STIs, TORCHES, Childhood Rashes, HIV Flashcards

(41 cards)

1
Q

HPV

A

E6 (p53)-E7(Rb); DNA VIRUS

Low Risk: 6, 11; High Risk: 16, 18, (31, 33)

Most clear virus, few progress to CIN I, fewer to II/III;

Cervical, Anal, Oral, vulvular.

Conoldymoas (PAINLESS****), flat and confluent lesions. CERVICITIS WITHOUT PURULENT DISCHARGE

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2
Q

HSV

A

DNA Virus; HSV1 (oral; trigemnal gang, (Temporal lobe) Enchepalitis in newborns), HSV2 (Genital, sacral ganglia, cervicits, herpetic vsciles, dyuria).

Oral Pharyngitis, painful “shingle-like” type of outbreak in pharyx.

Tx with Zovirax.

Preg women with active lesions should get C-section; if active on nipple don’t breast feed.

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3
Q

Gonorrhea

A

G negative (neisseria), 2nd most common STD (prevelent in young adults). COINFECTION WITH CHLAMYDIA COMMON (tx for both)

Cervicits, or Pelvic Inflam Disease (PID; causes scaring of fallopian tubes which messes up ovulation=infertility), skin rash, eye vagina, anus, urethra (GREEN/Colored discharge)

CAN BE ASSYMPTOMATIC. Tx with DNA PCR (female); Males (gram stain)

Ceftriaxone (Cefalosporin) AND CHLAMYDIA TX (Doxy or Azythromycin)

Can cause Disseminated Septic Joint disease

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4
Q

Chlamydia Trichomatus

A

Gram negative obligate intracuellar bacteria (CANNOT PRODUCE OWN ATP).

Most common for women under 25******; Common co-infection with Gonorrhea

LEADING CAUSE OF PID (infertility from fallopian tube scaring causing poor ovulation).

ASSYMPTOMATIC WOMEN (cervicits, mucolpurelent discharge*), PID/ectopic pregnancies

Tx: Doxy/Azithromycin And Tx for gonorrhea (cefatriaxone)

Serotype L–Lympogranuloma Venerium: swelling of groin lymph nodes

Fitzhugh Curtis Sydnrome (adhesions between the liver and diaphragm)

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5
Q

HIV

A

ELISA (highly sensitive) followed by Western blot (highly specific, rules out false positives)

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6
Q

Scabbies

A

Parasite, like lyse; common among children can be transmitted sexually.

Gential itching RASH WITH BURROW FROM MITE***

Vesicular maculopapular rash on vuvla.

Dx via visualization of MITE

Permetrhin Cream/shampoo

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7
Q

Mulcosum Congentiosa

A

DOME SHAPED PAPULES WITH CENTRAL DIMPLE

DNA Pox. Autoinnoculation or close contact

Small painless papules (usually assymptomatic, highly contagious)

Kids/Daycares

Dx: clinical appearance then biopsy looking for viral bodies in cytoplasm

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8
Q

Trichomonas Vaginalis

A

Protazoa, Oval, flagella; TX WITH METRONAZOLE

Most curable and most common

Females with FOUL SMELLING, FROTHY green discharge, STRAWBERRY CERVIX, vulvular edema, itching/burning

Asymptomatic in men; sexual transmission

Dx: Wet mount pH of vagina (w/t 4.5, more alkaine with parasite)

TX PREG WOMEN BECAUSE IT CAN CAUSE PRETERM LABOR AND DELIVERY (LOW BIRTH WEIGHT)

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9
Q

Syphillis

A

Treponmoa Pallidum: Gram Negative spirocye.

Homosexual men, HIV +, 13-35 yo

Dx: VDRL/RPR antidodies (non-trep antiody titer—false positives w/ autoimmunity); confirm with FTA (once you have infection always will be positive even after you clear it)

ALWAYS TX PREGNANT WOMEN: PENCILLIN (EVEN IF THEY HAVE ALLERGY)

PAINLESS LESION AT INFECTION (high infectioius)

Secondary: More Disseminated: Systemic, fever, maculopapular rash, palms fo sole feet (highly infectious still)

Teritary: neurosphyillus, destruction of vaso vasorum, argyl robersonian pupil (accomodate, but don’t react to light), tabes dorslais (not infectious anymore)

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10
Q

Blood Markers for:

Seminoma:
Yolk Sac tumor:
Choriocarcinoma:
Embyronal carcinoma:

A

o Seminoma: Placental alkaline phosphatase or Lactate Dehydrogenase (whats seen in lysed RBCs) “semen, milk lactate”
o Yolk Sac tumor (endodermal cyst): Alpha feto protein
o Choriocarcinoma: Beta-hCG
o Embyronal carcinoma: Alpha feto AND beta hCG

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11
Q

Enlarged ventricles and calcifications on CT with white-yellow lesions on retina.

A

Congential Toxoplasmosis:

Hydrocephalus, Intracranial Calcifications, and Chorioretinitis

Transplacental Transmission

Also can get seizures, rash, and eye movement defects and hepatosplenomegaly

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12
Q

Chorioretiniits, hydrocephaus and intracranial calcifications.

Cause, mode of transmission, and maternal manifestations?

A

Toxoplasma Gondii

Ingestion of undercooked meat or Cat feces

Assymptomatic, rare lymphadenopathy

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13
Q

PDA (Tet of Fallot or Pulmonary Atery Hypoplasia), Cataracts, Deafness?

Cause, mode of transmission, and maternal manifestations?

