema pallidum)

19

Presentation of primary HSV infection (genitals)

1. May be asymptomatic
2. Painful vesiculo-ulcerative lesions
3. Fever
4. Tender lymphadenopathy

20

What is an atypical presentation of primary HSV infection (genital)?

1. Urethritis/cervicitis
2. Aseptic meningitis

21

Where does HSV go during latency (genital)?

Sacral sensory ganglion

22

What are some characteristics of recurrent genital HSV infections?

1. Prodromal symptoms (burning, itching, tingling)
2. Not as bad as primary episode
3. Become less frequent and less severe over time

23

How do you Dx HSV?

1. Viral swab for HSV PCR

24

What is the Tx for HSV infection?

1. Valacyclovir
2. Famiciclovir
3. Acyclovir

25

What is characteristic of primary syphilis?

Painless chancres

26

How do you Dx Syphilis?

1. Serology (RPR or VDRL)
2. Can take fluid from chancre for staining or PCR

27

What is the Tx for Syphilis?

IM benzathine penicillin

28

What are 3 causes of vaginal discharge?

1. Bacterial vaginosis
2. Vulvovaginal candidiasis
3. Trichomonas

29

Bacterial vaginosis is the most common cause of vaginal discharge, what is it a result of?

Overgrowth of genital tract organisms

30

What is Trichomonas?

1. Vaginal discharge caused by the protozoan Trichomonas vaginalis
2. This is an STI

31

What diagnostics can be done for vaginal discharge?

1. Vaginal swab
2. Gram stain
3. ELISA for trichomonas Ag

32

Tx for Vulvovaginal candidiasis

1. OTC antifungal cream
2. Fluconazole PO
3. Eliminate risk factors (i.e. antibiotics)

33

Tx for Trichomonas

1. Tx pt and partners with Metronidazole

34

When and how should you Tx Bacterial Vaginosis?

1. Tx if symptomatic and/or pregnant
2. Use Metronidazole or Clindamycin (PO or topical)
3. Don't Tx partners

35

What causes Prostatitis?

1. Gram -ve bacilli (i.e. E. coli)
2. Not usually an STI

36

How to Dx Prostatitis

1. Clinical - Hx and tender/mushy prostate on exam
2. Urine microscopy (WBCs)
3. Urine culture
4. Blood culture

37

Tx for Prostatitis

1. Antibiotics that cover Gram -ve bacilli (cipro, TMP-SMX)
2. Tx for 4-6 weeks

38

Clinical presentation of Prostatitis

1. Fever
2. Chills
3. Dysuria
4. Pelvic pain

39

What should you screen all pregnant women for?

1. HIV
2. Hep B
3. Chlamydia
4. Gonorrhea
5. Syphilis

40

What 2 things does HPV cause?

1. Warts
2. Cancer

41

What HPV strains cause anogenital warts (AKA Condyloma acuminata)?

HPV 6 and 11

42

Which HPV strains cause cervical cancer?

HPV 16 and 18

43

What are the 2 HPV vaccine available?

1. Gardasil - (quadravalent) against 6, 11, 16, and 18
2. Cervarix - (bivalent) against 16, 18

44

How can you Dx HPV?

1. Pap tests
2. HPV DNA

45

What is the Tx for HPV?

1. Ablation for warts/pre-cancer
2. Test for other STIs