Term
| What is atrophic vaginitis? |
|
Definition
| produced by a hypoestrogenic state in females (most common cause is menopause) |
|
|
Term
| Management of atrophic vaginitis |
|
Definition
water soluble lubricants
topical oestrogens
oral/transdermal/combo estrogens |
|
|
Term
| Special population to keep AV in mind |
|
Definition
| postpartum women and women who breastfeed b/c they are in a hypoestrogenic state and present with s/s |
|
|
Term
| Number one cause of vaginal discharge in women of childbearing age is |
|
Definition
|
|
Term
| Amsel diagnostic criteria for BV (need 3 of the 4) |
|
Definition
homogenous, thin, white discharge
presence of clue cells on microscopy
pH of vag fluid >4.5
fishy odor or positive whiff |
|
|
Term
|
Definition
-Metronidazole 500 mg po bid x 7 days
-Metronidazole gel 0.75% one full applicator (5 g) intravaginally once a day for 5 days
-Clindamycin cream 2% one full applicator intravaginally at bedtime for 7 days |
|
|
Term
|
Definition
|
|
Term
| Management of HSV genital herpes |
|
Definition
Acyclovir 400 mg po tid x 7-10 days
Acyclovir 200 mg po 5x/day x 7-10 days
Famciclovir 250 mg po tid x 7-10 days
Valacyclovir 1 g po bid x 7-10 days |
|
|
Term
| Treatment for BV in pregnancy |
|
Definition
-Metronidazole 500 mg po bid x 7 days
-Metronidazole 250 mg po tid x 7 days
-Clindamycin 300 mg po bid x 7 days |
|
|
Term
| Most genital HSV infections are from |
|
Definition
|
|
Term
| What is the leading cause of transmission of HSV? |
|
Definition
| asymptomatic shedding aka virus can be shed even when there is no current outbreak |
|
|
Term
|
Definition
Acyclovir 400 mg po bid
Famiciclovir 250 mg po bid
Valacyclovir 500 mg po qd
Valacyclovir 1 g po qd |
|
|
Term
|
Definition
-Give pt. rx for this w/initial outbreak
-educate to take when feeling tingling/burning/itching (prodromal sx)
-often comes back in the same spot
-many same medication just different dosage and time needed to medicate |
|
|
Term
| Treatment of HSV during pregnancy |
|
Definition
-Acyclovir can be used
-If HSV + at first OB visit --> suppressive therapy at 36 wks
-If any thought of active HSV infection the patient will not be able to delivery vaginally b/c it causes blindness in neonate |
|
|
Term
| Cause of condyloma acuminata |
|
Definition
HPV
90% are c/b types 6 & 11 |
|
|
Term
| PE findings for condyloma acuminata |
|
Definition
-cauliflower like , flat, papular
-pt. may indicate itching, burning, painful intercourse
-can be found anywhere in the vagina, anus, mouth, but most commonly found around the introitus |
|
|
Term
| How is condyloma acuminata dx |
|
Definition
| by visual inspection and history |
|
|
Term
| Treatment of condyloma acuminata |
|
Definition
-Warts can resolve on their own
-Gardasil for prevention |
|
|
Term
| Patient applied tx for condyloma acuminata |
|
Definition
-Podofilox 0.5% solution/gel --> applied bid x 3 days
-Imiquimod 5% cream --> apply at bedtime for up to 16 weeks
-Imiquimod 3.5% cream --> daily application for up to 8 weeks
-Sinecatechins 15% ointment --> tid for no longer than 16 weeks; not for immunocompromised pts. |
|
|
Term
| Provider administered tx for condyloma acuminata |
|
Definition
-Cryotherapy w/liquid nitrogen
-Podophyllin resin 10-25% (not recommended for vaginal use)
-Trichloracetic acid (TCA)or Bichloracetic acid (BCA) 80-90% --> common and use vaseline around the ward
-Surgical removal |
|
|
Term
| PE findings indicative of gonorrhea infection |
|
Definition
-purulent cervical discharge
-skene/bartholin gland inflammation
-cervical inflammation
-PID |
|
|
Term
|
Definition
| Nucleic acid amplification tests (NAATs) |
|
|
Term
|
Definition
-Ceftriaxone (Rocephin) 250 mg IM OR Cefixime 400 mg po
AND (if chlamydia infection)
-Azithromycin 1 g po OR Doxycycline 100 mg po bid x 7 days |
|
|
Term
|
Definition
|
|
Term
| Treatment of Gonorrhea in pregnancy |
|
Definition
Cephalosporin or azithromycin 2 g po
tx is essentially to prevent opthalmia neonatorum |
|
|
Term
| PE findings/ sx of chlamydia infection |
|
Definition
-vaginal discharge
-pain with urination
-increased urination
-pain during sex
-pelvic or abdominal pain
-sore throat
-mouth sores
-irregular bleeding |
|
|
Term
| Labs for Chlamydia infection |
|
Definition
-NAAT (Gold Standard)
-Culture
-ELISA
-DFA
-Nucleic Acid Hybridization Test |
|
|
Term
|
Definition
