Id Unit 4, Last Minute Flashcards

Front 1

Intro Slide: 4 Groups of STIs

1) STIs --> Genital Ulcers
A) Genital Herpes
B) Syphylis
C) Chancroid
D) Granuloma Inguinale
E) Lymphogranuloma Venereum

2) STIs --> Urethritis and Cervicitis
3) STIs --> PID & Genital Warts

4) STIs --> Vaginal Discharge
A) Vaginitis From:
1. Bacterial Vaginosis
2. Candadiasis
3. Trichomoniasis

Back 1

Intro Slide: 4 Groups of STIs

1) STIs --> Genital Ulcers
A) Genital Herpes
B) Syphylis
C) Chancroid
D) Granuloma Inguinale
E) Lymphogranuloma Venereum

2) STIs --> Urethritis and Cervicitis
3) STIs --> PID & Genital Warts

4) STIs --> Vaginal Discharge
A) Vaginitis From:
1. Bacterial Vaginosis
2. Candadiasis
3. Trichomoniasis

Front 2

1) STIs --> Genital Ulcers
A) Genital Herpes: Vesicles that become Irregularly shaped ulcers
B) Syphylis: Solitary, Hard, Painless Ulcer
C) Chancroid: Multiple soft, Painful Ulcers
D) Granuloma Inguinale
E) Lymphogranuloma Venereum

Back 2

1) STIs --> Genital Ulcers
A) Genital Herpes: Vesicles that become Irregularly shaped ulcers
B) Syphylis: Solitary, Hard, Painless Ulcer
C) Chancroid: Multiple soft, Painful Ulcers
D) Granuloma Inguinale
E) Lymphogranuloma Venereum

Front 3

STIs --> Genital Ulcers: Genital Herpes

1) Define Genital Herpes?

2) Etiology of Genital Herpes?

3) Major Manifestation of Genital Herpes?

4) Major lab test of Genital Herpes?

5) Is their a cure for genital herpes?

Back 3

STIs --> Genital Ulcers: Genital Herpes

1) Vesicles that become Irregularly shaped ulcers

2) HSV-2 (80%); HSV-1 (20%)

3) Vesicles that become irregularly shaped ulcers

4) Positive Tzanck Test (Multinucleated Giant Cells)

5) No. Friend for life.

Front 4

STIs --> Genital Ulcers: Syphilis

1) Define Syphilis?

2) Etiology of Syphilis?

3) Major manifestations of Syphilis?

4) Major labs of Syphilis?

Back 4

STIs --> Genital Ulcers: Syphilis

1) Solitary, Hard, Painless Ulcer

2) Treponema pallidum

3) Primary Syphilis:
Hard, Indurated, PAINLESS chancre (ulcer)

Secondary Syphilis:
Maculopapular lesion, patchy alopecia, condyloma lata (not condyloma acuminata!) 6-8 wks after chancre appears; Disseminated Dz, TF Systemic signs (Arthalgia, Fever, Generalized Lymphadenopathy, etc...)

Tertiary Syphilis:
Gummas (nodular lesison w/ granulomatous inflammation);
Aortitis; Aortic Regurg, Aortic Aneurysm;
Neurosyphilis: Tabes Dorsalis

Congenital Syphilis:
Clutton's joints, deafness, saddle nose, hutchinson's teeth, mulberry molars, Saber Shins

Latent Syphilis:
Positive serological test w/ absence of any clinical disease sx

4) Spirochetes on Darkfield;
Positive Reagin Test (VDRL or RPR) w/ confirmatory FTA-ABS, MHATP, TP-PA

Front 5

STIs --> Genital Ulcers: Chancroid (Soft Ulcer)

1) Define Chancroid?

2) Etiology of Chancroid?

3) Major manifestations of Chancroid?

4) Major labs of Chancroid?

