GN 4 VLVR DS Flashcards by 18 22

Causes of acute vulvar pruritus and irritation EXCEPT

a. allergic contact dermatitis
b. irritant contact dermatitis
c. candidiasis
d. psoriasis

D (chronic)

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Causes of chronic vulvar pruritus and irritation except

a. allergic contact dermatitis
b. irritant contact dermatitis
c. candidiasis
d. HPV
e. trichomoniasis

E (acute

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Acute causes of vulvar pruritus (infectious)

MaCaTi ShaDo
Molluscum contagiosum
Candidiasis
Trichomoniasis
Scabies
Human papilloma virus

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Neoplastic differential diagnoses of vulvar pruritus (2)

Paget disease

Vulvar cancer

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Where are the Bartholin gland drainage located?

ducts 2 cm long located at the entrance of the vagina at 5 and 7 o’clock, in the groove between hymen and labia minora

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Location of mesonephric cysts

more anterior and cephalad in the vagina

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location of epithelial inclusion cyst

more superficial

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True about Bartholin duct cysts

a. most are asymptomatic
b. may vary from 1 to 8 cm in diameter
c. most are unilocular
d. treatment of choice is marsupilization in all patients

A-C
D. marsupialization is for women younger than 40, women older than 40 with persistent deep infection, multiple recurrences, recurrent enlargement of gland, excision of a bartholin duct and gland is indicated.

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T/F it is best to use regional block or geeral anesthesia for excision of bartholin duct cyst

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most contagious of all STIs

pediculosis pubis

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etiologic agent of pediculosis pubis

crab louse a.k.a pubic louse,

Phthirus pubis

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predominant clinical symptom of louse infestation of pediculosis pubis

constant pubic pruritus

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what causes constant pubic pruritus in pediculosis pubis

allergic sensitization

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Etiologic agent of scabies

Sarcoptes scabiei

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Infection is widespread all over the body

a. scabies
b. pediculosis pubis
c. both
d. neither

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what is the predominant clinical symptom of scabies

severe but intermittent itching (unlike pediculosis scabies: constant pubic pruritus)

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pathognomonic sign of scabies

burrow in the skin

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Treatment of pediculosis pubis per CDC guidelines

permethrin, 1% cream rinse, pyrethrins, with
piperonyl butoxide applied to affected areas and washed off after 10 minutes
* do not apply on eyelids

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Treatment of scabies per CDC guidelines

Permethrin 5% cream applied to all areas of
the body (8 to 14 hours)

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Oral treatment for scabies

ivermectin, 200 microgram/kg orally, repeated in 2 weeks if necessary

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To avoid reinfection of pediculosis pubis or scabies, treatment should be prescribed for sexual contacts within the previous _____, Include close household contacts

6 weeks

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chronic localized infection consisting of flesh-colored, dome-shaped papules with an umbilicated center

molluscum contagiosum

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Incubation period of molluscum contagiosum

2-7 weeks

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genital ulcers (6)

Love DCHS
L  ymphogranuloma Venereum
D onovanosis
C hancroid
H erpes
S yphilis

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``` Incubation period Syphilis: ____ Herpes: ____ Chancroid: ____ Lymphogranuloma venereum: ____ Donovanosis: ______ ```

``` Syphilis: 2-4 wk Herpes: 2-7 days Chancroid: 1-14 days Lymphogranuloma venereum: 3 days- 6wk Donovanosis: 1-4wk ```

``` Primary lesion Syphilis: ____ Herpes: ____ Chancroid: ____ Lymphogranuloma venereum: ____ Donovanosis: ______ ```

``` Syphilis: Papule Herpes: Vesicle Chancroid: Papule or pustule Lymphogranuloma venereum: papule, pustule, or vesicle Donovanosis: papule ```

``` Diameter (mm) Syphilis: ____ Herpes: ____ Chancroid: ____ Lymphogranuloma venereum: ____ Donovanosis: ______ ```

``` Syphilis:5-15 mm Herpes: 1-2 mm Chancroid: 2-20 mm Lymphogranuloma venereum: 2-10 mm Donovanosis: Variable ```

``` Edges Syphilis: ____ Herpes: ____ Chancroid: ____ Lymphogranuloma venereum: ____ Donovanosis: ______ ```

Syphilis: sharply demarcated elevated, round, oval Herpes: erythematous Chancroid: undermined, ragged, irregular Lymphogranuloma venereum: elevated, round or oval Donovanosis: elevated, irregular

``` Induration Syphilis: ____ Herpes: ____ Chancroid: ____ Lymphogranuloma venereum: ____ Donovanosis: ______ ```

