Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
100 Cards in this Set
- Front
- Back
|
what is usually the chief complaint of STI in women?
|
vaginal discharge
|
|
|
what are 6 differential diagnoses for vaginal discharge?
|
vulvovaginal candidiasis
bacterial vaginosis trichomonaisis chlamydia gonorrhea physiologic leukorrhea |
|
|
what are 3 questions to ask about vaginal discharge?
|
color
odor consistency |
|
|
what 3 things must you do on PE for vaginal discharge?
|
abdomen for suprapubic tenderness
inguinal nodes pelvic exam |
|
|
what should you examine in the pelvic exam for vaginal discharge? (4)
|
external for lesions
internal for discharge, inflammation, cervical tenderness |
|
|
what is the benefit of low pH and normal flora in the vagina?
|
protection, especially from HIV
|
|
|
what is normal vaginal pH?
|
<4.5
|
|
|
what is the normal odor of vaginal discharge?
|
odorless
|
|
|
what is the predominant normal flora in the vagina?
|
lactobacilli
|
|
|
what 4 things should you test for in vaginal discharge?
|
pH
odor abnormal cells micro-organisms |
|
|
what are 3 diagnostic test for vaginal discharge?
|
vaginal pH
wet mount KOH amine |
|
|
if vaginal pH is greater than 4.5 what does it indicate?
|
some type of infection
|
|
|
what are clue cells a sign of?
|
gardnerella vaginalis
|
|
|
what are pseudohyphae a sign of on wet mount?
|
candida
|
|
|
what 3 things do you look for with a wet mount?
|
clue cells
motile trichinosis pseudohyphae |
|
|
when is a KOH amine test positive/
|
with a really strong fishy odor
|
|
|
what are 7 diagnostic tools you need in the clinic?
|
pH paper
KOH saline microscope slides coverslips ability to detect odor |
|
|
what are the top 3 causes of vaginitis?
|
bacterial vaginosis
vulvovaginal candidiasis trichomoniasis |
|
|
what is bacterial vaginosis caused by?
|
gardnerella vaginalis
|
|
|
what are 3 risk factors for bacterial vaginosis?
|
new sexual partner
IUD douching |
|
|
what is vaginal discharge in bacterial vaginosis described as? (3)
|
white grey
homogenous non-adherent |
|
|
what will the pH be with bacterial vaginosis?
|
>4.5
|
|
|
how will bacterial vaginosis respond with the whiff test?
|
positive
|
|
|
what will wet mount show will bacteria vaginosis?
|
clue cells
|
|
|
what is the treatment of choice for bacterial vaginosis?
|
metronidazole x7days
|
|
|
what must you tell patients being given metronidazole?
|
no alcohol
antabuse effect |
|
|
what causes vulvovaginal candidiasis (yeast infection)?
|
candida albicans or glabrata
|
|
|
who is vulvovaginal candidiasis more common in?
|
women taking antibiotics or using oral contraceptives
|
|
|
what are 3 typical symptoms in vulvovaginal candidiasis?
|
vulvovaginal itching
irritation vaginal discharge |
|
|
how is vaginal discharge in vulvovaginal candidiasis classically described? (3)
|
white
odorless curd-like adherence to the vaginal wall |
|
|
what will the pH be in vulvovaginal candidiasis?
|
normal
|
|
|
how will vulvovaginal candidiasis respond to the whiff test?
|
negaitve
|
|
|
what will wet mount show with vulvovaginal candidiasis?
|
pesudohyphae or budding yeast
|
|
|
how do you treat vulvovaginal candidiasis? (2)
|
topical antifungals
diflucan x1 dose |
|
|
out of the three vaginal infections, which is considered a UTI?
|
trichonmoniasis
|
|
|
what causes trichonmoniasis?
|
trichomonas vaginalis
|
|
|
what are 4 typical symptoms of trichonmoniasis?
|
vaginal discharge
vulvovaginal irritation dyspaeunia dysuria |
|
|
what is almost always asymptomatic in men?
|
trichonmoniasis
|
|
|
what is vaginal discrharge desrcibed as with trichonmoniasis? (3)
|
green-yellow
frothy adherent |
|
|
what will be seen on wet mount with trichonmoniasis?
|
motile trichomonads
|
|
|
what will pH be with trichonmoniasis?
|
greater than 4.5
|
|
|
what will the whiff test show with trichonmoniasis?
|
negative
|
|
|
what is the treatment of choice for trichonmoniasis?
|
metronidaole or same treatment as bacterial vaginosis
|
|
|
what is considered primary prevention of STIs?
|
education
|
|
|
what is considered secondary prevention of STIs?
|
screening
|
|
|
what is considered tertiary prevention of STIs? (2)
|
prevention of complications
prevention of transmission |
|
|
who is uinversal STI screening recommended for? (3)
|
all sexuall active younger than 25
pregnancy any individual with a new sexual partner, multiple partners, or inconsistent condom use |
|
|
what is a chronic, life-long viral infection?
|
genital herpes
|
|
|
what is the major problem with herpes?
|
only 10-20% know they are infected
|
|
|
how is herpes usually transmitted?
