STDs (part 2- slide 119-173)- Schoenwald Flashcards
(80 cards)
Epididymitis= Pain, swelling and inflammation of epididymis for < ___ weeks
Chronic epididymitis if Sx > ___months
- 6 weeks
- 3 months
Epididymitis: demographic
-IF Sexually active men <35, most likely ______ or _____
**Gonorroeae or Chlamydia
Epididymitis:
IF Age >35, enteric organisms more likely ie _____
E coli
Epididymitis:
-unilateral or bilateral testicular pain?
*unilateral
Epididymitis:
tx for GC/Chlamydia=
**Ceftriaxone 250 mg IM x 1 plus doxycycline100 mg bid x 10 days (GC/chlamydia)
Epididymitis:
tx if enteric organism suspected:
**Levofloxacin 500 mg po q day x 10 days
Prostatitis is NOT part of STD tx guidelines, but less than 35 yo male with prostatitis–> MOST likely ______
GC/chlamydia
Prostatitis= acute swelling and inflammation of the prostate gland usually due to ______
*infection
Prostatitis: etiology?
**Etiology same as with epididymitis (GC/Chlamydia, or in older Pts enteric organisms)
Prostatitis:
Sx?
-Dx w/:
- dysuria, pain with erection, fever, chills, low back pain
- UA/culture pre and post prostate exam (pre prostate exam culture would be likely negative, but the post culture (after you massage prostate gland) would most likely be positive)
Prostatitis: tx?
-similar to epididymitis but longer duration.
(Ceftriaxone 250 mg IM x 1 plus doxycycline100 mg bid x 10 days (GC/chlamydia)
If enteric organism suspected-Levofloxacin 500 mg po q day x 10 days
normal prostate is about the size of a _____
walnut (and there’s no obstruction of the urethra)
Bacterial Vaginosis: Controversy: STD - yes or no
- need for tx:
- -in 1980: only if Pt complains
- -in 2002: increased risk of:
Preterm birth / premature rupture of membranes
Amniotic fluid infection
Chorioamnionitis / Postpartum endometritis
PID
Postsurgical infection
Cervical intraepithelial neoplasia
Mucopurulent cervicitis
Acquisition of HIV infection
Bacterial Vaginosis= alteration in ______
**vaginal flora
_________ makes up 95% of normal vaginal flora
**lactobacillus
BV:
-list 5 known risk factors
New sex partners Douching Decrease in normal flora Absence of barrier methods IUDs
BV:
-MC etiology?
**Gardnerella vaginosis
BV:
-Wet prep shows _____** and positive _____ test
**Clue cells, positive whiff test
KNOW
BV:
-Discharge appearance, odor and vaginal pH?
**White discharge, fishy odor, pH >4.5
BV:
tx regimens:
**Metronidazole 500 mg BID for 7 days
or
Metronidazole gel 0.75%, 5 g intravaginally QD for 5 days
or
Clindamycin cream 5%, 5 g intravaginally q hs for 7 days
BV: tx in pregnancy
-symptomatic women should be treated due to:
- **association with adverse pregnancy outcomes
- Existing data do not support use of topical agents in pregnancy
- Some experts recommend screening and treatment of asymptomatic women at high risk for preterm delivery (previous preterm birth) at the first prenatal visit; optimal regimen not established
BV tx in Pregnancy:
-Specific regimen ?
**Metronidazole 500 mg po bid x 7 days
or
Metronidazole 250 mg three times daily for 7 days
or
Clindamycin 300 mg twice daily for 7 days
BV: Management of Sex Partners
Woman’s response to therapy and the likelihood of relapse or recurrence not affected by tx of sex partner
Recurrent Vulvovaginal Candidiasis is defined as __ or more symptomatic episodes/year
4**