``` Syphilis: Firm Herpes: None Chancroid: Soft Lymphogranuloma venereum: Occassionally firm Donovanosis: Firm ```

``` Pain Syphilis: ____ Herpes: ____ Chancroid: ____ Lymphogranuloma venereum: ____ Donovanosis: ______ ```

``` Syphilis: unusual Herpes: common Chancroid: usually very tender Lymphogranuloma venereum: variable Donovanosis: uncommon ```

``` Lymphadenopathy Syphilis: ____ Herpes: ____ Chancroid: ____ Lymphogranuloma venereum: ____ Donovanosis: ______ ```

Syphilis: firm, nontender, pseudoadenopathy bilateral Herpes: firm, tender, often bilateral Chancroid: tender, may supurate usually unilateral Lymphogranuloma venereum: tender, may suppurate, loculated, usually unilateral

Treatment for herpes simplex virus in the nonpregnant patient, antiviral agents (3)

Valacyclovir Acyclovir Famciclovir

Treatment for herpes simplex virus First clinical episode

Valacyclovir - 1000mg bid, 7-10 days Acyclovir -200mg five times/day or 400 mg tid, 7-10 days Famciclovir 250 mg tid, 7-10 days

Treatment for herpes simplex virus Recurrent clinical episode

Valacyclovir - 1000mg daily, 5 days, or 500 mg bid, 3 days Acyclovir - 400 mg tid, 5 days; 800 mg bid, 5 days or 800 mg tid, 2 days Famciclovir 125 mg bid, 5 days 500 mg once then 250 mg bid 2days 1000 mg bid 1 day

Treatment for herpes simplex virus Daily suppressive

Valacyclovir - 1000mg daily, >= 10 Acyclovir - 400 mg bid Famciclovir 250 mg bid

Granuloma inguinale a.k.a

Donovanosis

Chronic infection of lymphatic tissue produced by Chlamydia trachomatis

Lymphogranuloma venereum

Etiologic agent of chancroid

Haemophilus ducreyi

Etiologic agent of syphilis

Treponema pallidum

The following are potential causes of biologic false positive results in syphilis serology EXCEPT a. pregnancy b. smallpox c. typhoid fever d. varicella e. NOTA

E all are answers

Etiologic agent of Donovanosis

Klebsiella granulomatis

T/F Granuloma inguinale can be spread via sexual and nonsexual contact

Treatment for Donovanosis (CDC recommendation)

azithromycin 1 g orally once a week or 500 mg daily for 3 weeks and until all lesions have healed

Alternative antibiotic regimens for donovanosis include the | following:

doxycycline, 100 mg orally, twice daily for a minimum of 3 weeks; ciprofloxacin, 750 mg orally twice daily; erythromycin base, 500 mg orally four times daily; trimethoprim-sulfamethoxazole (TMPSMZ), one double-strength tablet orally twice daily.

chronic infection of lymphatic tissue | produced by Chlamydia trachomatis

Lymphogranuloma Venereum

C. trachomatis serotypes causing Lymphogranuloma venereum

L1, L2, L3

A classic clinical sign of LGV is a depression | between groups of inflamed nodes. What do you call this?

double | genitocrural fold, or groove sign

How to establish diagnosis of lymphogranuloma venereum

``` Diagnosis is established by detecting C. trachomatis by culture, direct immunofluorescence, or nucleic acid detection from the pus or aspirate from a tender lymph node. ```

Treatment of LGV

100 mg twice daily for at least 21 days, as the preferred treatment.

The initial lesion is a small papule. How long til the papule evolves into a pustule and subsequently ulcerates?

48-72 hours

Treatment of Chancroid?

azithromycin, 1 g orally in a single dose

painless papule a. primary syphilis b. secondary syphilis c. tertiary syphilis

Primary syphilis manifest as painless papule that appears at the site how long after exposure?

2-3 weeks

chancre or painless ulcer a. primary syphilis b. secondary syphilis c. tertiary syphilis

Chancre (secondary syphilis) spontaneously heal after how long?

within 2-6 weeks

What percentage of untreated primary syphilis will result in hematogenous dissemination of spirochetes

25%

Secondary syphilis is a systemic disease that develops between ______ after the primary chancre.

6 weeks and 6 months (average 9 weeks)

The latent stage of syphilis follows the | secondary stage and varies in duration from _______ years

2-20 years

What percentage of untreated primary, secondary, or latent phases of the disease develops into tertiary syphilis?

33%

Antibiotic of choice for Syphilis

Penicillin G. | Benzathin Pen G IM

Approximately 60% of women develop an acute febrile reaction associated with flulike symptoms such as headache and myalgia within the first 24 hours after parenteral penicillin therapy for early syphilis. This response is known as the _________.

Jarisch-Herxheimer reaction

What is the established gold standard test for neurosyphilis.

NONE

GN 4 VLVR DS Flashcards

(62 cards)