|
asymptomatic viral shedding
|
|
|
what will the pH be in vulvovaginal candidiasis?
|
normal
|
|
|
how will vulvovaginal candidiasis respond to the whiff test?
|
negaitve
|
|
|
what will wet mount show with vulvovaginal candidiasis?
|
pesudohyphae or budding yeast
|
|
|
how do you treat vulvovaginal candidiasis? (2)
|
topical antifungals
diflucan x1 dose |
|
|
out of the three vaginal infections, which is considered a UTI?
|
trichonmoniasis
|
|
|
what causes trichonmoniasis?
|
trichomonas vaginalis
|
|
|
what are 4 typical symptoms of trichonmoniasis?
|
vaginal discharge
vulvovaginal irritation dyspaeunia dysuria |
|
|
what is almost always asymptomatic in men?
|
trichonmoniasis
|
|
|
what is vaginal discrharge desrcibed as with trichonmoniasis? (3)
|
green-yellow
frothy adherent |
|
|
what will be seen on wet mount with trichonmoniasis?
|
motile trichomonads
|
|
|
what is the clincal predentation of herpes? (3)
|
multiple, bilatera, painful vesicles
ulcers found on an erythematous base |
|
|
what are the 4 goals of herpes management?
|
pain relief
acceleration of healing of lesion decrease recurrences prevent transmission |
|
|
what are 3 antivirals to treat herpes lesions?
|
acyclovir
famciclovir valacyclovir |
|
|
how long does it typically take for hepetic lesions to go away?
|
4 weeks
|
|
|
what can HPV cause?
|
condyloma accuminata (genital warts)
|
|
|
what is the clinical presentation in HPV?
|
usually asymptomatic growth in the genital area
|
|
|
what is the most prevalent STI in the US?
|
HPV
|
|
|
what kills/gets rid of HPV?
|
our own body
|
|
|
why do we treat HPV?
|
cosmetic reasons
|
|
|
what is the most common method to manage HPV?
|
cryotherapy
|
|
|
what are 4 topical treatment options for HPV?
|
podophyllin
TCA/BCA imiquimod podofilox |
|
|
what are 4 surgical options for HPV?
|
cryotherapy
excision electrocautery intralesional interferon injections |
|
|
what is the most commonly reported STI?
|
chlamydai
|
|
|
what is the problem with chlamydia?
|
it is largely asymptomatic
|
|
|
what is the clinical presentation of chlamydia? (3)
|
dysuria
mucopurulent discharge from cervix/urethra inflammed, friable, easily bleeding cervix |
|
|
what is the danger of untreated chlamydia?
|
can progress to PID
|
|
|
what STI is 90% asymptomatic in women?
|
gonorrhea
|
|
|
what STI is very symptomatic for men?
|
gonorrhea
|
|
|
what is the danger of gonorrhea?
|
15% progresses to PID
|
|
|
what is the clincal presentation of gonorrhea?
|
dysuria
mucopurulent discharge inflammed, easily bleeding, friable cervix |
|
|
what swab type do you use for men to diagnose GC/chlamydia?
|
urethral
|
|
|
what swab type do you use for women to diagnose GC/chlamydia?
|
cervical swab
|
|
|
what is the idea urine specimen for diagnosis GC/chlamydia?
|
first urine of the morning
|
|
|
who should you treat with GC/chlamydia?
|
all sexual partners within the last 2 months
|
|
|
how can you treat GC/chlamydia?
|
antibiotics
abstience form sex for 7 days |
|
|
what is considered a misdemenor?
|
not reporting GC or chlamydia
|
|
|
what are 2 treatments for chlamydia?
|
doxycycline x7days
azithromycin xsingle dose |
|
|
what are 3 treatments for gonorrhea?
|
ceftriazone IM
cefixime single dose azitrhomycin single dose |
|
|
what is an STI of the upper reproductive tract?
|
pelvic inflammatory disease
|
|
|
what are 3 microbial causes of PID?
|
chlamydia trachomiatis
n gonorrhea genital mycoplasmosis |
|
|
what does PID increase the risk for? (4)
|
ectopic pregnancies
infertility endometrosis chronic pelvic pain |
|
|
what are 4 objective symptoms of PID?
|
fever
lower abdominal tenderness adenexal tenderness cervical motion tenderness |
|
|
what is the first test to do with PID?
|
pregnancy test
|
|
|
what are 6 diagnostic tests done in PID?
|
UA
CBC CRP GC/chlamydia RPR HIV pelvic US |
|
|
what US finding is positive for PID?
|
free fluid in the pelvic cul-de-sac
|
|
|
how long do you treat PID and with what?
|
14 days with levoquin
|
|
|
if there are surgical emergencies with PID, how should you treat?
|
admit to hospital
|
|
|
if the patient has severe nausea, vomiting, or fever, how should you treat PID?
|
admit to hospital
|
|
|
if the patient has a tuboovarian abscess, how should you treat PID?
|
admit to hospital
|
|
|
if the patient is immunodeficient, how should you treat PID?
|
admit to hospital
|
