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Gynecology

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Question
Answer
What is the 2nd most commonly reported infectious disease in the US?   Gonorrhea  
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Symptoms of gonorrhea   Vaginal discharge, abdominal pain, 50% asymptomatic  
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Female complications of gonorrhea   PID, infertility, ectopic pregnancy, tubo-ovarian abscess, perihepatitis (Fitz-Hugh-Curtis syndrome), septic arthritis, vertical transmission, ophthalmia neonatorum  
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What will gram stain show for positive Gonorrhea infection?   Gram negative intracellular diplococci  
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Patients infected with Gonorrhea have a high rate of co-infection with:   Chlamydia  
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Violin string adhesions between liver and parietal peritoneum, RUQ pain, in young women; PID complication   Fitz-Hugh-Curtis syndrome  
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Secondary syphilis usually only lasts for __   2-6 weeks  
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Clinical appearance of secondary syphilis   Symmetric papulosquamous rash on palms & soles, condyloma, alopecia, denuded tongue, lymphadenopathy (firm, rubbery, non-tender)  
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Secondary syphilis is contagious via __   Skin on skin contact (any portion of the body)  
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Latent syphilis   Period after secondary stage; no clinical manifestation. Infectious in 1st 1-2 years of latency.  
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Tertiary syphilis is __ infectious   Rarely  
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Diagnosis of neurosyphilis   CSF examination recommended in symptomatic, late-latent, HIV co-infection (lumbar puncture)  
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Etiology of syphilis   Treponema pallidum spirochete  
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How many stages of syphilis are there   4  
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Characteristic of acute syphilis. Chancre develops on skin near infection site about __ after inoculation   10-90 days  
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How long does the acute syphilitic chancre last?   1-5 weeks  
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How long may syphilis remain inactive   Up to 5 years  
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About how many patients with latent syphilis progress to tertiary phase   2/3  
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What is tertiary syphilis?   End organ manifestation, including CNS, skin, cardiovascular, and ocular. 4-20+ years post-infection  
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VDRL becomes positive __ after inoculation with syphilis   About 2 weeks  
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Indurate firm painless papule, with heaped up or rolled edge =   Syphilitic chancre ( may be associated with LAD)  
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What type of bacterium is chlamydia trachomatis   Intracellular obligate bacteria  
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The most commonly reported STI in the US   Chlamydia: >1 million infections in 2006  
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Who should be tested for chlamydia   Women<26 yo annually, new sex partner in past 60 days, >2 sex partners in past year, exam findings of cervical mucopus/friability/ectopy  
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Clinical course of chlamydia   Often asymptomatic. Vaginal discharge, dysuria, mucopurulent cervicitis, acute urethral syndrome, pelvic pain, lower abdominal pain  
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Perinatal transmission of chlamydia can cause __   Ophthalmia neonatorum, pneumonia  
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Female chlamydia complications   PID, infertility, ectopic pregnancy, perihepatitis, perinatal transmission  
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What is the most frequently occurring STD in developed countries   Chlamydia  
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Chlamydia is most prevalent in what population   <20 yr olds, nulliparous, users of non-barrier contraceptive methods  
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Symptoms of PID   Abd pain, dyspareunia, cervicitis/CMT, fever/chills, RUQ pain, diarrhea, purulent vaginal discharge  
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Start empiric treatment for these 3 CDC minimum criteria for PID   Lower abdominal tenderness, adnexal tenderness, cervical motion tenderness  
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Besides 3 CDC minimum criteria, additional criteria for PID   Elevated oral temp (>101), abnormal cervical or vaginal discharge, elevated ESR, Elevated C-reactive protein, positive GC or chlamydia, increased WBC  
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Which PID patients need hospitalization   Nulliparous/adolescents/non compliant, pregnant, treatment failure, HIV/immunosuppression, unable to tolerate oral regimen, Tubal ovaria cyst, severe peritonitis/uncertain diagnosis  
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Condyloma lata   Smooth, moist, flat lesions of secondary syphilis;  
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Microorganism spreads from lower genital tract, infects & inflames upper genital tract structures (endometrium, tubes, ovaries & peritoneum) =   PID  
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