Term
| What % of US adults have either chlamydia, gonorrhea or trichomoniasis? |
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Definition
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Term
| 24 000 women in US will become infertile due to STDs per year |
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Definition
Just a fact
didn't know how to make it into a good question |
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Term
| Age range when most of STDs occur |
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Definition
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Term
| When in history did the incidence of syphillis peak? |
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Definition
| In 1946, right after WWII |
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Term
| Men or women have a higher rate of syphillis infection? |
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Definition
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Term
| How have syphillis rates been changing in the last 6 years? |
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Definition
| They have been increasing since 2006 |
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Term
| During which stages is syphillis most infectious? |
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Definition
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Term
| Common signs and symptoms of primary syphillis |
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Definition
most skin and mucous membrane involvement -chancre
Regional lymphadenopathy |
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Term
| What is the risk of developing secondary syphillis if primary is not treated? |
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Definition
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Term
| Common signs and symptoms of secondary syphillis |
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Definition
widespread systemic signs
symmetrical, papular rash on trunk, palms and soles
ulcerated mucous membrane lesions (tonsils and throat)
alopecia
flu-like symptoms |
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Term
| Common signs and symptoms of latent syphillis |
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Definition
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Term
| Common signs and symptoms in tertiary syphillis |
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Definition
| localized soft granulomas (gummas), chronic inflammation, pain, swelling and fibrosis |
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Term
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Definition
painless red papule 2-6 weeks after exposure
caued by infiltration of PMN
ulcerates in 1-2 days
heals in 3-6 weeks |
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Term
Syphillis Timeline
Initial incubation |
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Definition
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Term
Syphillis Timeline
Primary |
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Definition
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Term
Syphillis Timeline
Secondary
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Definition
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Term
Syphillis Timeline
Latent |
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Definition
| 4-8 weeks after secondary |
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Term
Syphillis Timeline
Tertiary stage |
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Definition
| 10-15 years after infection |
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Term
Syphillis Timeline
Cardiovascular tertiary syphillis |
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Definition
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Term
| Cardiovascular changes in tertiary syphillis |
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Definition
Aortic aneurysm
Aortic valve insufficiency/regurgitation
Coronary artery disease
MI
Heart Failure
Strokes
Seizures |
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Term
| Signs and symptoms of neurosyphillis |
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Definition
mental changes
cranial nerve involvement
meningitis
stokes
seizures
paresthesias -->paraplegia
loss of vibratory sense |
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Term
| 4 symptoms of Tabes dorsalis |
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Definition
Unusual gait
lightning pain in extremities
decreased peripheral reflexes
urinary/fecal incontinence |
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Term
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Definition
Uveitis
Pupil abnormalities
chorioretinitis
optic atrophy
blepharoptosis
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|
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Term
| uveitis tends to occur in which stage of syphilis? |
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Definition
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Term
When you see ocular involvement how will that affect the syphillis treatment plan?
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Definition
You will then treat for Neurosyphillis,
send for evaluation of the CSF |
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Term
| Correlate stage of syphillis with risk of congenital infection |
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Definition
Earlier the stage of syphillis the greater the risk of it being passed on to the baby
Primary & Secondary =100%
Early Latent=40%
Late Latent=10% |
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Term
| Manifestions of early congenital syphillis |
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Definition
Develops before age 2
mucocutaneous lesions, bilateral rash
vesicles on palms/soles
inflammation of cartilage and bone that may paralyze the child with pain |
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Term
| Manifestations of late congenital syphillis |
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Definition
Fewer clinical signs
Hutchinson's triad
poorly formed bones |
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Term
| Describe the process of DFA-TP (Direct Fluorescent Antibody-T. pallidum) |
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Definition
tagged antibodies are mixed with patient serum, antibodies will attach to the organism if it is present.
