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Emma Repro > Infections of the Genital Tract > Flashcards

Infections of the Genital Tract Flashcards

(75 cards)

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1
Q

3 common causes of vaginitis

A
  • bacterial vaginosis*
  • vulvovaginal candidiasis*
  • trichomoniasis

*=not sex transmit

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2
Q

In repro age women, predominant organism within vagina?

A

lactobacilli

dec vaginal pH: 3.5-4.5

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3
Q

pH < 4.5 (normal range) suggests

A

yeast infection

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4
Q

pH >4.7

A

bacterial vaginosis*

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5
Q

amine “whiff” test

A
  • fishy odor that results when a drop of KOH is mixed in with discharge
  • suggests dx of BV
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6
Q

Wet mount

A

slide of discharge mixed w/ saline and on other side mixed w/ KOH

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7
Q

Clue cells

A

bacteria studded w/ squamous epithelial cells –> BV

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8
Q

motile protozoa

A

trichomoniasis

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9
Q

spaghetti and meatballs

A

hyphae and budding yeast –> candidiasis

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10
Q

vulvovaginal candidiasis tx

A

topical antifungals

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11
Q

bacterial vaginosis

A

polymicrobial infection, lack of H2O2-producing lactobacilli –>overgrowth of anaerobic organisms

gardneraella vaginalis found w/ greater freq

thin, watery discharge
fishy odor

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12
Q

Amsel’s criteria

A

for bacterial vaginosis (need 3/4)

  • abnormal gray discharge
  • vaginal pH > 4.5
  • positive amine “whiff” test
  • more than 20% of epithelial cells being clue cells
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13
Q

Nucleic acid amplifcation tests (NAAT)

A

high sensitivity for bacterial vaginosis, chlamydia

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14
Q

bacterial vaginosis tx

A

5 – night course of intravaginal metronidazole or clindamycin

or

7-day course of oral metronidazole

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15
Q

Vaginal trichomoniasis sx

A

discharge, itching, burning, or postcoital bleeding

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16
Q

Vaginal trichomoniasis transmission

A

sexually transmitted infection caused by parasitic protozoan, Trichomonas vaginalis

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17
Q

Vaginal trichomoniasis dx

A

based on seeing the moving trichomonads on saline microscopy

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18
Q

based on seeing the moving trichomonads on saline microscopy. tx

A

oral metronidazole

TX PARTNER TOO

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19
Q

metronidazole can cause a ____-like effect

A

disulfram-like (Antabuse) effect when alcohol is ingested resulting in nausea, vomiting, headaches, and sweating