Back 5

STIs --> Genital Ulcers: Chancroid (Soft Ulcer)

1) Multiple soft, Painful Ulcers

2) Haemophilus ducreyi

3) Papules that develop into a multiple soft, painful ulcers

4) None - just dx clinically

Front 6

STIs --> Genital Ulcers: Granuloma Inguinale

1) NO DEFINITION FOR GRANULOMA INGUINALE

2) Etiology of Granuloma Inguinale?

3) Major Manifestations of Granuloma Inguinale?

4) Major labs of Granuloma Inguinale?

Back 6

STIs --> Genital Ulcers: Granuloma Inguinale

1) NO DEFINITION FOR GRANULOMA INGUINALE

2) Klebsiella granulomatis

3) Papules --> Ulcers w/ rolled border
Sub-Q granulomas in the inguinal region (Pseudo-Buboes)

4) Gram Neg Rod
DONOVAN BODIES: when the Klebsiella granulomatis is in a vacuole in the WBCs!!!!!!!!!!!!!!!!!!!!!!!!! = PATHONOMONIC!!!!!!!!!!

Front 7

STIs --> Genital Ulcers: Lymphogranuloma Venereum

1) NO DEFINITION FOR LYMPHOGRANULOMA VENERUM

2) Etiology of Lymphogranuloma Venerum?

3) Major Manifestations of Lymphogranuloma Venereum?

4) NO MAJOR LABS

***Drain Pus***

Back 7

STIs --> Genital Ulcers: Lymphogranuloma Venereum

1) NO DEFINITION FOR LYMPHOGRANULOMA VENERUM

2) Chlamydia Trachomatis from L1 - L3 serovars

3) Primary Inguinal Syndrome: Enlarged Lymph Node in the inguinal region

Genito-anorectal Syndrome: Rectal strictures, genital elephantiasis

Complications: Abscesses, Fistulas

4) NO MAJOR LABS

Front 8

STIs --> Urethritis and Cervicitis: Gonorrhea, NGU, Chlamydia

Back 8

STIs --> Urethritis and Cervicitis: Gonorrhea, NGU, Chlamydia

Front 9

Some Definitions:

1) Urethritis?

2) Cervicitis?

3) Both Urethritis and Cervicitis are MC'ly caused by what 2 IAs?

***Now we'll look @ 3 Dz'es that --> Cervicitis and Urethritis:
1. Gonorrhea
2. Chlamydia
3. Non-Gonococcal Urethritis

Back 9

1) Inflamm and mucopurulent or purulent discharge from the urethra (Unless NGU, then the discharge is CLEAR!)

2) Inflamm and mucopurulent or purulent discharge from the endocervix

3) Neisseria gonorrhoeae; Chlamydia Trachomatis

Front 10

STIs --> Urethritis and Cervicitis: Gonorrhea

1. Definition of Gonorrhea?

2. Etiology of Gonorrhea

3. Major Manifestations of Gonorrhea?

4. Major Labs of Gonorrhea?

Back 10

1. Infxn w/ Neisseria gonorrhoeae

2. Neisseria gonorrhoeae

3. Heterosexual Males:
Urethritis: Inflamm and mucopurulent or purulent discharge from the urethra

Homosexual Males:
Urethritis: Inflamm and mucopurulent or purulent discharge from the urethra
Anorectal Infxn
Pharyngitis

Females:
Urethritis: Inflamm and mucopurulent or purulent discharge
Cervicitis: Inflamm and mucopurulent or purulent discharge from the endocervix
Anorectal Infxn
Bartholinitis

Kids & Infants:
Ophthalmia neonatorum (Just like Chlamydia)

Disseminated Gonococaal Infxns:
Low Grade Fever
Polyarthralgia

4. Intracellular, gram negative, diplococcus grown on Thayer-Martin Agar

Front 11

STIs --> Urethritis and Cervicitis: NGU (Non-gonococcal Urethritis)

1. Definition of NGU?

2. Etiology of NGU?

3. Major Manifestations of NGU?

4. Major labs of NGU?

Back 11

STIs --> Urethritis and Cervicitis: NGU (Non-gonococcal Urethritis)

1. Urethritis NOT caused by N. gonorrhoeae, but rather by Chlamydia trachomtis

2. Chlamydia trachomtis

3. Inflamm and discharge from the urethra THAT IS CLEAR RATHER THAN PURULENT!!!!!!

4. No gonorrhea by culture or other lab tests
+
Documented Urethritis

Front 12

STIs --> Urethritis and Cervicitis: Chlamydia

1) Define Chlamydia?

