Term
| What diseases are higher in which gender? |
|
Definition
Women - chlamydia 3x
- gonorrhea 2x higher
Men - syphilis 6x higher |
|
|
Term
|
Definition
3 out of 4:
Presence of homogenous grey/white DC that coats vaginal walls
Presence of clue cells on wet prep
pH > 4.5
Positive whiff test on KOH prep |
|
|
Term
|
Definition
Location
Single vs. Grouped
Border-regularity, diffuse, raised
Tenderness
Consistency
Lymphandenopathy |
|
|
Term
| Types of genital ulcers (3) |
|
Definition
Herpes Virus
Molluscum Contagiosum
Syphilis |
|
|
Term
|
Definition
◦ Vulva, cervix, vagina, buttocks
◦ Glans, shaft of penis, scrotum, perianal |
|
|
Term
| Primary herpes infection characteristics |
|
Definition
◦ Flu-like syndrome (Fever, arthralgias, headache, inguinal lymphadenopathy)
◦ Prodrome—Itching and burning
◦ Blister eruption
◦ Painful urination
◦ Monitor for Urinary retention
◦ Grouped shallow lesions, exquisitely tender |
|
|
Term
| Asymptomatic herpes tests |
|
Definition
ELISA and western blot
Tests for HSV-1 and HSV-2
12-26 weeks post exposure
Sensitivity 80-98%
Specificity 97-100%
Confirmatory testing may be indicated in some settings |
|
|
Term
|
Definition
◦ Acyclovir 400 mg three times a day
◦ Acyclovir 200 mg five times a day
◦ Famciclovir 250 mg three times a day
◦ Valacyclovir 1000 mg twice a day
** x 7-10 days |
|
|
Term
| Herpes episodic therapy (7) |
|
Definition
Acyclovir 400 mg three times daily x 5 days
or
Acyclovir 800 mg twice daily times daily x 5 days
or
Acyclovir 800 mg three times daily x 2 days
or
Famciclovir 125 mg twice daily x 5 days
or
Famciclovir 1000 mg twice daily x 1 day
or
Valacyclovir 500 mg twice daily x 3 days
or
Valacyclovir 1 gm orally daily x 5 days |
|
|
Term
| Herpes suppression therapy daily (3) |
|
Definition
Acyclovir 400 mg twice a day
or
Famciclovir 250 mg twice a day
or
Valacyclovir 500-1000 mg daily |
|
|
Term
| Treatment for molluscum contagiosum |
|
Definition
Trichloracetic acid
cryotherapy |
|
|
Term
|
Definition
Primary (9-90 days post exposure)
Secondary (6 wks- 6 mos. Post exposure)
Latent (non-infectious except in pregnancy)
Early (< one year post exposure)
Late (> one Year post exposure)
Tertiary (advanced disease) |
|
|
Term
|
Definition
Chancre
◦ 1-3 weeks post exposure
Painless Ulcer
Indurated
Raised borders
- labial chancre - sometimes undetected |
|
|
Term
|
Definition
Systematic Disease
Occurs 6 weeks to 6 months following healing of Chancre
Generalized lesions of the skin and mucus membranes (rashes, especially palmar and plantar, condyloma lata)
Alopecia
Papulosquamous rash occurs anywhere on body, including face, trunk, palmar and plantar surfaces |
|
|
Term
|
Definition
Nontreponemal (Screening Tests)
VDRL, RPR
Titers Correlate with disease activity
High False positives
Treponemal
FTA-ABS or MHA-TP
75% Reactive for lifetime regardless of treatment |
|
|
Term
| Syphilis Definitive diagnosis |
|
Definition
Darkfield Examination (microscopic)
Direct fluorescent antibody tests
CSF |
|
|
Term
| Syphilis - primary, secondary, early latent treatment |
|
Definition
Recommended Regimen
Benzathine Penicillin G1 2-4 million units IM
Penicillin Allergy*
Doxycycline 100 mg twice daily x 14 days
or
Ceftriaxone 1 gm IM/IV daily x 8-10 days (limited studies)
or
Azithromycin 2 gm single oral dose (preliminary data)
*Use in HIV-infection has not been studied |
|
|
Term
|
Definition
Benzathine penicillin G 2.4 million units IM at one week intervals x 3 does.
