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EOR - Women's Health > Infections > Flashcards

Infections Flashcards

(108 cards)

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1
Q

what women’s health infections do we need to know about

A

cervicitis
HPV
chancroid
LGV (lymphogranuloma venereum)
PID
syphilis
candida vaginitis
BV
trichomonas
atrophic vaginitis

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2
Q

what are the different types of cervicitis

A

gonorrhea
chlamydia
HSV
HPV

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3
Q

mucopurulent vaginal d.c
gram negative diplococci

A

gonorrhea cervicitis

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4
Q

dx for gonorrhea cervicitis

A

NAAT of d.c or urine

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5
Q

tx for gonorrhea cervicitis

A

</=150 kg: ceftriaxone 500 mg IM single dose
>/= 150 kg: 1 g

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6
Q

tx for coinfection of gonorrhea cervicitis PLUS chlamydia trachomatis

A

cetriaxone
PLUS
doxy

give doxy if you haven’t excluded chlamydia

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7
Q

what should you think of if a pt has persistent pharyngitis

A

gonococcal pharyngitis

get samples for culture

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8
Q

urethritis, vulvovaginitis
pain, pruritis
cervicitis
clcear vaginal d.c

A

chlamydia cervicitis

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9
Q

mc STI of the urethra, cervix, and rectum

A

chlamydia

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10
Q

what bacteria causes chlamydia infxn

A

chlamydia trachomatis
sterotypes D-K

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11
Q

symptoms of chlamydia (5)

A

urethritis
bartholinitis
cervicitis
d.c
post-coital bleeding

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12
Q

8 complications of chlamydia

A

PID
endometritis
salpingo-oophritis
neonatal conjunctivitis
neonatal PNA
infertility
miscarriage
ectopic pregnancy

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13
Q

dx for chlamydia

A

NAAT

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14
Q

tx for chlamydia

A
  1. doxy
    alt: azithromycin OR levofloxacin
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15
Q

all pt’s w. chlamydia should also be tested for _

A

gonorrhea

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16
Q

t/f: all pt’s w. positive NAAT for gonorrhea should also be treated for chlamydia, even if asymptomatic

A

t!

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17
Q

tx for chlamydia in pregnant pt

A

azithromycin
OR
amoxicillin

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18
Q

painful blisters on vulva/vaginal introitus - prodrome of burning, tingling, pruritis - vesicles on an erythematous base

A

HSV cervicitis

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19
Q

which HSV strain causes HSV cervicitis

A

HSV 2

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20
Q

enveloped linear double-stranded DNA virus

A

HSV 2

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21
Q

with genital herpes, were do ulcers/pustules mc form

A

labia majora/minora
mons pubis
vaingal mucosa
cervix

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22
Q

classic description of HSV

A

vesicles on an erythematous base

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23
Q

t/f: reactivation of HSV is often asymptomatic

A

t!

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24
Q

gs dx for HSV (3)

