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STI 2

Gynecology

QuestionAnswer
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
Created by: Abarnard
 

 



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