Definitive test |
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Term
| 2 Non Treponemal Serological tests |
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Definition
Venereal Disease Research Laboratory
Rapid plasmin Reagin |
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Term
| When is a treponemal serological test performed? |
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Definition
| After a positive non-treponemal test, as a confirmation |
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Term
| 3 Treponemal Serological Tests |
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Definition
Fluorescent Treponemal Antibody Absorption (FTA-Abs)
T. pallidum Agglutination Assay (TP-PA)
Enzyme Immunoassay (EIA) |
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Term
| What may cause a false negative on a treponemal serological test? |
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Definition
| Early syphillis-not developed enough to detect antibodies |
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Term
| Which test is best to perform when ocular conditions are thought to be caused by syphilis? |
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Definition
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Term
| Which stage of syphillis is commonly diagnosed inadvertently? |
|
Definition
Latent form, since there are no symptoms
Patients get checked for reasons other than health problems |
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|
Term
| Name some conditions that may cause a false positive on syphillis serology tests |
|
Definition
Lyme dz
autoimmune dz
malaria
TB
Mononucleosis
Measles
Aging
Pregnancy |
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|
Term
| 5 Indications for ordering lumbar puncture in syphillis patient |
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Definition
Unresponsive to treatment
Child
Neuro signs/symptoms
Ophthalmic signs/symptoms
HIV+ |
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|
Term
| Primary tx for Primary, Secondary & Early Latent Syphillis |
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Definition
| Penicillin G Benzathine 2.4 million U I.M. once |
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Term
| Treatments for Primary, Secondary or Early Latent Syphillis OTHER than penicillin |
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Definition
Doxycycline 100mg PO bid x 14d
Tetracycline 500mg PO qid x 14d
Azithromycin 2 g PO once (retest) |
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Term
| Treatment for late latent or tertiary syphillis w/o neuro |
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Definition
| Penicillin G Benzathine 2.4 million U I.M q1week x 3weeks |
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Term
| Treatment of Neurosyphillis |
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Definition
Penicillin G Benzathine 2.4 million U IV or IM x 10-14 days
Procaine Penicillin 2.4 million U IM qd wiht Probenicid 500mg PO qid x 10-14 days
or if pen allergy
Ceftriaxone 2g qd IM or IV x 10-14 if not pregnant |
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Term
| How is the VDRL used to determine if syphillis treatment was effective |
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Definition
| Retreat if titers are not decreased by a factor of 4 in 6 months |
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Term
| What is the most common reported notifiable disease? |
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Definition
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Term
| Chlamydia more common in males or females? |
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Definition
| 2.7X more common in females (sample may be skewed since women are more likely to see a doctor routinely) |
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Term
| Risk factors for Chlamydia & gonorrhea |
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Definition
Adolescence
New/Multiple sex partners
STIs
Lack of Barrier Contraception |
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Term
| Name 2 life stages of C. trachomatis |
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Definition
Elementary body
Reticulate Body |
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Term
| Infectious life stage of C. trachomatis |
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Definition
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Term
| Duplicating life stage of C. trachomatis |
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Definition
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Term
| Characterize transmission of chlamydia |
|
Definition
Contact with genital/urine secretions, incubates 7-21 days
Highly transmissible |
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Term
| Name 3 Clinical symptoms in men caused by chlamydia |
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Definition
URETHRITIS
Conjunctivitis
Prostatis |
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Term
| Name 4 Clinical symptoms in women caused by chlamydia |
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Definition
CERVICITIS
Conjunctivitis
urethritis
Proctitis |
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Term
| Name 4 Clinical symptoms in infants caused by chlamydia |
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Definition
CONJUNCTIVITIS
pneumonitis
pharyngitis
Rhinitis |
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Term
| Describe the most common manifestation of chlamydia in men |
|
Definition
URETHRITIS
50% asymptomatic
Symptoms:Develop in 1-2 weeks, clear, mucoid discharge, dysuria, urethral pruritis, meatal erythema, tenderness |
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Term
