STEP 1- UTI, Vaginal infections, STDs, and PID

Question 1

Cystitis presents with (5)

Answer 1

dysuria
frequency
urgency
suprapubic pain
WBCs (not casts) in urine

Question 2

Cystitis is primarily caused by what?
Males?
Elderly?

Answer 2

Ascension of microbes from urethra into bladder
Males: infants with congenital defects and vesicoureteral reflux
Elderly- enlarged prostate

Question 3

How does pyelonephritis present?

Answer 3

Fever, chills, flank pain, costovertebral tenderness, hematuria, and WBC CASTS

Question 4

Predisposing factors of UTI (6)

Answer 4

Obstruction
kidney surgery
catheterization** 
GU malformation
diabetes
pregnancy

Question 5

Diagnostic markers of UTI:
leukocyte esterase test +
nitrite test+

Answer 5

leukocyte esterase test + = bacterial UTI

Nitrite test + = gram-NEGATIVE UTI

Question 6

Leading cause of UTI. Colonies show green metallic sheen on EMB (eosin methylene blue) agar

Answer 6

E. coli

Question 7

2nd leading cause of UTI in sexually active women

Answer 7

Staphylococcus saprophyticus

Question 8

3rd leading cause of UTI.

Large mucoid capsule and viscous colonies

Answer 8

Klebsiella pneumonia

Question 9

Some strains produce a red pigment; often nosocomial and drug resistant (UTI)

Answer 9

Serratia marcescens

Question 10

Often nosocomial and drug resistant (UTI)

Answer 10

Enterobacter cloacae

Question 11

Motility causes “swarming” on agar
produces urease
associated with struvite stones
(UTI)

Answer 11

Proteus mirabilis

Question 12

Blue-green pigment and fruity odor (allegedly)

Usually nosocomial and drug resistant (UTI)

Answer 12

pseudomonas aeruginosa

Question 13

Signs and symptoms of bacterial vaginosis (3)

Answer 13

No inflammation

Thin, white discharge with FISHY odor

Question 14

Lab findings of bacterial vaginosis (2)

Answer 14

Clue cells

pH> 4.5

Question 15

Treatment for bacterial vaginosis (1)

Answer 15

Metronidazole

Question 16

Signs and symptoms of Trichomoniasis:

Answer 16

Inflammation

FROTHY, GREY-GREEN, FOUL-SMELLING discharge

Question 17

Lab findings for Trichomoniasis:

Answer 17

Motile trichomonads

pH> 4.5

Question 18

Treatment for Trichomoniasis:

Answer 18

Metronidazole

Also treat partner

Question 19

Signs and symptoms for Candida vulvovaginitis

Answer 19

Inflammation

Thick, white, “COTTAGE CHEESE” discharge

Question 20

Lab findings for Candida vulvovaginitis

Answer 20

PSEUDOHYPHAE

pH is normal (4-4.5)

Question 21

Treatment for candid vulvovaginitis

Answer 21

-azoles (there’s about a dozen+ that work well)

Question 22

Opportunistic infections
KS lesions
Lymphoma

Answer 22

AIDS/ HIV

Question 23

Painful genital ulcers, inguinal adenopathy

Answer 23

Chancroid
Haemophilus ducreyi (you cry with ducreyi)

Question 24

Chlamydia
clinical features (6)
organism

Answer 24

Urethritis
Cervicitis
Conjunctivitis
Reactive arthritis
PID
mucopurulent discharge

Chlamydia trachomatis (D-K)

Question 25

Genital warts and koilocytes | disease and organism

Answer 25

Condylomata acuminata: HPV 6 & 11

Question 26

Painful penile, vulvar, or cervical ulcers | Can cause systemic symptoms such as fever, HA, and myalgia

Answer 26

Genital herpes | HSV 2 > HSV 1

Question 27

``` Urethritis Cervicitis PID prostatitis epididymitis arthritis "creamy purulent discharge" ```

Answer 27

Gonorrhea Neisseria gonorrhoeae

Question 28

Jaundice

Answer 28

Hepatits B

Question 29

Infection of lymphatics painless genital ulcers painful lymphadenopathy

Answer 29

Lymphogranuloma venereum C. trachomatis L1-L3

Question 30

Painless chancre

Answer 30

Treponema pallidum | 1º syphilis

Question 31

Fever, lymphadenopathy, skin rashes, condylomata lata

Answer 31

2º syphilis

Question 32

Gummas, tabes dorsalis, general paresis | aortitis, pupil that accommodates but does't react

Answer 32

3º syphilis

Question 33

Vaginitis strawberry cervix motile in wet prep

Answer 33

Trichomonas vaginalis

Question 34

Top two bugs that cause PID

Answer 34

Chlamydia trachomatis | neisseria gonorrhoeae

Question 35

Three common symptoms of PID

Answer 35

Chandelier sign purulent cervical discharge PID shuffle

Question 36

Common signs of PID

Answer 36

Salpingitis Endometritis hydrosalpinx tubo-ovarian abscess

Question 37

Your patient has been diagnosed with salpingitis due to PID. What is she at risk for? (4)

Answer 37

1. Ectopic pregnancy 2. infertility 3. chronic pelvic pain 4. adhesions

Question 38

If PID remains undiagnosed, what syndrome does it cause?

Answer 38

Fitz-Hugh-Curtis syndrome