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23 Cards in this Set
- Front
- Back
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a pt with secondary syphilis will always have what kind of lab test results?
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positive RPR/VDRL; positive MHA-TP (remains positive for life once infected with T. pallidum)
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pt comes in with clearly demarcated genital lesion wiht raised margin and clean base
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syphilitic chancre (painless; characteristic of primary stage -- will be positive for T. pallidum on darkfield exam)
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what are symptoms of secondary syphilis?
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-maculopapular rash on palms and soles
- lymphadenopathy - condyloma lata (wart-like eruption of vulva, perineum, or anus) - CNS invasion (sets up for neurosyphilis) - arthritis and hepatitis |
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who are the most common pt population to get neurosyphilis?
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HIV pts (Sx's include cranial nerve abnormalities, meningitis, CVA, sometimes stroke)
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tell me about RPR/VDRL lab test
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measures Ab's to cardiolipin
- always positive in secondary syphilis - titer proportional to disease activiey (peaks in secondary stage) - treated pts can be positive and still have lower titers - slowly subsides during 1-2 yrs after Rx, becoming negative in persons whose dz wasn't present too long before starting treatment |
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tell me about the MHA-TP test
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-always positive in secondary syphilis
- excellent exam to RULE OUT syphilis BUT NOT POSITIVE Dx bc it only tells you that pt has had it in the past - once positive, remains so for life! - used in cases of neurologic dz and in pts wiht positive RPR that might be due to a rheumatologic condition |
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what is the Tx for syphilis?
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benzathine penicillin G for a long period of time
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cause of chancroid - genital lesion with jagged margin and purulent base (PAINFUL!! as opposed to a PAINLESS syphilitic chancre)
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H. ducreyi (Dx with culture)
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what kind of genital lesions do herpes (HSV-2) cause?
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multiple painful vesicles
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how do you get a fixed drug eruption?
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its just an allergy to drugs like erythromycin or azithromycin where pt gets a lesion on the penis and sometimes mouth as a result...too bad, man.
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cause of condyloma acuminata. what are the serotypes? are they painful or painless?
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HPV serotypes 6 and 11. they are painless!!
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"pearl-like" genital lesions
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molluscum contagiosum
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which bacterial cause of non-gonococcal urithritis/cervicitis is also an important cause of infertility in women?
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C. trachomatis
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name the main etiological agent for urethritis/cervicitis. what does it usually cause clinically?
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N. gonnorhea
- causes PAINFUL purulent discharge - mayy cause proctitis/pharyngitis |
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name 3 non-gonococcal causes of urethritis/cervicitis and what does it usually present as?
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-C. trachomatis
-Mycoplasma hominis - ureaplasma urealyticum presents are LESS PAINFUL and NON-PURULENT |
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why cant you do a gram stain with urethral pus in women, only men?
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women have contaminated cervix and have a bunch of random agents in that area
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culture for Dx of Neisseria is on _____ medium
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thayer-martin medium (contains antibiotics that suppress gram pos and gram neg rods as well as fungi)
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Tx of urethritis/cervicitis
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ALWAYS treat both gonnorhea and non-gonnococal
for gonnorhea - it's one dose of ceftriaxone (3rd gen cephalosporin) at a high level for chlamydia - it's erythromycin or arithromycin |
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Sx's of pelvic inflammatory dz; lab tests results? Tx?
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lower abdominal pain, dyspareunia (painful sex)
tremendous pain when cervix is touched lab results: elevated WBC count, pus on cervix tx: treat for N. gonnorhea (ceftriaxone) and C. trachomatis (erythromycin or azithromycin) |
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2 complications of PID
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infertility
ectopic pregnancy |
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enlarged inguinal lymph nodes that are of modest size and minimally tender
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syphilis (T. pallidum)
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enlarged inguinal lymph nodes that are tender and large
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chancroid (H. ducreyi)
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enlarged inguinal lymph nodes that are large and minimally tender
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lymphogranuloma venereum (aka. venereal bubo caused by C. trachomatis)
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