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Q4 Women's Health > STD (lec 1) > Flashcards

STD (lec 1) Flashcards

(53 cards)

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1
Q

Vulvovaginal Candidiasis (VVC) is?

A 
yeast infec (Not STD)
(U) c. albacans
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2
Q

VVC presentation?

A

itching, burning
dyspareunia (painful sex)
thick, white d/c

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3
Q

VVC diagnostics?

A

Wet prep = buds/hyphae

Cx = candida

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4
Q

VVC tx?

A

Uncomplicated:
1-3 d topical azole

Complicated (≥4/yr, non-albican, DM, immuncomp):
7-14 d topical or
oral fluconazole

**if non-albicans, NO fluconazole (choose other azole)

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5
Q

VVC tx men?

Recurrent/difficult?

Preggos?

A

Not neces u/l blanitis

eval for DM, HIV

topical only

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6
Q

Bacterial Vaginosis (BV) is?

A

disruption in N flora, Not STD

(U) gard. vaginalis/mobiluncus G-var anaerobes

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7
Q

BV presentation?

Risks?

A

fishy, gray d/c

(P) ↑ risk HIV, HSV, gonor, chlam

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8
Q

BV diagnostics?

A 
Amsel's (3 of 4):
thin/white d/c
clue cells
vag pH >4.5
fishy KOH

Gram Stain = anaerobes and ↓ lactobacilli

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9
Q

BV tx?

A

Tx all symptomatic pts:
DOC: Oral Metro 7d (avoid etoh)
or Topical Metro 5d
or Clindamycin

**Preggos use ORAL!

No partner tx

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10
Q

Trichomoniasis caused by?

Presentation?

A

t. vaginalis

vag pH > 4.5
irrit, odor, yellow-green froth
petechiae cervix/vagina

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11
Q

Trichomoniasis diagnostics?

In men?

A

Wet mount = motile protoz
Nuc Acid Amp test (NAAT), esp for male

Difficult
5-20% of non-gon urethritis is trich

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12
Q

Trichomoniasis tx?

A

Treat pt and partners:
Oral Metro
No sex until well

Preggos -> tx if sxs

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13
Q

Trichomoniasis complications?

A

↑ risk HIV
Preggos -> preterms (tx doesn’t reduce risk)
No breast feeding during tx

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14
Q

Chlamydia (CT) screening?

A

yearly for under 26 yo or high risk
all preggos

frequent co-inf w/ gonorr

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15
Q

CT presentation?

A

(C) asympt
oral or rectal also P

Women:
CERVIX d/c, bleeding, low abd pain, fever/chills

Men:
urethritis, d/c, dysuria

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16
Q

CT diagnostics?

A 
NAAT:
Swab
Urine
Pap
Pharynx/rectal
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17
Q

CT tx?

A

Treat all pts/partners:
Doxy 7d or Azith 1d
No sex for at least 7d
Retest 3-4 mo

Preggos:
NO doxy
Retest 3 wks post tx

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18
Q

CT complications?

A

↑ risk HIV
PID
Epididy

Preterms
Neonate eye inf/PNA

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19
Q

Gonorrhea (GC) screening?

A 
at risk (prior inf, > partners, sex workers)
(C) co-inf w/ CT
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20
Q

GC sxs?

Diag?

A

like CT, more severe

like CT

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21
Q

GC tx?

A

Treat all pts/partners:
ceftriaxone IM + azith or doxy
No sex
Retest 3-4 mo

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22
Q

GC complications?

Study These Flashcards
A

same as CT

Neonate also meningitis, endocard

23
Q

Non-gono Urethritis (NGU) caused by?

Study These Flashcards
A

anything other than gonorr

(U) chlamy

24
Q

NGU diagnostics?

Tx?

Study These Flashcards
A

test for GC/CT

azith or doxy

25
PID is?
inflamm disorders of up genital tract (U) from STDs (ascending infection) (P) h. flu
26
PID presentation?
Acute: d/c, low abd pain, cervical motion tenderness, fever Chronic: from insuff tx vague sxs
27
PID risk factors?
``` < 25 yo blacks x partners IUD prior PID ```
28
PID diagnostics?
Serum quant HCG (pregnancy) GC/CT WBCs in vag fluid CBC, ESR, CRP US -> r/o ectopic, abscess
29
PID tx? F/U?
Emphiric while waiting for tests Outpt: Ceftri IM + Doxy 14d + Metro 14d Inpt: IV 48 hr f/u
30
PID hospitalize when? (5)
``` can't r/o ectopic, append, etc preggos no abx response 48 hrs tubo-ovarian cysts looks ill ```
31
Fitz-Hugh-Curtis is?
(P) complication of PID | perihepatitis w/ RUQ pain/adhesions
32
HSV diagnostics?
``` Swab cx (standard): P false +, requires lesion ``` Ab serology: Ab not present until 3 wks post + result not definitive for genital herp
33
HSV tx?
clovirs Initial outbreak 7-10d Recurrent 1-5d Suppression daily
34
Neonatal HSV syndromes? (3)
1) Skin/Eye/Mouth (localized) 2) CNS (long-term morbidity) 3) Disseminated (organ involv)
35
Neonate HSV prevention?
Supression @ 36 wks for active/recurrent C-section for active or prodrome
36
HPV diagnostics?
Visible warts Pap smear No test for men
37
HPV tx?
treat dzs caused by HPV, no cure Destruction: LN2, TCA Podofilox Imiquimod Vaccine: Cervarix (girls) Gardasil (girls/boys)
38
HPV complications?
CA, esp cervical (U) types 16/18 rare transmission to neonate
39
Syphillis caused by? At risk?
trep. pallidum direct contact w/ lesion (U) M 20-29yo
40
°Syphilis presents?
painless chancre 4-6 wks
41
2° Syphilis presents?
U 2-6 wks No itch rash (U) includes palms/soles ``` Condyloma lata (moist warts) (U) intertriginous areas CONTAGIOUS ``` Mucous patches, not painful mouth/genitals CONTAGIOUS Malaise, LAD
42
Latent Syphilis?
asympt not transmittable can last yrs
43
Late Syphilis?
yrs post infection | Neurosyphilis
44
Syphilis diagnostics?
Darkfield for chancre Rapid Plasma Reagin -> titer = dz (confirm w/ FTA-ABS Ab test) Neurosyphilis: Lumbar punct -> VDRL test
45
Syphilis tx?
Treat all pts/partners: Benazthine PCN-G IM single dose unless had dz for > 1 yr, then multi dose Oral Doxy for PCN allergy Confirm clearance w/ RPR titer 3, 6, 12, 24 mo (4 x DECREASE = cleared)
46
Syphilis in preggos: Complications? (4) Screen?
stillbirths deafness neuro defects bone deformities screen at 1st visit high risk again 28 wks and delivery Close serology monitoring
47
Chancroid caused by? Presentation?
h. ducreyi Painful genital ulcer Foul, contagious d/c Inguinal adenitis/Buboes
48
Chancroid diagnostics?
r/o syphilis | report to county health
49
Lymphogranuloma Venereum (LGV) caused by? Most at risk?
chlamydia trachomatis MSM
50
LGV presentation? (5)
``` Systemic infection, Unilateral inguinal bubo (swollen node), Self-limit ulcer/papule Anal d/c or bleeding, Groove sign ```
51
LGV diagnostics?
r/o syphilis | report
52
Pediculosis Pubis tx?
Treat pt/partner: | permethrin 1% crm
53
STD screening for Pregnancy?
1st visit: HIV, syphilis, Hep B, GC/CT Hep C if risk Hx for HSV

Q4 Women's Health (20 decks)

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