A

Rubella (also can have blue berry muffin rash): German Measles (Togavirus; + strand RNA)

Respiratory Droplets

Rash Lymphadenopathy, arthritis

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14
Q

Hearing Loss, Seizures, Petcheial Rash

Cause, mode of transmission, and maternal manifestations?

A

CMV (also have blueberry muffin rash)–UNILATERAL HEARING LOSS****

Sexual Contact, organ transplant

Mononucleosis like sxs

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15
Q

Recurrrent infections, Chronic Diarrhea

Cause, mode of transmission, and maternal manifestations?

A

HIV

Sexual Contact, Needlestick

Variable penetration based on mom’s CD4 count

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16
Q

Encephaltitis, rash on skin

Cause, mode of transmission, and maternal manifestations?

A

Herpes simplex 2 (rash will be vesicular)

Skin or mucous membrane contact

Herpetic lesions

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17
Q

Facial Abnormalities and Deafness

Cause, mode of transmission, and maternal manifestations?

A

Syphills (often still birth=hydrops fetalis); notched teeth, saddle nose, short maxilla, saber shins, CN8 deafness

Chancre (1) or disseminated rash (2) more likely than teritary syphyllis to present as infection

Sexual Contact

18
Q

Hydrops Fetalis in newborn

19
Q

Meningitis in neonate

A

Group B strep (name?), E coli, Listeria

20
Q

In AIDS Patient:

Systemic Disease

A

Histoplasmosis Capsulatum

21
Q

In AIDS Patient:

Vascular Proliferation

A

Bartonella Henselae causing bacillary angiomatosis

22
Q

In AIDS Patient:

Ring enhancing lesion? Tx?

A

Toxoplasmosis Gondii

Pyrimethamine and Sulfadiazine

23
Q

In Aids Patient:

Meningitis

A

Cryptococcus Neoformans (NOT CRYPTOSPORIDIUM)

Coccus=Cock=penis has a head=brain=meningitis

Sporidium=spores=oocytes in GI tract

24
Q

In AIDS Patient:

Encephalopathy

A

JC virus causing PML

JC=Junky Cerebrum (BK virus = Bad kidney)

25
In AIDS Patient: Retinitis (what else?)
CMV (can also cause esophagitis) "COTTON WOOL SPOTS on retina"
26
In AIDS Patient: Oropharyngeal cancer? Primary CNS lymphoma? Squamous cell carcinoma? Superficial Neoplastic proliferation of Vasculature?
EBV EBV HPV 16/18/31/33 (usually anal/cervical cancer) HHV8 (kaposi)--DD this bacillary angiomatosis. HHV8 you will see skin and GI tract (GI=almost exclusively seen in AIDS pnts aka not middle eastern old dude)
27
In AIDS Patient: Intersitial Pneumonia? Pleuritic pain hemoptysis, infiltrates on imaging? Ground glass appearance on imaging? Pneumonia? Tb like disease?
CMV INVASIVE Aspergillus fumigatus PJP S. Pneumoniae Mycobacterium avium-intracellulare (Mycobacterium avium complex=MAC)
28
Prophylaxis in AIDS at (drug + condition): CD4\<200 \<100 \<50
200: Sulfa (Dapsone if allergic): risk for PJP 100: Reactivation of Toxoplasmosis (Sulfa or Dapsone+pentaminidine+leucovorin) 50: MAC (mycobacterium avaieum): Azithromycin Nb: Dapsone and sulfa need to watch out for G6PD def
29
Codes for? pol gene env gag
pol: reverse transcriptase (is a POLymerase) env: gp120/41 gag: p24
30
navirs? General SEs? SEs specific for Ritonavir? Specific for Indinavir/Atazanavir?
Protease inhibitors "navir tease a protease" SEs: fat redistribution syndrome (cushionoid body type); Pancreatitis Nephrolithitiasis (atazanavir=increase bilirubin=harmless but distinct jaundice)
31
NRTIs?
Need to be activated by thymidine kinase. COMPETITIVE inhibitors of reversetranscriptase.
32
Didanosine Type of drug? MOA? SEs?
Pancreatisis. Class in general: Lactic acidosis
33
Abacavir? Type of drug? MOA? SEs?
NRTIs: Lactic acidosis Life threatening Hypersensitivity Rxn
34
Zidovudine Type of drug? MOA? SEs?
NRTIs: Lactic acidosis Megaloblastic anemia, bone marrow supression. Used in prophylaxis, preggers, and occupational exposure. ZDV (used to be called AZT; this is the big gun to remember)
35
NNRTIs? MOA? SEs?
Noncompetitive inhibitors of reverse transcriptase No phosphorylation needed for activation. SEs: Rash and hepatotoxicity, contraindicated in preggers (except for nevirapine).
36
Efavirenz? Type of drug? MOA? SEs?
NNRTI, Rash and haptotoxicity, and teratogen CNS sxs common (vivid dreams)
37
Nevirapine? Type of drug? MOA? SEs?
NNRTI Rasha nd hepatotoxicity, SAFE IN PREGGERS
38
Delaviridine? Type of drug? MOA? SEs?
NNRTI Rash and hepatoxicity and no preggers.
39
Raltegravir? Type of drug? MOA? SEs?
Integrase inhbitor (competitively inhibited HIV integrase) SEs: hypercholesterolemia
40
Enfuvirtide? Type of drug? MOA? SEs?
Fusion inhibitor (enFUV stops the FUSion) binds gp41 inhibiting entry. Skin reactions at injection sites
41
Maraviroc? Type of drug? MOA? SEs?
Fusion inhibitor Binds CCR-5 on surface of T-cells/monocytes ("change the letters around to macro-avir=antiviral for macros") Tropism test: before therapy need to test HIV virus for CCR5 tropism