Duke PA Gyn Infections
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| What is the lifetime risk of contracting an STD | 1 in 4
🗑
|
||||
| What age group is the highest at risk population | 15-24
🗑
|
||||
| What geographic regions are at highest risk for STD’s | southeast and urban
🗑
|
||||
| History of sexual intercourse with trauma increases the risk for what STD | Hep B , and Hep C
🗑
|
||||
| Why would you check the palms of a patient when concerned about STD’s | you are looking for secondary syphilis
🗑
|
||||
| 3 causes of genital ulcers in US | Herpes simplex virus, primary syphilis, chancroid
🗑
|
||||
| Herpes ulcers are __ | Painful, small, shallow, may have a clear exudate
🗑
|
||||
| Secondary herpes ulcers are __ | Smaller, and less dramatic looking than the primary lesions
🗑
|
||||
| Primary syphilis is a __ | Solitary, painless, indurated, large/deep ulcer
🗑
|
||||
| Agent responsible for chancroid | H. ducreyi
🗑
|
||||
| Clinical presentation of lymphogranuloma venereum (LGV) | Rectal ulceration or stricture, inguinal LAD.
🗑
|
||||
| Etiology of LGV | Chlamydia trachomatis
🗑
|
||||
| Clinical presentation of granuloma inguinale | Chronic or recurrent ulcerative vulvitis. Donovan bodies on stained direct smear or biopsy of ulcer.
🗑
|
||||
| What is the etiologic agent of granuloma inguinale | Calymmatobacterium granulomatous
🗑
|
||||
| What is the etiologic agent of condyloma acuminata | HPV
🗑
|
||||
| What is the clinical appearance of condyloma acuminata | Papillomatous, white, cauliflower like
🗑
|
||||
| Vaccine available for HPV | Gardasil
🗑
|
||||
| Who should Gardasil be offered to | Females 9-26 years old (full benefit if given prior to onset of sexual activity) even if history of hpv
🗑
|
||||
| Secondary syphilis usually only lasts for __ | A few weeks
🗑
|
||||
| Clinical appearance of secondary syphilis | Bilaterally symmetrical papulosquamous rash, condyloma, alopecia, denuded tongue, lymphadenopathy (firm, rubbery, non-tender)
🗑
|
||||
| Secondary syphilis is contagious by __ | Skin on skin contact (any portion of the body)
🗑
|
||||
| Latent syphilis | period after secondary stage, no clinical manifestation
🗑
|
||||
| Tertiary syphilis is __ infectious | Rarely
🗑
|
||||
| Primary diagnosis of syphilis | Darkfield microscopy of chancre
🗑
|
||||
| Diagnosis of neurosyphilis | CSF examination recommended in symptomatic, late-latent, HIV co-infection (lumbar puncture)
🗑
|
||||
| What is herpetic whitlow | Herpes on the fingers (especially around the nail bed)
🗑
|
||||
| Characteristic of primary HSV outbreak | 2-7 day course, systemic symptoms possible, local symptoms (painful), first outbreak is the worst
🗑
|
||||
| Precipitants of HSV recurrent outbreaks | Sun, wind, trauma, fever, menses, stress
🗑
|
||||
| __ may reduce transmission of HSV | Antivirals
🗑
|
||||
| What type of bacterium is chlamydia trachomatis | Intracellular obligate bacteria
🗑
|
||||
| What is the most commonly reported STI in the US, >1 million infections in 2006 | Chlamydia
🗑
|
||||
| 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
🗑
|
||||
| If you are treating a patient for gonorrhea what else should you treat for | Chlamydia
🗑
|
||||
| If you are treating a patient for chlamydia do you need to also treat for gonorrhea | Not necessarily
🗑
|
||||
| Clinical course of chlamydia | Asymptomatic or minor symptoms in majority, vaginal discharge, dysuria, mucopurulent cervicitis, acute urethral syndrome, pelvic pain, lower abdominal pain
🗑
|
||||
| Perinatal transmission of chlamydia can cause __ | Ophthalmia neonatorum, pneumonia
🗑
|
||||
| Female chlamydia complications | PID, infertility, ectopic pregnancy, perihepatitis, perinatal transmission
🗑
|
||||
| What type of bacterium is Neisseria gonorrhea | Gram negative intracellular diplococcus