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20
Q

most comm bacterial STI in US

A

Chlamydia

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21
Q

Most non-gonococcal urethritis (NGU) in a male patient is caused by

A

Chlamydia trachomatis

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22
Q

chlamydia

A

vaginal discharge, post-coital bleeding, or dyspareunia

majority=ASYMPTOMATIC

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23
Q

untreated chlamydia puts women at high risk for

A

pelvic inflammatory disease

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24
Q

high risk of recurrence/reinfection

A

BV

chlamydia

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25
many polymorphonuclear cells with gram negative intracellular diplococci which looks like a pair of kidney beans
Neisseria gonorrhea
26
Gonorrhea primary affects the mucous membranes of the
lower genital tract
27
gonorrhea in men, main sx
urethritis
28
gonorrhea in women, main sx
often asymptomatic
29
polymigratory arthralgias in knees or elbows
Disseminated gonococcal infection (DGI) occurs in untreated chlamydia pt
30
pelvic inflammatory disease (PID) etiology
-female repro tract, begins in cervix --> peritoneal cavity --> peritonitis --> agglutination --> pelvic adhesive disease --> chronic pain, infertility, ectopic preg
31
known etiologic agents of PID
Neisseria gonorrhea and Chlamydia trachomatis
32
PID presumptive dx
should be made and the patient treated for PID for any sexually active women presenting with... - abdominal or pelvic pain - either cervical motion tenderness, fundal tenderness and/or adnexal tenderness on exam - if no other cause for her pain is found.
33
lymphogranuloma venereum (LGV)
- caused by type "serovars of Chlamydia trachomatis" - genital ulcer which progresses into a lymphatic infection with associated inguinal abscesses (buboes) and systemic illness
34
groove sign
lympgranuloma venereum (LGV) regional inguinal lymph nodes become exquisitely tender/erythematous fevers/chills/malaise/HA/weight loss
35
late lymphogranuloma venereum (LGV)
genital elephanitsis
36
lymphogranuloma venereum (LGV) tx
3 week course of doxycycline
37
chancroid
- causes ulcerative genital disease - low income - erythema w halo
38
chancroid natural history
begins as tender papule --> ulcerates --> ragged with erythematous halo ulcers can bleed easily, merge and form serpingious ulcers no tx --> bubo formation --> sinus tract formation
39
chancroid dx
clinical dx | -painful genital ulcers, tender lymphadenopathy, and negative testing for HSV or syphilis
40
large numbers of gram negative coccobacilli in a “school of fsh” pattern
Hemophilus ducreyi --> CHANCROID
41
chancroid
azithromycin or cefriaxone (single dose therapy)
42
granuloma inguinale | Donovanosis
- chronic, progressive, ulcerative - painless papule --> ulcerates to form an exuberant, beefy red ulcer w/ satin-like surface and easy bleeding -cliniical + histo of Donovan bodies
43
lymphogranuloma venereum vs Granuloma inguinale
both can lead to elephantiasis constitutional sx absent in Granuloma inguinale
44
Donovan bodies
gold standard for Granuloma inguinale
45
Granuloma inguinale tx
doxycycline
46
HSV-1 transmission
oral
47
HSV-2
contact with genital secretions
48
HSV lesion
painful, thin-walled vesicle on an ingammatory base
49
primary HSV sx
fever, malaise, anorexia, and tender bilateral inguinal adenopathy
50
HSV maintained in a repressed state in neurons
"latency" - transcription of only a few proteins - activ of entire genome can occur --> full transcription, viral release, etc
51
recurrence of HSV?
common recurrent episodes are usually associated with less severe symptoms than the primary infection and can even be asymptomatic
52
dx of HSV
PCR culture (1 vs 2) serology Tzanck prep
53
Tzanck prep
The presence of multinucleated giant cells indicates infection with a herpes virus (“ground glass” appearance) low sensitivity no 1 vs 2 distinguish
54
multinucleated giant cells indicates infection with a ____ virus (“ground glass” appearance)
herpes
55
HSV tx
acyclovir for outbreaks -need to tx recurrences EARLY ON
56
HSV and pregnancy
neonatal HSV --> sepsis, encephalitis, DIC spontaneous abortion, congenital HSV manifestations
57
If the pregnancy patient has no symptoms suggestive of HSV outbreak or lesions on exam, ____________ is recommended to avoid neonatal exposure.
cesarean delivery
58
high risk HPV
cervical dysplasia and cervical cancer
59
low-risk HPV
condyloma acuminata
60
condyloma tx
excisional or ablative techniques (TCA)
61
Treponema pallidum
tight coil spirochete --> SYPHILIS (variety of system affected)
62
highly infectious stage of syphillis
primary syphilus painless ulcer and painless lymphadenopathy
63
90% secondary syphilis patients develop
a rash
64
punched out tissue | made up of granulation and yellow slough
tertiary syphilis
65
Findings of neurosyphilis include:
meningovascular syphilis tabes dorsalis general paresis syphilitic otitis
66
syphilis dx
RPR | VDRL
67
primary and secondary syphilis tx
benzathine penicillin
68
scabies transmission
intimate personal contact, often sexual in nature, but casual contact or contact with fomites may be adequate for transmission. Institutional epidemics can occur.
69
public louse
- pediculosis pubis - highly infectious - severe itching/low-grade fever/constitutional - dx on inspection
70
tertiary/neurosyphilis tx
IV penicillin
71
molluscum contagiosum
caused by moderately infectious DNA pox virus diffuse papule distinguished by central umbilication Henderson-Patterson bodies
72
Henderson-Patterson bodies
molluscum contagiosum
73
scabies
- Sarcoptes Scabiei - itching most severe at night - worldwide, all rases/SES - erythematous papules/excoriations classically seen in webbed spaces of fingers
74
scabies tx
Permethrin cream | Ivermectin oral
75
pubic louse tx
Permethrin cream | similar to scabies

Emma Repro (23 decks)

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