A

PCR
direct fluorescence antibody
type-specific serologic tests

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25
what prep is associated w. HSV and waht does it show
Tzanck prep ->multinucleated giant cells
26
tx for HSV (3)
acyclovir valacyclovir famiciclovir
27
severe presentation of HSV (3)
sacral nerve involvement urinary retention meningitis
28
who should get suppressive tx for HSV
severe/frequent recurrent episodes 6 or more/year
29
suppressive tx for HSV
valacyclovir
30
more than 90% of genital warts are caused by
HPV 6 HPV 11
31
which HPV vaccination is indicated for females and males ages 9-45 yo
gardasil-9 (HPV 9-valent)
32
more than 90% of cervical ca is associated with which types of HPV (5)
16 18 31 33 35
33
_ is commonly seen in combo w. condyloma acuminata
trichomonas
34
condylomata acuminata is a clinical dx, but _ can confirm dx
shave or punch bx
35
pap smear findings of condylomata acuminata
koilocytic squamous epithelial cells in clumps
36
tx for condylomata acuminata (4)
most resolve w.in months-years pdophyllin OR trichloroacetic acid (TCA) topical imiquimod (aldara) cryotherapy w. liquid nitrogen vs excision vs laser
37
3 HPV vaccines
quadrivalent (gardasil) 9-valaent (gardasil-9) bivalent (cervarix)
38
t/f: both garadasil vaccines cover HPV 6, 11, 16, 18
t! *gardasil 9 also covers 31, 33, 45, 52, 58*
39
the cervarix vaccine targets HPV (2)
16 18
40
only HPV vaccine available in the US
gardasil-9
41
all persons _ to _ yo should receive _ doses of gardasil 9
11-12 2 doses
42
gardasil 9 may be given starting at age _
9
43
catch up gardasil 9 should be given to all persons _ to _ yo regardless of risk factors
13-26
44
what are the 4 ulcerative STIs of the genital area
HSV chancroid lymphogranuloma venereum (LGV) syphilis
45
30 yo f c/o painful sore on vulva that first resembled a pimple - PE shows an ulcer w. clearly demarcated borders on a gray base w. foul smelling d.c
chancroid
46
STI that results in painful genital ulcers
chancroid
47
what pathogen causes chancroid
haemophilus ducreyi
48
t/f: chancroid ulcers bleed easily when scraped
t!
49
where are chancroid ulcers mc found
areas most susceptible to friction: glans penis, vaginal introitus
50
half of pt's w. chancroid will have what associated PE finding
marked LAD in the inguinal chain
51
dx for chancroid
RPR/VRDL *gram stain, culture, bx used in combo due to high rates of false negatives*
52
tx for chancroid
ceftriaxone +/- needle aspiration/drainage of LAD
53
what pathogen causes LGV
chlamydia trachomatis serotypes L1, L2, L3
54
primary infxn of LGV occurs in the
lymph nodes
55
3 rf for LGV
HIV Hep C MSM
56
3 stages of LGV infxn
primary secondary late
57
primary stage of LGV is chracterized by
painless genital ulcers/papules
58
secondary stage of LGV infxn is chracterized by
unilateral or bilateral tender inguinal and/or femoral LAD **aka buboes**
59
late stage of LGV infxn is characterized by
strictures/fibrosis/fistulae of the anogenital area
60
definitive dx for LGV
serology
61
preferred dx test for LGV for MSM
NAAT of rectal specimens
62
tx for LGV
1. doxy alt: azithromycin pregnant: erythromycin
63
t/f: you should wait for official dx before treating for LGV
f! treat if you suspect
64
STI that ascends from the cervix or vagina to involve the endometrium and/or fallopian tubes
PID
65
causative agents for PID
gonorhea chlamydia
66
what is chandelier sign what does it make you think of
cervical motion tenderness PID
67
4 sx of PID
pelvic pain fever vaginal d.c cervicitis
68
3 complications of PID
infertility ectopic pregnancy tubo-ovarian abscess (adnexal mass)
69
PE findings suggestive of PID
abdominal tenderness cervical motion tenderness adnexal tenderness PLUS one or more: -temp > 38 -WBC > 10,000 -pelvic abscesses via exam or US
70
inpt tx of PID: op tx of PID:
inpt: cefotetan/cefoxitin PLUS doxy OR clinda PLUS gentamicin outpt: ceftriaxone PLUS doxy +/- metronidazole OR cefoxitin PLUS probenecid PLUS doxy +/- metronidazole
71
6 indications for hospitalization w. PID
-uncertain dx w. inability to exclude d.o requiring surgical intervention (ex appendicitis) -pregnancy -no response to op tx w.in 72 hr -severe illness: high fever, n/v -inability to tolerate or follow op instructions -tubo-ovarian abscess
72
what pathogen causes syphilis
spirochete Treponema pallidum
73
3 phases of syphilis
primary secondary tertiary
74
presentation of primary syphilis
chancre
75
describe a chancre
painless ulcer groin or genital region presists 3-6 weeks
76
presentation of secondary syphilis
erythematous rash on palms/soles OR condyloma lata
77
presentation of tertiary syphilis
neurosyphilis mucosal growths (gummas)
78
dx for syphilis
RPR/VDRL confirmed by: FTA-ABS
79
tx for primary and secondary syphilis
benathine pcn g 2.4 million units IM x 1 dose *more doses if infected > 1 year or if pregnant *
80
tx for syphilis if pt is pcn allergic
doxy
81
tx for tertiary or congenital syphilis
iv pen g
82
what are the 4 types of vaginitis
trichmoniasis BV atrophic candidiasis
83
mc cause of vaginitis
candida
84
describe the d.c w. candida vaginitis
clumpy/cheesy mmmm
85
sx of candidal vaginitis (6)
pruritis dysuria burning dyspareunia vaginal/vulvar edema erythema
86
3 predisposing factors for candidal vaginosis
DM OCP abx
87
dx for candidal vaginosis
KOH
88
KOH findings of candidal vaginosis
budding hyphae
89
pH associated w. bacterial candidiasis
acidic: < 4.5
90
tx for candidal vaginosis
1. oral fluconazole alt: topical: clotrimazole, tioconazole severe: amphotericin B, capsofungin, voriconazole
91
pathogen associated w. BV
gardnerella
92
d.c associated w. BV
grayish white fishy smelling
93
dx for BV
gram stain -> clue cells
94
KOH prep findings of BV
fishy smell -> whiff test
95
pH associated w. BV
basic: > 4.5
96
first line tx for BV
metronidazole alt: clinda
97
important pt ed for pt on metronidazole
avoid etoh
98
d.c associated w. trichomonas vaginitis
greenish gray frothy
99
rf for trichomonas vaginitis
sexually active *considered STI*
100
hallmark PE finding of trichomonas
strawberry cervix -> petecchiae on cervix
101
dx for trichomonas
wet mount
102
wet mount findings of trichmonas
mobile and pear shaped protozoa w. flagella
103
tx for trichomonas
metronidazole
104
important tx consisderation w. trichmonas
considered an STI to treat partner too
105
post menopausal woman w. irritation, dryness, painful intercourse, increased UTI's, urinary incontinence
atrophic vaginitis
106
what do you think when you see a pt w. recurrent UTI's despite treatment in a post menopausal woman
atrophic vaginitis
107
dx for atrophic vaginitis
pelvic exam: thin, pale appearing mucosa
108
tx for atrophic vaginitis
1. conjugated estrogen vaginal cream 2. HRT if no contraindication 3. non hormonal vaginal moisturizers

EOR - Women's Health (15 decks)

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