🗑
|
||||
| What is the 2nd most commonly reported infectious disease in the US | Gonorrhea
🗑
|
||||
| Symptoms of gonorrhea | Vaginal discharge, abdominal pain, 50% asymptomatic
🗑
|
||||
| Female complications of gonorrhea | PID, infertility, ectopic pregnancy, tubo-ovarian abscess, perihepatitis (Fitz-Hugh-Curtis syndrome), septic arthritis, vertical transmission, ophthalmia neonatorum
🗑
|
||||
| Offer __ testing for all patients evaluated for STIs | HIV
🗑
|
||||
| Acute HIV symptoms | Fever, mono-like illness, diarrhea
🗑
|
||||
| Which hepatitides are commonly sexually transmitted | A, B, and C (especially B)
🗑
|
||||
| Vaccinations are available for which hepatitides | A and B (no hep C vaccine available yet)
🗑
|
||||
| Males voiding within __ before urethral culture washes secretions away | 1-2 hours
🗑
|
||||
| Best source of HSV for testing | Unroofing the vesicle
🗑
|
||||
| Gold standard for HSV testing | Culture
🗑
|
||||
| __% of US population have positive herpes antibodies on serological testing | 50
🗑
|
||||
| Etiology of syphilis | Treponema pallidum spirochete
🗑
|
||||
| How many stages of syphilis are there | 4
🗑
|
||||
| Characteristic of acute syphilis. Chancre develops on skin near infection site about __ after inoculation | 3-6 weeks
🗑
|
||||
| Characteristic of secondary syphilis | Maculopapular rash often on palms and soles, generalized lymphadenopathy, typically lasts about 3 months
🗑
|
||||
| How long does the acute syphilitic chancre last | 5-6 weeks
🗑
|
||||
| How long may syphilis remain inactive | Up to 5 years
🗑
|
||||
| About how many patients with latent syphilis progress to tertiary phase | 2/3
🗑
|
||||
| What is tertiary syphilis | End organ manifestation, including CNS, cardiovascular and ocular
🗑
|
||||
| VDRL becomes positive __ after inoculation with Syhpilis | About 2 weeks
🗑
|
||||
| What will gram stain show for positive Gonorrhea infection | Gram negative intracellular diplococci
🗑
|
||||
| If a patient is infected with Gonorrhea they are probably also infected with __ | Chlamydia
🗑
|
||||
| What is the etiology of Chancroid | Haemophilus ducreyi
🗑
|
||||
| Chancroid is most often a co-infection with what | Herpes and or syphilis
🗑
|
||||
| Gram stain with a “school of fish” appearance is probably what | Chancroid (Haemophilus ducreyi)
🗑
|
||||
| What is the most frequently occurring STD in developed countries | Chlamydia
🗑
|
||||
| Chlamydia is most prevalent in what population | <20 yr olds, nulliparous, users of non-barrier contraceptive methods
🗑
|
||||
| What are the 4 methods for diagnosis of HIV | Detect antibodies to the virus, detect viral p24 antigen, detect viral nucleic acid, culture HIV virus
🗑
|
||||
| What is the most widely used method to diagnose HIV | Detection of antibody to HIV
🗑
|
||||
| What is the most common cause of false positive tests for HIV in low risk patients | Recent immunization
🗑
|
||||
| What is the initial screening for HIV | EIA enzyme immunoassay (EILISA)
🗑
|
||||
| What is the confirmatory test for HIV (done after the screening test) | Western blot or IFA (Immunofluorescence Assay)
🗑
|
||||
| Multiple, vesicular, pruritic, painful, recurrent rash | Herpes simplex
🗑
|
||||
| Single, heaped up or rolled edge, textbook case never painful | Syphilitic chancre
🗑
|
||||
| Most appropriate way to test for herpes | Culture (not serological)
🗑
|
||||
| Trichomonas is tested for by use of what | Wet prep
🗑
|
||||
| Treatment for contact dermatitis | 1% hydrocortisone cream and removal of offending agent
🗑
|
||||
| What causes the fishy odor in bacterial vaginosis | Anaerobes
🗑
|
||||
| What do you look for on microscopic examination to show the presence of bacterial vaginosis | Clue cells (epithelial cells with irregular borders in clusters, very shiny)
