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Sexually Transmitted Diseases
Terms in this set (59)
a single episode of pelvic inflammatory disease gives a woman a __% risk of infertility
3 or more:
12%, 25%, 50%
a single episode of PID gives a woman a __% risk of ectopic pregnancy
what is another possible consequence of PID, besides infertility and ectopic pregnancy?
pelvic inflammatory disease
what are causes of genital ulcers?
-non infectious (drug reaction, Behcet disease, neoplasms, trauma)
Primary syphilis presentation
-onset 3-6 weeks
-clean, indurated, painless chancre
-regional lymphadenopathy, without acute inflammatory signs
Secondary syphilis presentation
-2-8 weeks after the appearance of the chancre
-skin manifestations are the most common: maculopapular rash on the palms and soles
-involvement of the CN VIII
smooth, flat, fleshy lesions that arise in the mucocutaneous regions
syphilis latent stage
sero-reactive but with no evidence of disease
tertiary syphilis general presentation types:
normally, tertiary syphilis occurs ___ years down the line
-____ can make this happen earlier by ____
-altering the blood brain barrier, giving the spirochetes better access
what are the stages of neurosyphilis?
early- meningovascular (vasculitis of the blood vessels- leads to strokes)
late- paresis (cortical involvement)- GPI
Tabes dorsalis- spinal cord involvement
general paresis of the insane
-delusions of grandeur
involves the posterior columns of the spinal cord
-granulomatous lesions in skeletal, skin, and mucocutaneous tissues
how is syphilis visualized?
-visualization of motile T. pallidum on darkfield examination (except mouth lesions)
what are the serological tests use to screen syphilis?
nontreponemal tests (nonspecific):
-Veneral Disease Research Laboratory (VDRL)
-Rapid plasma reagin (RPR)
what are the confirmatory tests for syphilis?
--remain reactive indefinitely
Rapid plasma reagin (RPR) usually becomes positive within ___ weeks of a primary syphilis infection. The highest titer is usually during ___
secondary, early latent
what is the treatment of syphilis?
penicillin (desensitize if allergic and pregnant)
-doxycycline can be use if patient is allergic and not pregnant
-test and treat sex partners presumptively (within 90 days)
who should get a lumbar puncture for neurosyphilis?
anyone with neurological, eye or ear symptoms
how sensitive is the CSF VDRL test? what do you do if it is negative?
-treat if there is an elevated WBC or protein, or neurological symptoms
chancroid is caused by ___
-painful, shaggy ulcers that look dirty and aren't indurated
-tender, regional lymphadenopathy
what is the treatment of chancroid?
azithromycin or ceftriaxone
granuloma inguinale (Donovanosis) is caused by:
granuloma inguinale (Donovanosis) presentation
-painless, progressive, ulcerative lesions without regional lymphadenopathy
-highly vascular and bleed easily
granuloma inguinale (Donovanosis) is common in what regions?
India, New Guinea, Australia, Southern Africa
how do you diagnose granuloma inguinale (Donovanosis)?
-visualize dark-staining Donovan bodies in tissue sample- Giemsa or silver stain
granuloma inguinale (Donovanosis) treatment
Lymphogranuloma Venereum (LGV) is caused by:
Lymphogranuloma Venereum (LGV) primary lesion
-small papule or herpetiform ulcer
Lymphogranuloma Venereum (LGV) secondary stage:
days to weeks
-significant inguinal adenopathy (buboes)
-proctocolitis (inflammation in the rectal region)
Lymphogranuloma Venereum (LGV) tertiary stage:
-hypertrophic chronic granulomatous enlargement with ulceration of the external genitalia
-lymphatic obstruction- elephantiasis of male or female genitalia
how is Lymphogranuloma Venereum (LGV) diagnosed? how is it treated?
-doxycycline and ask for sexual partner history
what are the most common causes of urethritis and cervicitis?
what does the discharge look like in GC urethritis? chlamydia?
-thick and purulent
-thin and watery
GC in newborns
inflammation of the liver
-presents as right upper quadrant pain
disseminated GC infection:
how is GC diagnosed in the clinic?
NAAT (nucleic acid amplification test)
if a patient has GC, you have to look for and treat ___
treatment for GC
ceftriaxone (and azithromycin or doxycycline for chlamydia)
what is the most common cause of bacterial STD? why?
-many are asymptomatic, providing reservoirs for infection
what is the most common caused of viral STD?
C. trachomatis serovars L1, L2, L3 cause ____
C. trachomatis serovars A-C cause ____
trachoma of the eyes
C. trachomatis serovars D-K cause ____
typical STD chlamydia
what is the leading cause of PID?
what percent are of women infected with chlamydia are asymptomatic? what about men?
presentations of genital chlamydia infections in men:
-Reiter's syndrome (men and women)
diagnostic tests for c. trachomatis:
treatment for chlamydia
azithromycin or doxycycline
what are causes of Non-Gonococcal Urethritis (NGU)
inflammation of the epididymis that presents with painful scrotal swelling
epididymitis in older patients is usually caused by:
gram negatives from the urinary tract (like e. coli)
epididymitis in younger patients is usually caused by:
GC or chlamydia
how does PID usually present?
-lower abdominal tenderness
-cervical motion tenderness
2/3 of cases of PID are caused by ___, particularly ___
-GC, Chlamydia, mixed flora
1/3 of cases of PID are caused by ___, which is seen in ___
-polymicrobial (anaerobes, gram-neg rods, streptococci)
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