| How is Reactive Arthritis related to Chlamydia? |
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Definition
| Reiter syndrome can be a complication of chlamydia in both men and women. It can be associed with uveitis, arthritis, conjunctivitis and rash |
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Term
| Describe the most common manifestation of chlamydia in women? |
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Definition
CERVICITIS
70-80% asymptomatic
Symptoms-mucopurulent discharge, cervix easily bleeds |
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Term
| 3 complications in newborns with chlamydia |
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Definition
Pneumonia
Otitis
Vaginal/Rectal Infections |
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Term
| 3 Indicators that conjunctivitis may be cause by chlamydia |
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Definition
New Sexual partner
Prolonged infection
Unresponsive to topical antibiotics |
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Term
| Time course for neonatal inclusion conjunctivitis |
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Definition
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Term
| Which chlamydia test results in false negatives 50% of the time and thus is no longer the standard test? |
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Definition
| McCoy cell tissue culture |
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Term
| What is the most sensitive test for chlamydia |
|
Definition
Nucleic Acid Amplification Tests (NAATs)
-urethral/cervical swabs |
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Term
| Name 3 Non-NAATs used to test for chlamydia |
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Definition
Direct Fluorescent Antibody
Enzyme immunoassay
Nucleic Acid Hybridization |
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|
Term
| Name an easy, in office test that can be used to see if a conjunctivitis is caused by chlamydia? |
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Definition
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Term
| How can optometrists cause a false positive on the MicroTrak test? |
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Definition
| By using sodium fluorescein on the patient prior to testing, would cause a false positive |
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Term
| 2 Methods for treating an uncomplicated genital infection of Chlamydia |
|
Definition
Azithromycin 1g PO once
or
Doxycycline 100 mg po bid 2 1 week min |
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|
Term
| Tx for Adult Inclusion Conjunctivitis |
|
Definition
Systemic tx
Plus
Topical Tetracycline/Erythromycin ung bid-tid x3 weeks
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|
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Term
| Tx for Neonatal inclusion conjunctivitis |
|
Definition
Erythromycin elixir or ethylsuccinate 50 mg/kg/day (4 doses) po x 2 weeks
and
Topical Erythromycin/Sulfacetamide ung qid x2 weeks
Follow up cultures in 3 weeks |
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|
Term
| Recent Change in gonorrhea rates |
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Definition
| Have been dropping, all time low |
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Term
| Epidemiology of gonorrhea |
|
Definition
100/100 000
asymptomatic in 10% of men and 50% of women
Equal distribution b/w men and women |
|
|
Term
| How is gonorrhea transmitted? |
|
Definition
| Direct contact with reproductive organs, mouth or anus or to newborn during delivery |
|
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Term
| Clinical syndromes caused by gonorrhea in newborns |
|
Definition
Conjunctivitis
Joint infection
Septicemia |
|
|
Term
| Name the clinical syndromes of gonorrhea in men |
|
Definition
Similar to Chlamydia
Urethritis
Conjunctivitis |
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|
Term
| Name the clinical syndromes of gonorrhea in women |
|
Definition
Similar to chlamydia
Conjunctivitis
Urethritis
Cervicitis
Perihepatitis |
|
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Term
| Common clinical manifestations of gonorrhea |
|
Definition
profuse/thick mucopurulent discharge
conjunctival chemosis
corneal ulcers/penetration
tender lymph nodes |
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|
Term
| 2 complications found in newborns with gonorrhea |
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Definition
|
|
Term
| 3 tests for confirmation of gonorrhea |
|
Definition
|
|
Term
| Why are fluoroquinolones no longer recommended for treatment of gonorrhea |
|
Definition
|
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Term
| Treatment of uncomplicated gonorrhea infections |
|
Definition
250 mg Ceftriaxone in1 IM dose
PLUS
Azithromycin 1 g po single dose |
|
|
Term
| Ocular Treatment for gonorrhea in adults |
|
Definition
Lavage infected eye
Ceftriaxone 1g IM single dose
Possibly topical therapy |
|
|
Term
| Ocular treatment for gonorrhea in children |
|
Definition
Lavage with saline solution
Ceftriaxone 25-50mg/kg IM or IV, no more than 125mg. |
|
|
Term
| Describe the cause of cardiovascular tertiary syphillis |
|
Definition
| The body attacks the cardiolipin when trying to get rid of the disease |
|
|
Term
| Which substances are used in treatment of syphillis to change absorption and elimination characteristics |
|
Definition
- Benzathine is used to keep the drug in the muscle and keeps it in the body longer to allow a slow continuous delivery of the drug.
- Probenicid is also used to prevent the kidneys from excreting the penicillin
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