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STI Flashcards

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1
Q
  • 85% of primary & secondary syphilis
  • 51% also w/ HIV
A

MSM

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2
Q
  • Most prevalent NON-VIRAL STI in United States?
  • MC presentation?
  • When do sxs occur?
A

Trichomoniasis

  • Asymptomatic
  • 1-4 weeks after exposure
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3
Q
  • urethritis
  • epididymitis
  • prostatitis
A

3 sxs of Trichomoniasis in men

(but men are usually asymptomatic)

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4
Q
  • Increased vag pH >4.5
  • Vag irritation, malodorous, frothy, yellow/green discharge
  • LOTS of discharge
  • Petechiae on cervix or vagina (what’s this called)?
  • Organism?
A

Trichomoniasis

  • Strawberry Cervix
  • Trichomonas vaginalis
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5
Q

Dx of Trichomoniasis

  • 60% accurate?
  • Most accurate?
A
  • 60% - wet mount w/ flagellated organisms
  • Swab –> culture (takes 7 days)
  • NAAT = fast and most accurate
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6
Q

Tx of what?

  • Metronidazole (oral)
  • Tinidazole (single dose)
  • Retest in __
  • Test of cure in ___ (for pregnant pts)
A

Trichomoniasis

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7
Q

Increases risk of premature rupture of membranes, preterm deliv, low birth weight

(but tx does NOT reduce risk)

A

Trich

(can tx pregnant women w/ Metronidazole)

(Lactating women should not breast feed 12-24 hrs after Metron single dose)

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8
Q
  • MC bacterial STI in United States
  • Organism?
  • Peaks in late teens/early 20s
  • Screening?
A

Chlamydia

  • Chlamydia trachomatis (gram -)
  • Women 25 or younger screened yearly
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9
Q
  • cervical dsch
  • vag bleeding
  • low abd pain
  • F/chills
  • adnexal tenderness
  • burning
  • SMALL amt discharge
A

Chlamydia sxs of women

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10
Q
  • Oral & Rectal infections are more common in Trich or Chlamydia??***
  • Possible in which other infection?
A

Chlamydia

  • Gonorrhea
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11
Q
  • 1st catch urine
  • NAAT
  • Pharynx/Rectal swab
  • Tx: Azithromycin single dose or Doxy x7 days
  • Don’t use which med in pregnant pts?? Cat D
A
  • Chlamydia
  • Doxy is Class D Preg
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12
Q
  • Increased risk of HIV
  • Untreated –> PID
  • Males –> epididymitis
A

Chlamydia & Gonorrhea

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13
Q
  • May lead to preterm delivery
  • Leading cause of MILD conjunctivitis and PNA in newborns (ophthalmia neonatorum)
A

Chlamydia

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14
Q
  • Severe conjunctivitis in newborns
A

Gonorrhea

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15
Q
  • sxs 1-14 days after exposure
  • Screen sexually act women under 25
  • NO recommendations for men or women over 25
A

Gonorrhea

(Neisseria gonorrhea = gram -)

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16
Q
  • Women:
    • Usually asymptomatic
    • cervical motion tenderness
  • Men:
    • urethritis, dysuria
    • white/yellow/green discharge
A

Gonorrhea

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17
Q
  • 1st catch urine
  • NAAT
  • Gram stain: PMN leuks w/ intracellular Gram-negative diploccoci**

(On exam)

A

Dx of Gonorrhea

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18
Q
  • IM Ceftriaxone + Azithromycin PO
  • or DOxy
A

Tx of Gonorrhea

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19
Q

Newborns: perforation of globe & blindness

A

Gonorrhea

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20
Q

MC cause of PID

A
  • STI organisms
    • Chlamydia & Gonorrhea
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21
Q

IUD within ___ of insertion can be cause of PID

A

3 weeks

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22
Q
  • Lower abd/pelvic pain
  • Cervical Motion Tenderness (Chandelier sign)
  • Uterine or adnexal tenderness
  • Cervical friability
A

PID

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23
Q
  • Get serum quant HCG
  • US to r/o ectopic
24
Q

Outpatient regimen:

  • Cef
  • Doxy x 14 days
  • +/- Metronidazole x 14 days

Inpatient: IV

**FU in 48 hrs**

25
**Hospitalize pts w/ ___ if:\*\*** * cannot r/o ectopic, appy, torsion * pregnant * Unresponsive to oral abx (48-72 hrs) * Tubo-ovarian abscess * Pt is VERY ill w/ 102.2F, N/V, looks sick
PID
26
Main compliation of PID?
Infertility
27
**Fitz-Hugh -Curtis syndrome** * What is it? / Which disease? * WHat 2 sxs?
**PID** * _Perihepatitis_ * RUQ pain & Adhesions * Adhesions between liver & diaphragm
28
* Acyclovir * Valacyclovir * Famciclovir * Reduce dose if renal insufficiency * Initial outbreak: ___ days * Recurrent outbreak ___ days
**Tx of Genital Herpes** * initial: 7-10 days * recurrent: 1-5 days
29
Transmission during vaginal delivery MC C-section to reduce transmission
Genital Herpes
30
MC syndrome of Neonate HSV from genital herpes
Localized Skin, Eye, Mouth (SEM disease) 4 weeks after birth
31
MC STI overall?\*\*\* on exam
**HPV** 6&11 are sexually transmitted
32
* Most asymptomatic * Condyloma acuminata * flesh colored / soft * cauliflower * Persistence of this infection is MCC of \_\_\_\_
**HPV** * Cervical Cancer
33
**Pt applied therapy:** * Imiquimod * Podofilox **Provider applied:** * Cryotherapy * Surgical therapy * Trichloroacetic Acid (TCA) (NO CURE of this)
HPV
34
Vaccine for HPV?
9-valent HPV (Gardasil 9)
35
* Treponema pallidum * painless chancre
Syphilis
36
Primary Syphilis
Painless Chancre
37
Secondary Syphilis
* **Rash** * diffuse, symmetric, macular/papular, NON-pruritic * Palms and soles of feet * Salmon colored lesions
38
When is syphilis no longer sexually transmittable?
Latent | (asymptomatic)
39
Late syphilis
* 10-20 yrs after infection * Neuro deficits: blindness, dementia, damage to internal organs
40
What type of syphilis can happen at ANY stage?
Neurosyphilis
41
Dx of syphilis
* Non-treponemal serological assays * RPR (MC used) = rapid plasma reagin
42
* Benzathine PCN G (IM) * If PCN allergy: oral doxy * retreatment: weekly Benzathine PCN G (IM x 3 weeks)
Tx of Syphilis
43
**Early Congenital Syphilis** * Manifests prior to __ yrs **Late Congenital Syphilis** * Manifests after __ yrs
* 2 * 2
44
* CNS syphilis * Long bone abnorm * PNA * Severe anemia
Early COngenital Syphilis
45
* Gumma Formation (granulomatous lesion) * Hutchinson Triad\*\*\*?? ## Footnote **(On exam)**
Late Congential Syphilis * Hutchinson teeth * Interstitial keratitis * Sensorineural hearing loss
46
Tertiary Syphilis
* Multi-organ involvement * Gummatous syphilis (skeletal, spinal, mucosal) * CV syphilis: aortic regurg, CAS, aortitis
47
* Haemophilus ducreyi * Sporadic outbreak in US * Painful ulcer * fould discharge * buboes * Contact County Health Dept
Chancroid
48
* Chlamydia trachomatis * "groove sign" * rectal bleeding * Contact County Health Dept
Lymphogranuloma venereum (LGV)
49
* Pthirus pubis * Crab louse * Tx: Permethrin cream rinse
Pediculosis Pubis
50
All pregnant women should be screened for what 3 things?
* HIV * Syphilis * HBsAg
51
Annual screenings for which 2?
* Chlamydia * Gonorrhea
52
Screen MSM annually for what 2?
* HIV * Syphilis
53
Screen 13-64 y/o
HIV
54
55
9-Valent HPV (Gardasil 9) vaccine for \<15 y/o
**2 doses** * 0 months * 6-12 months
56
9-Valent HPV (Gardasil 9) vaccine for 15+ y/o
**3 doses** * 0 months * 1-2 months * 6 months

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