2) Etiology of Chlamydia?

3) Major Manifestations of Chlamydia?

4) NO MAJOR LABS FOR YOU TO KNOW

Back 12

STIs --> Urethritis and Cervicitis: Chlamydia

1) Urethritis and Cervicitis resulting from Chlamydia Trachomatis

2) Chlamydia trachomatis

3) Women:
PID, Urethritis, Cervicitis

Men:
Urethritis

Neonates:
5-12 days PP = Ophthalmia neonatorum (Just like Gonorrhea)
1-3 mos PP: Pneumonia

4) NO MAJOR LABS FOR YOU TO KNOW

Front 13

STIs --> PID & Genital Warts

Back 13

STIs --> PID & Genital Warts

Front 14

PID

1) Define PID?

2) Etiology of PID?

3) Major Manifestations of Chlamydia?

4) HOW DO YOU DX?

Back 14

PID

1) Syndrome resulting from ascending spread of infxn from vagina and endocervix to the endometrium, fallopian tubes and contiguous structures

2) Neisseria gonorrhoeae; Chlamydia trachomatis

3) Cerviciitis --> Discharge? (Look @ previous flashcards and fill in s/s)
Endometritis --> Irregular Bleeding and increased vaginal discharge
Salpingitis --> BL Lower Quadrant Pain;
Cervical motion, Uterine & Adnexal tenderness
Peritonitis -> N/V, pelvic or ABD abscesses

4) Clinical picture
Direct Visualization of inflammed fallopian tubes (laparscope)
Biopsy evidence of salpingitis
Labs for N. gonorhoeae & C. trachomatis

Front 15

Genital Warts

1) NAME IS SELF EXPLANATORY

2) Etiology of Genital Warts?

3) Major Manifestations of Genital Warts?

4) Major Labs for Genital Warts?

Back 15

Genital Warts

1) NAME IS SELF EXPLANATORY

2) HPV Types 6 & 11 BUT Cervical Carcinoma can be caused by 16, 18, 31, 33

3) Condyloma Acuminata:
Cauliflower-like lesions on skin, genitalia, perineum and perianal regins

4) Presence of Koilocytes Indicating HPV on PAP smear or other collection mechanism

Front 16

STIs --> Vaginal Discharge
A) Vaginitis From:
1. Bacterial Vaginosis
2. Mycotic Vulvo-Vaginitis
3. Trichomoniasis

Back 16

STIs --> Vaginal Discharge
A) Vaginitis From:
1. Bacterial Vaginosis
2. Mycotic Vulvo-Vaginitis
3. Trichomoniasis

Front 17

STIs --> Vaginal Discharge:
Bacterial Vaginosis --> Vaginitis

1) Define Vaginitis?

Back 17

STIs --> Vaginal Discharge:
Bacterial Vaginosis --> Vaginitis

1) Infxn & Inflamm of Vagina from bacterial vaginossi, candadiasis or trichomaniasis

Front 18

STIs --> Vaginal Discharge
Vaginitis From Bacterial Vaginosis

1) Define Vaginitis from Bacterial Vaginosis?
A) Define Bacterial Vaginosis?

2) Etiology of vaginitis from bacterial vaginosis?

3) Major Manigestations of vaginitis from bacterial vaginosis?

4) You need 3/4 of the following criteria to dx Vaginitis from bacterial vaginosis?

