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28 Cards in this Set

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What is the modern day tool to diagnose chlamydia and gonorrhea?
Nucleic Acid Amplification Testing
Where do Gonorrhea and Chlamydia infect?
NOT VAGINAL DISEASES.

G & C can infect cervix and up.
Why doesn't gonorrhea grow in the vagina?
Gonorrhae does not grow well in areas of LOW [CO2]
What type of discharge is seen in gonorrhea in men? women?
Men: Gram - Mucopurulent urethral discharge

Women: Gram - Mucopurulent cervical discharge.
What is the main reservoir of gonorrhea?
Asymptomatic carriage in women (carry ~50%)
What are main risks of G & C on newborns?
Conjunctivitis
What is the most highly reported STD in the US?
Chlamydia ~ 4 million per year
What is the LEADING CAUSE IN FEMALE INFERTILITY?
PID!
What are symptoms of chlamydia?
Painful urination...abdominal discomfort. Can be asymptomatic though.
TRUE/FALSE

PID is BOTH a lower and upper tract infection?
FALSE!

PID is stricly an upper tract infection. PID PRIMARILY STEMS FROM STD'S
How does one get PID from chlamydia and gonorrhea?
The host's immune response against chalmuydia and gonorrhea allows for opportunistic infections to occur. Particularly gram -'s and anaerobic bacteriodes.
What is the adnexal region?
Fallopian tubes and ovaries.

THIS IS A BIG SIGN FOR PID! Also look for discharge to confirm infection.
What are the MINIMUM CRITERIA for PID Diagnosis?
1) Adnexal tenderness

2) Lower abdominal pain

3) Cervical motion tenderness

ALSO...can look for elevated white count, purulent discharge, fever
What are the 4 sequlae of PID?
1) Infertility (MAIN CAUSE!) due to tubal scarring, hydrosalpinx, tube scarring/occlusion

2) Ectopic pregnancy

3) Chronic pelvic pain

4) Tuboovarian abscess and subsequent peritonitis
How do you treat PID?
Treat with broad-spectrum antibiotics against STD's. Also must be effective against Gram - and anaerobic bacteriodes that are opportunisitc in PID
What symptom would lead to including PID in the differential?
Lower abdominal pain!
What must be RULED OUT with abdominal pain?
Pregnancy.
Who should be treated upon positive result for G or C?
Sexual partners!
Why are women more susceptible to infection?
More glandular epithelium?
What does HPV look like grossly?
HPV looks like cauliflowers

Look for koilocytes on histology.
Why are younger women more likely to get infected with HPV?
More glandular epithelium than older women.
Is gonorrhae intra or extra cellular?
Can be BOTH

Gonorrhea is bean-shaped, gram negative.
What is infective salpingitis?

What causes it?
Infective salpingitis is an inflammation of the fallopian tubes.

Caused by gonorrhea and chalmydia. Chlamydia is known as "ascending salpingitis"
What can occur if acute salpingitis becomes chronic?
Result: Tubal obstruction. Fimbrial end of fallopian tube may become wholly obstructed.

Pilcae can fuse together to form barriers. OCCLUSION of fallopian tubes
What is a sequelae of chronic salpingitis?

Hint: there are 4 PID sequelae
TUBOOVARIAN ABSCESS. Infection can spread from tbue to ovary.
What are hallmarks of PID?
Scar adhesions to adjacent structures.

Bilateral hydrosalpinx and scarring.
What is Actinomyces israelli?
A bacteria than can infect patients and cause PID, particularly in women with IUD's.

IUD's work by causing a local inflammatory reaction.
Where do tubal pregnancies happen most?
Ampulla