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31 Cards in this Set
- Front
- Back
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what 2 categories is urethritis divided into?
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GU- gonococcal
NGU- non-gonococcal |
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causes of NGU
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chlamydia
ureaplasma mycoplasma trichamonas HSV (atypical) coliforms (males and anal sex) mechanical or chemical irritation |
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dysuria without discharge is most likely
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chlamydia
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describe GU presentation
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< 2week incubation
sudden onset of sympt spontainously draining, copious amnts of yellow/green discharge |
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characteristics of epididimitis
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unilateral scrotal pain w/ fever, swelling, and tenderness
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characteristics of chronic prostititis
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discomfort upon ejaculation
perineal discomfort deep pelvic pain radiation of pain to the back pain/no pain on rectal exam |
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characteristics of acute prostititis
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fever/ chills
dribbling/ hesitancy exquisite tenderness on rectal exam |
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characteristics of disseminated gonorrhea
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fever, arthralgia, distal rash on extremities
reiters synd (post infection. circinate balanitis, keratoderma blenorrhagica) |
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why should you ask if an individual or their sex partner was recently in SE Asia or Hawaii
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high prevalence of quinolone resistant gonorrhea there
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if a fever is present with urethritis, what is that indicative of
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epididymitis
prostititis pyelonephritis disseminated gonococcal infection |
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thin watery secretion only seen when the urethra is "stripped"
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indicative of an NGU
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LGV (lymphogranuloma venerum)
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chlamydia L1-L3
painless papule of genitalia that dissapears followed by tender lymph nodes that break down and cause draining sinuses and extensive scarring |
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granuloma inguinalae
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calymmatobactierum
painless red ulcer no lymphadenopathy |
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chancroid
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hemophilus ducreyi
painfull ulcer tender enlarged lymphnodes |
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indications of testicular torsion
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testicle high on affected side
no cremasteric reflex sudden and severe onset |
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what is the preferred test for GC and Chlamydia
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NAAT
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what are the ways you can confirm urethritis
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mucopurulent discharge on exam
leukocyte esterase >5 WBC on gram stain of secretions >10 WBC on first void urinalysis |
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how do you perform both a routine UA and a urethritis screen for GU and NGU infections at the same timw
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have the pt do both a first void (GU & NGU) and a midstream catch (norm UA)
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is a gram stain showing the presence of WBCs or G- dipolococci considered diagnostic?
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for men, yes
for women, no. need a culture for women |
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when looking for an NGU or GU, can you just send it off to the lab and have them culture it normally?
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No, you must inform them that you want a GC culture
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when legal actions are ensuing, what must you do in order for courts to accept the evidence?
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you must culture.
secretions are fine if you can get them, but a swab must be done if you cant. wait at least an hour past last urination |
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can you use discharge for a chlaymidial culture?
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no, you must swab
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what is the advantage of using a GEN-PROBE (DNA probe)
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you can test for Gonorrhea and chlamydia concurrently
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what is a NAAT?
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the test of choice for gonorrhea and chlamydia
DNA amplification test 100% sensitive Need first void urine |
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how do you test for Trichamonas?
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wet mount: look for swimming protozoa (50% sensitivity)
NAAT: Swab, most accurate Culture: swab, trichosel broth |
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how do you test for syphilis
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RPR- Rapid Plasma Reagin
WITH confirmatory Treponema pallidum Ab test (TP-PA) FTA-ABS is also used |
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what are the USPSTF reccomendations for screenings of GC & Chla during a pelvic exam
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All sexually active women under 25
All women over 25 with risk factors All men who have sex with men |
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what is the treatment protocol for GC & chlamydial infections
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Treat any pt with discharge as soon as cultures have been taken
treat for both, every time Ceftriaxone 250mg IM SD AND Azithromycin 1 gm PO SD OR Doxycycline 100mg 1Tab PO BID for 7 days |
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What must you do when treating an individual for GC or chlamydia
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You must attempt to treat the sex partner as well
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once you have examined and treated an individual for an STD, what should you do next?
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retest in 3 months
AND report the disease to the Dept of Health and Human Services |
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what is the most likely cause of epididymitis for men under 35? older men?
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<35= GC or Chlamydia
>35= E.coli |