Clinical follow up =quantitative VDRL titers and exam at 3, 6 and 12 months
Penicillin allergy*
Doxycycline 100 mg orally twice daily
or
Tetracycline 500 mg orally four times daily
for 28 days |
|
|
Term
| Gonorrhea symptoms - male |
|
Definition
Usually symtomatic
Purulent Urethral discharge
Dysuria
Complications
Epididymitis
Urethral Stricture
Disseminated GC |
|
|
Term
| Gonorrhea symptoms - female |
|
Definition
Up to 80% have no sx
Abnormal vaginal discharge
Abnormal menses
Pelvic pain
Dysuria
Complications
PID
Infertility
Disseminated GC |
|
|
Term
|
Definition
- ceftriaxone 250 mg x 1 IM
- PLUS either azithromycin 1 g PO x 1
- OR doxycycline 100 mg PO BID x 7 days |
|
|
Term
| Women have no symptoms for what disease? |
|
Definition
| - gonorrhea, chlamydia, HPV, HSV |
|
|
Term
|
Definition
Indirect – DNA Probe
Direct – Tissue Culture
Urine- Nucleic acid amplification test |
|
|
Term
|
Definition
Azithromycin 1 g orally in a single dose
OR
Doxycycline 100 mg orally twice a day for 7 days
Encourage partner delivered therapy |
|
|
Term
| PID - predisposing factors |
|
Definition
Sexually Active
Multiple partners
History of STIs
Age Under 25
Recent Instrumentation
IUD Insertion
D&C |
|
|
Term
|
Definition
Abnormal vaginal discharge (different from usual cyclic changes related to menses)
Spotting, especially post-coital
Pain with intercourse (dyspareunia)
Vague, intermittent abdominal pain
Often asymptomatic (important to screen persons with high risk behaviors)
Low grade fever |
|
|
Term
|
Definition
Ceftriaxone 250 mg IM in a single dose
PLUS
Doxycycline 100 mg orally twice a day for 14 days
WITH or WITHOUT
Metronidazole 500 mg orally twice a day for 14 days |
|
|
Term
|
Definition
Cefotetan 2 g IV every 12 hours
OR
Cefoxitin 2 g IV every 6 hours
PLUS
Doxycycline 100 mg orally or IV every 12 hours |
|
|
Term
|
Definition
| cauliflower-shaped growths with granular surface and fingerlike projections |
|
|
Term
|
Definition
| smooth, skin colored, well-circumscribed papules; no fingerlike projections |
|
|
Term
|
Definition
|
|
Term
|
Definition
| ◦ Lesions appear 2-3 months after infection, with range of 3 weeks to 8 months |
|
|
Term
|
Definition
Hybrid Capture II assay captures 13 different high risk types
HPV DNA testing recommended only with cervical cancer screening |
|
|
Term
|
Definition
Goal – eradicate or reduce the size of apparent warts
Reasonable not to delay treatment unless warts persist or enlarge given that they may resolve spontaneously
Patient applied – Imiquimod 5% cream
Clinician applied – TCA and cryotherapy most common
Cervical – refer to OBGYN
Vaginal – cryotherapy or TCA
Urethral - cryotherapy
Anal - cryotherapy
Oral - cryotherapy |
|
|
Term
|
Definition
Series of 3 shots over 6 months
Cervarix (Types 16 & 18) and Gardasil (Types 6, 11, 16, & 18) available
Females: Gardasil prevents cervical, vulvar, and vaginal cancer; genital warts; and anal cancer
Males: Gardasil prevents anal cancer and genital warts
Available age 11-26 for females and 11-21 for males |
|
|
