STI's and other genital tract infections Flashcards Preview

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Flashcards in STI's and other genital tract infections Deck (29):
1

STI risk factors

known contact with STI
anonymous sex
<25 y.o
new partner
multiple partner
no barrier contraception
drugs, alcohol, IDU
sex workers/ survival sex
sexual assault
Hx of STI

2

Urethritis/cervicitis
-S/S

Men:
Burning or pain during urination
Discharge from penis

Women:
Vaginal discharge/Abnormal bleeding
Pain during sex
Dysuria
***can be asymptomatic***

3

Urethritis/cervicitis
-etiology

Neisseria gonorrhea
Chlamydia trachomatis

4

How to diagnose gonorrhea or chlamydia

Swab the urethra/cervix and culture
OR
Send first-catch urine to lab for NAAT

5

Gonorrhea management

-Cefixime or IM ceftriaxone (but resistance is growing)
-contact tracing (reportable)
-test for other STIs
-determine vaccination status of HBV and HPV

6

Chlamydia management

-doxycycline or azithromycin
-contact tracing (reportable)
-test for other STIs
-determine vaccination status of HBV and HPV

7

Pelvic Inflammatory Disease
-definition

infection of the female upper genital tract (uterus, fallopian tubes, ovaries

8

Pelvic inflammatory disease
-etiology

Usually polymicorbial:

STI+ endogenous

(STI: gonorrhea/chlamydia)
(endogenous is local flora, aerobic and anaerobic)

9

Pelvic inflammatory disease
-S/S
-complications

Abdominal pain
Fever
cervical motion tenderness
adnexal tenderness

Complications: infertility, ectopic pregnancy, chronic pelvic pain

10

Pelvic inflammatory disease
-management

-Antibiotics to cover STI and endogenous (aerobic and anaerobic)
-report any confirmed STIs
-test for other STIs
-determine vaccination status of HBV and HPV

11

Genital ulcer disease
-etiology

-usually HSV-2, HSV-1
- sometimes syphilis (Treponema pallidum)

12

HSV course of infection

Primary infection:
-painful vesiculoulcerative lesions
-fever
-lymphadenopathy
- rarely: urethritis/cervicitis or meningitis

Then infects the sacral sensory ganglion and becomes latent.

Reactivation has a prodrome of burning/itching/tingling.

13

Diagnosis of HSV

Viral swab of open vesicle

14

Management of HSV

Oral antiviral:
-valacyclovir
-famciclovir
-acyclovir
NOT REPORTABLE
Test for other STIs
Determine HBV and HPV vaccination status

15

Primary syphilis
-S/S

-painless chancre of mouth/penis/rectum

16

Diagnosis of syphillis

-RPR (rapid plasma reagin) serology test
-PCR on fluid from chancre
-Special stain on fluid from chancre

17

Management of syphillis

-IM benzathine penicillin
-Contact tracing (reportable)
-Test for other STIs
-Determine HBV and HPV vaccination status

18

Causes of vaginal discharge

1) bacterial vaginosis
2) vulvovaginal candidiasis
3) Trichomonas vaginalis infection

19

How to find out what's causing vaginal discharge

Take a vaginal swab, gram stain, smear.
Look at the type of discharge:
-White clumpy (candidiasis)
-watery white/grey, copious (bacterial vaginosis)
-frothy white or yellow (Trichomoniasis)

20

Management of vulvovaginal candidiasis

- OTC antifungals or fluconazole PO
-Eliminate risk factors like Ab use
-NOT REPORTABLE

21

Management of Trichomonas

-metronidazole for patient and partner
- NOT REPORTABLE

22

Bacterial vaginosis

-metronidazole of clindamycin PO/topical for patient only
- NOT REPORTABLE

23

Prostatitis
-S/S

Fever, chills, pain in rectum, dysuria
tender, boggy prostate on exam

24

Prostatitis
-etiology

Gram-negative bacilli (e.g. E. coli)
Sometimes gonorhhea or chlamydia (but not usually)

25

Prostatitis
-diagnosis

-physical exam
-urine microscopy
-urine culture
-blood culture

26

Prostatitis
-management

-Ab that cover G(-) bacillin
-ciprofloxacin
-TMP-SMX
-Report only if due to STI

27

All pregnant women should be screened for:

HIV
HBV
Chlamydia
Gonorrhea
Syphilis

28

HPV serotypes and what they cause

HPV 1,2,3,4- skin warts
HPV 6, 11- genital warts
HPV 16,18- cervical cancer and other cancers

29

Prevalence of HPV

75% of sexually active adults