Back 18

STIs --> Vaginal Discharge
Vaginitis From Bacterial Vaginosis

1) Vaginitis resulting from bacterial vaginosis.
A) MCC of Vagintis!!!!!! Resulting from imbalance of normal flora --> overgrowth of normal flora

2) Gardnerella vaginalis

3) Vaginal odor
White or grey vaginal discharge

4)
1. Thin, homogenous discharge
2. pH of discharge > 4.5
3. Clue cells
4. Vaginal Discharge + KOH --> "amine-like" or "fishy" odor

Front 19

STIs --> Vaginal Discharge
Mycotic Vulvo-Vaginitis

1) Define Mycotic Vulvo-Vaginitis?

2) Etiology of Mycotic Vulvo-Vaginitis?

3) Major manifestations of mycotic vulvo-vaginitis?

4) Major labs for mycotic vulvo-vaginitis?

Back 19

STIs --> Vaginal Discharge
Mycotic Vulvo-Vaginitis

1) Vaginitis resulting from infxn w/ Candida albicans

2) Candida albicans

3) Curd like vaginal discharge

4) Pseudohyphae on KOH Prep

Front 20

STIs --> Vaginal Discharge
Vaginitis From Trichomoniasis

1) Define Vaginitis from Trichomoniasis?

2) Etiology of Vaginitis from Trichomoniasis?

3) Major Manifestations of Vaginitis from Trichomoniasis?

4) Major labs for Vaginitis from Trichomoniasis?

Back 20

STIs --> Vaginal Discharge
Vaginitis From Trichomoniasis

1) Vaginitis resulting from infxn w/ Trichomonas Vaginalis

2) Trichomonas Vaginalis

3) Frothy, green discharge that is leukorrheic and malodorous

4) Look for presence of Trichomonas under the microscope

Front 21

NOTE: Males can get tichomoniasis as well -->
Urethritis and prostatovesiculitis

Back 21

NOTE: Males can get tichomoniasis as well -->
Urethritis and prostatovesiculitis

Front 22

Bacteremia, Sepsis & Septic Shock

Back 22

Bacteremia, Sepsis & Septic Shock

Front 23

Some Initial Definitions

1) Bacteremia?

2) Sepsis?

3) Septic Shock?

Back 23

1) The presence of micro-organisms and/or their toxins in the bloodstream

2) The body's systemic response to bacteremia

3) When the body's systemic response to bacteremia (sepsis) -->
Low effective circulating blood volum -->
Hypotension and Hypoperfusion of organs

Front 24

Usually people who get septic shock get it from an infxn which has spread from 1 of what 3 places?

Back 24

Lung, ABD, Urinary Tract

Front 25

Memorize This Chart of Etiologies of bacteremia, sepsis, septic shock

Back 25

Memorize This Chart of Etiologies of bacteremia, sepsis, septic shock

Front 26

1) Define Septick Shock? - ALREADY DONE

2) Etiology of Septick Shock? - ALREADY DONE

3) Major aspects of pathophysiology?

4) Major Manifestation of Septic Shock?

5) Major lab test of Septic Shock? -- NONE

6) Tx for Septic Shock?

Back 26

3) Endotoxin / LPS of Gram Negs
& Lipoteichoic Acid, Sup-Ags (TSST) of gram Pos -->
Release of Pro-Inflamm Mediators IL-1,6,12, TNF and IFN-gamma -->
Endothelial Cell Damage-->
leakage out of vessels to peripheral tissues
+
Thrombosis -->
Poor Perfusion and Hypo-TN


4)
Signs of SIR (Severe Inflamm Response Syndrome)
1.Fever
2. Tachycardia
3. Tachypnea
4. HypoTN

Signs of MOD (Multi-Organ Dysfnctn Syndrome)
1. Skin Lesions
A) Ecthyma Gangrenosum
B) Petechia & purpura (Neisseria meningitidis)
C) Sunburn like rash (S aureus TSS)

6)
1. ABCs
2. ABX to get rid of bugs in blood
3. Tx original location of infxn