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30 Cards in this Set
- Front
- Back
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Venereal Chancres
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(1) Syphillis
(2) Chanchroid: Haemophilus ducreyi (3) Herpes Simplex |
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Treponema pallidum
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Spirochete
Chancre: primary syphilis Raised border, PAINLESS Therefore, primary infection underdiagnosed in women/homosexual men |
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Chancroid
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Haemophilus ducreyi
Jagged border, purulent, PAINFUL |
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Herpes
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Multiple vesicles that ulcerate (due to friction w/underwear)
Painful and recurring condition |
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Non-veneral chancres
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(1) Fixed-drug eruption
(2) Trauma (3) Unknown cause |
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Fixed drug eruption
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Results in non-venereal chancres
Single, round and clean |
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Genital Warts
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(1) HPV
(2) Molluscum contagiosum (3) Condyloma lata |
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HPV
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Human papillomavirus
Frequent infection, giving rise to genital warts |
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Molluscum contagiosum
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Cause pearl-like lesions that're self-limiting
Pox virus |
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Condyloma lata
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An extension of an untreated primary infection
But before secondary (disseminatd) disease |
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Secondary syphilis
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Maculopapular rash
INVOLVES HANDS AND FEET Multisystem disease (reflects dissemination): lymphadenopathy; hepatitis; arthritis; gen. asymptomatic CNS involvement |
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Syphilis and HIV Patient
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Little distinction between stages but tendency of primary syphillis toward meningeal or meningovascular involvement
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Primary syphilis: diagnosis
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Darkfield microscopy
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RP
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Antibody to cardiolipin (~autoantibody)
100% positive by 2ndary syphilis Titers often reflection of intensity of infection Possibility for "false-positives" (i.e. aging) |
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MHA-TP
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Micro Hemoagglutinating Antibody to TP
Positive for life (not diagnostic; only used for exclusion purposes) |
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Why is MHA-TP not diagnostic of acute infection?
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It remains positive for life. You don't know if this is a reflection of current or past infection.
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Herpes: diagnosis
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Rapid PCR
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Treating chancre
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Do darkfield/RPR
If darkfield (+), penicillin G (single dose, long release) If darkfield (-), treat chancroid BUT HAVE LOW THRESHOLD FOR TREATING SYPHILIS ANYWAY |
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Treating herpes
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Acyclovir
Smaller doses on reactivation |
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When diagnosing STDS . . .
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KEEP IN MIND - EXPOSURE TO ONE = EXPOSURE TO SEVERAL (be vigilant!)
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Urethritis/Cervicitis
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Gonococcal or non-gonococcal
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Gonococcal urethritis/cervicitis
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Painful, purulent discharge
NOTE: may also cause proctitis/pharyngitis |
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Non-gonococcal urethritis/cervicitis: clinical presentation
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Less painful/purulent
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Non-gonococcal urethritis/cervicitis: bacteriology
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Chlamydia
Mycoplasma hominis Ureaplasma urelyticum |
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Urethritis/cervicitis: diagnosis (general points)
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GRAM STAIN IS USEFUL ONLY IN MALES
Can do culture and PCR (for gonorrhea, mycoplasma, chlamydia) |
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Treatment: urethritis/cervicitis
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If gonococcal, SINGLE DOSE
If non-gonococcal, azithromycin for 1 WEEK |
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PID: symptoms
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Pain w/sex; hx of unprotected sex; lower ABDOMINAL PAIN; high WBC count
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If female presents w/lower abdominal pain, you should think . . .
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PID in addition to appendicitis
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PID: complications
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Infertility and ectopic pregnancy
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Buboes
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Enlarged lymph nodes
Overlying skin may thin and ulcerate (chancroid) or thicken (lymphogranuloma venereum) |
