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STI 2
Gynecology
Question | Answer |
---|---|
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 |
What will gram stain show for positive Gonorrhea infection? | Gram negative intracellular diplococci |
Patients infected with Gonorrhea have a high rate of co-infection with: | Chlamydia |
Violin string adhesions between liver and parietal peritoneum, RUQ pain, in young women; PID complication | Fitz-Hugh-Curtis syndrome |
Secondary syphilis usually only lasts for __ | 2-6 weeks |
Clinical appearance of secondary syphilis | Symmetric papulosquamous rash on palms & soles, condyloma, alopecia, denuded tongue, lymphadenopathy (firm, rubbery, non-tender) |
Secondary syphilis is contagious via __ | Skin on skin contact (any portion of the body) |
Latent syphilis | Period after secondary stage; no clinical manifestation. Infectious in 1st 1-2 years of latency. |
Tertiary syphilis is __ infectious | Rarely |
Diagnosis of neurosyphilis | CSF examination recommended in symptomatic, late-latent, HIV co-infection (lumbar puncture) |
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 | 10-90 days |
How long does the acute syphilitic chancre last? | 1-5 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, skin, cardiovascular, and ocular. 4-20+ years post-infection |
VDRL becomes positive __ after inoculation with syphilis | About 2 weeks |
Indurate firm painless papule, with heaped up or rolled edge = | Syphilitic chancre ( may be associated with LAD) |
What type of bacterium is chlamydia trachomatis | Intracellular obligate bacteria |
The most commonly reported STI in the US | Chlamydia: >1 million infections in 2006 |
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 |
Clinical course of chlamydia | Often asymptomatic. 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 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 |
Symptoms of PID | Abd pain, dyspareunia, cervicitis/CMT, fever/chills, RUQ pain, diarrhea, purulent vaginal discharge |
Start empiric treatment for these 3 CDC minimum criteria for PID | Lower abdominal tenderness, adnexal tenderness, cervical motion tenderness |
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 |
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 |
Condyloma lata | Smooth, moist, flat lesions of secondary syphilis; |
Microorganism spreads from lower genital tract, infects & inflames upper genital tract structures (endometrium, tubes, ovaries & peritoneum) = | PID |