🗑
|
||||
| Bacterial vaginosis requires 3 of 4 criteria. What are the 4 criteria | Typical discharge, alkaline pH(5.0-5.5), positive “whiff” test, clue cells on wet prep
🗑
|
||||
| Bacterial vaginosis is not considered an __ | STD
🗑
|
||||
| Treatment for bacterial vaginosis | Metronidazole or clindamycin, topical or orally
🗑
|
||||
| Should you treat male partners of women with bacterial vaginosis | No
🗑
|
||||
| Signs and Symptoms of trichomonas vaginitis | Severe pruritus, malodorous (musky) discharge, dysuria, dyspareunia, may be asymptomatic, greenish-yellow/frothy discharge, petechiae or “strawberry markings on cervix
🗑
|
||||
| Treatment for trichomonas vaginitis | 2gm metronidazole stat, treat partners, look for other STDs
🗑
|
||||
| Treatment for yeast vaginitis | Over the counter imidazoles, oral fluconazole 150mg stat
🗑
|
||||
| Atrophic vaginitis often masquerades as what | Infection
🗑
|
||||
| Signs and symptoms of atrophic vaginitis | Pruritis/burning, vaginal dryness, dyspareunia, possibly spotting, pale/thin vaginal mucosa, loss of vaginal rugation
🗑
|
||||
| Bilateral Bartholin’s abscess said to be associated with what | Gonorrhea
🗑
|
||||
| Treatments for Bartholin’s gland abscess if not pointing | Antibiotic treatment may be successful
🗑
|
||||
| Treatment for Bartholin’s gland abscess | I&D and placement of Word catheter (left in for 1-2 weeks), marsupialization, needs to remain open to avoid recurrence
🗑
|
||||
| What organism is associated with toxic shock syndrome | S. aureus/endotoxins
🗑
|
||||
| Woman with flu like symptoms, on her period think | Toxic shock syndrome
🗑
|
||||
| CDC case definition of __ ; fever >38.9 C, hypotension, diffuse erythroderma, desquamation, involvement of at least 3 organ systems | Toxic shock syndrome
🗑
|
||||
| Treatment for toxic shock syndrome | Supportive, look for foreign body in vagina and remove, clindamycin and oxacillin/nafcillin, MRSA: clindamycin and vancomycin/linezolid
🗑
|
||||
| Common condition in which microorganisms spreads from the lower genital tract infect and inflame upper genital tract structures including the endometrium, tubes, ovaries and peritoneum | Pelvic inflammatory disease
🗑
|
||||
| Symptoms of PID | Abdominal pain, dyspareunia, possibly fever/chills, possibly RUQ pain
🗑
|
||||
| Start empiric treatment for these 3 CDC minimum criteria for PID | Lower abdominal tenderness, adnexal tenderness, cervical motion tenderness
🗑
|
||||
| In addition to the 3 CDC minimum criteria what are the additional criteria for PID | Elevate oral temp (>101), abnormal cervical or vaginal discharge, elevated ESR, Elevated C-reactive protein, positive GC or chlamydia, increased WBC
🗑
|
||||
| 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
🗑
|
||||
| Violin string adhesions between liver and parietal peritoneum, RUQ pain may be prominent symptom especially in young women, PID complication | Fitz-Hugh-Curtis syndrome
🗑
|
||||
| What cancer is a sexually transmitted infection caused by HPV | Cervical cancer
🗑
|
||||
| Risk factors for cervical cancer | Smoker, hormones, multiple sexual partners, sex before 18, HIV, poor SES, age, multiple pregnancies, chlamydia infection, diet low in fruit and vegetables
🗑
|
||||
| Effective methods to prevent cervical cancer | Routine pap tests, avoid smoking, condom use, limit partners, HPV vaccine
🗑
|
||||
| Low risk HPV strains | HPV-6, and HPV-11 (cause genital warts)
🗑
|
||||
| High risk strain | HPV-16 and HPV-18
🗑
|
||||
| What is the HPV vaccine | Gardasil (HPV 6,11,16,18)
🗑
|
||||
| Bilateral papulosquamous rash on palms and soles | Secondary syphilis
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
bwyche
Popular Medical sets