Ob Kaplan Chap Std

Front 1

Type OF ORGANISMS

Back 1

1. Bacterial. These include chancroid, lymphogranuloma venereum, granuloma inguinale, chlamydia, gonorrhea, syphilis.
2. Viral. These include condyloma acuminatum, herpes simplex, hepatitis B virus, and human
immunodeficiency virus.
3. Protozoan. This includes trichomoniasis

Front 2

STDs WITH ULCERS

Back 2

Chancroid
Granuloma Inguinale (Donovanosis)
Herpes Simplex Virus (HSV)
Lymphogranuloma Venereum (LGV)
Syphilis

Front 3

Chancroid: cause and symptoms

Back 3

1. caused by Haemophilus ducreyi, a Gram-negative bacterium. (It is a cofactor for HIV transmission.)
2. Symptoms. This is one of the two STDs that presents with a painful ulcer. A pustule, usually on the vulva, within 72 hours becomes a painful ulcer with a typically "ragged edge:

Front 4

Dx and Tx for Chancroid

Back 4

1. Diagnosis. A positive culture confirms the diagnosis, although a diagnosis is often made clinically after excluding syphilis and genital herpes.
2. Management. single oral dose of Azithromycin, a single IM dose of ceftriaxone, or oral erythromycin base for 7 days.

Front 5

Lymphogranuloma Venereum: cause and symptoms

Back 5

1.caused by the L serotype of Chlamydia trachomatis. It is uncommon in the United States.
2. Symptoms. The initial lesion is a painless ulcer.
A painless vesiculopustular eruption, usually on the vulva, spontaneously heals. This is replaced within a few weeks by perirectal adenopathy that can lead to abscesses and fistula formation. The classic clinical lesion is a double genitocrural fold, the "groove sign:

Front 6

Lymphogranuloma Venereum (LGV): Dx and Tx

Back 6

1. Diagnosis. A positive culture of pus aspirated from a lymph node confirms the diagnosis.
2. Management. oral doxycycline or erythromycin for 3 weeks.

Front 7

Granuloma Inguinale: cause and symptoms

Back 7

1. caused by Calymmatobacterium granulomatis, a Gram-negative
intracellular bacterium. It is uncommon in the United States.
2. Symptoms. The initial lesion is a painless ulcer.
A vulvar nodule breaks down, forming a painless, beefy red, highly vascular ulcer with fresh granulation tissue without regional lymphadenopathy. Lymphatic obstruction can result in marked vulvar enlargement. Chronic scarring can lead to lymphatic obstruction.

Front 8

Granuloma Inguinale (Donovanosis): Dx and Tx

Back 8

1. Diagnosis. Culture of the organism is difficult but microscopic examination of an ulcer smear will reveal Donovan bodies.
2. Management. either oral doxycycline or trimethoprim-sulfamethoxazole for 3 weeks.

Front 9

STDs w/o ulcers

Back 9

Chlamydia
Condyloma Acuminatum
Gonorrhea
Trichomonas Vaginitis

Front 10

Condyloma Acuminatum: cause, predisposing factors, symptoms

Back 10

1. caused by the human papilloma virus (HPV). It is the most common overall STD in women, as well as the most common viral STD. Transmission can occur with
subclinical lesions. HPV subtypes 16 and 18 are associated with cervical and vulvar carcinoma whereas condyloma is associated with HPV types 6 and 11.
2. Predisposing factors include immunosuppression, diabetes, and pregnancy.
3. Symptoms. HPV is subclinical in most infected women. Symptoms of pain, odor, or bleeding occur only when lesions become large or infected.
Clinical lesions are found in only 30% of infected women. The characteristic appearance of a condyloma is a pedunculated, soft papule that progresses into a cauliflower-like mass. The most common site of lesions is the cervix.

Front 11

Condyloma Acuminatum: Dx and Tx

Back 11

1. Diagnosis. The lesions have an appearance so characteristic that biopsy is seldom necessary.
2. Management. Treatment is directed only at clinical lesions. Small lesions are treated topically with podophyllin, trichloroacetic acid, or imiquimod. Larger lesions are ablated with cryotherapy, laser vaporization, or surgical excision. No effective systemic therapy is available.

Front 12

Chlamydia: Cause and Symptoms

Back 12

1. caused by Chlamydia trachomatis, an obligatory intracellular bacterium. It is the most common bacterial STD in women, occurring up to five times more frequently than gonorrhea. The long-term sequelae arise from pelvic adhesions, causing chronic pain and infertility. When the active infection ascends to the upper genital tract and becomes symptomatic, it is known as acute pelvic inflammatory disease (acute PID). Transmission from an infected gravida to her newborn may take place at delivery, causing conjunctivitis and otitis media.
2. Symptoms. Most chlamydial cervical infections, and even salpingo-oophoritis, are asymptomatic.
The classic cervical finding is mucopurulent cervical discharge. Urethral and cervical motion tenderness may or may not be noted.

Front 13

Chlamydia: Dx and Tx

Back 13

1. Diagnosis. Nucleic acid amplification tests (NAAT) of either cervical discharge or urine is used
2. treatment includes a single oral dose of azithromycin or oral doxycycline for 7 days. Patients should avoid coitus for 7 days after therapy. A test-of-cure (repeat testing 3-4 weeks after completing therapy) is recommended for pregnant women.