-Azithromycin 1 g po
-Doxycycline 100 mg po bid x 7 days |
|
|
Term
| Treatment of Chlamydia infection in pregnancy |
|
Definition
Azithromycin 1 g po
Amoxicillin 500 mg po tid x 7 days |
|
|
Term
| Treatment education for chlamydia infection |
|
Definition
-abstain from sex for 7 days from beginning of treatment
-all sexual partners in last 60 days need to be tested and treated |
|
|
Term
| F/U for pregnant woman w/chlamydia infection |
|
Definition
| 3-4 weeks after treatment has finished --> test of cure |
|
|
Term
|
Definition
|
|
Term
|
Definition
-strawberry cervix/vagina
-copious, thin, yellow, green, frothy discharge
-ph > 4.5
-dysuria
-increased urinary frequency |
|
|
Term
|
Definition
Microscopy --> need to see them moving
Culture
Rapid antigen/Nucleic Acid Testing |
|
|
Term
|
Definition
Metronidazole 2 g po
OR
Tinidazole 2 g po |
|
|
Term
| Lactation during tx of trich |
|
Definition
| w/hold BF during treatment and for 12-24 hours after last dose |
|
|
Term
|
Definition
| STI c/b Treponema Pallidum |
|
|
Term
| PE findings indicative of syphilis |
|
Definition
| Chancre --> painless, indurated lesions |
|
|
Term
|
Definition
|
|
Term
| Tx for syphilis even in pregnancy and w/allergic rxn |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What condition will lead to false positive RPR |
|
Definition
|
|
Term
| What is molluscum contagiosum |
|
Definition
| benign viral infection of the skin that is spread by skin to skin contact |
|
|
Term
| PE finding of molluscum contagiosum |
|
Definition
| central umbilicated lesions |
|
|
Term
| Dx of molluscum contagiosum |
|
Definition
| typically made by clinical appearance |
|
|
Term
| tx of molluscum contagiosum |
|
Definition
-the lesions are self limiting so they will clear on their own in 6-12 months
-Mechanical methods --> curettage, cryotherapy, or laser ablation
-Chemical methods --> topical agents for acne or warts or oral meds can be used |
|
|
Term
| Causative agent of syphillis |
|
Definition
|
|
Term
| Transmission of syphillis |
|
Definition
-direct contact during vaginal, anal,and or oral sex w/a sore
-entry in subQ tissue by microscopic abrasions |
|
|
Term
| Clinical symptoms of Primary Syphillis |
|
Definition
|
|
Term
| Time after exposure: primary syphillis |
|
Definition
|
|
Term
| Clinical symptoms of Secondary Syphillis |
|
Definition
Membrane lesions
Diffuse rash
Patchy alopecia
Condylomata lata (highly infectious)
CNS sx
Fever, malaise
Sore throat
Muscle aches
Weight loss |
|
|
Term
| Time after exposure: Secondary syphillis |
|
Definition
|
|
Term
| Clinical symptoms of latent syphillis |
|
Definition
| usually none and not infectious |
|
|
Term
| Time after exposure: Latent syphillis |
|
Definition
|
|
Term
| Clinical symptoms of tertiary syphillis |
|
Definition
CNS sx
chest pain
cough
nodules/ulcers
gummas
bone destruction
arthritis
myalgia |
|
|
Term
| Time after exposure: tertiary syphillis |
|
Definition
|
|
Term
| Clinical symptoms of neurosyphillis |
|
Definition
seizures
ataxia
aphasia
paresis
hyperreflexia
cognitive changes
visual changes
hearing changes
neuropathy |
|
|
Term
| Time after exposure: neurosyphillis |
|
Definition
|
|
Term
| Diagnosis of Primary and Secondary Syphillis |
|
Definition
Dark field microscopy
FVDRL, RPR |
|
|
Term
| Diagnosis of Latent and Tertiary Syphillis |
|
Definition
|
|
Term
| Diagnosis of Neurosyphillis |
|
Definition
CSF examination of cell count
protein
VDRL |
|
|
Term
| Treatment for Primary and Secondary Syphillis |
|
Definition
| Penicillin G 2.4 million units IM x 1 |
|
|
Term
| Treatment for Latent and Tertiary Syphillis |
|
Definition
| Penicillin G 2.4 million units IM x 3 |
|
|
Term
| Treatment of Neurosyphillis |
|
Definition
| Penicillin G via IV + Probenecid |
|
|
Term
| Complications of Syphillis |
|
Definition
meningitis
Jarisch-Herxheimer rxn
increased risk of HIV transmission |
|
|
Term
| Pregnancy complications of syphillis |
|
Definition
transmission to fetus
premature labor
stillbirth |
|
|
Term
| Treat any sexual partners in the last how many days w/a syphilis infection? |
|
Definition
|
|
Term
| Causative agent of Gonorrhea |
|
Definition
|
|
Term
| Transmission of gonorrhea |
|
Definition
| contact w/penis, vagina, mouth, anus |
|
|
Term
| Clinical Symptoms of gonorrhea |
|
Definition
dypareunia
leukorrhea
Change in discharge (purulent)
Unilateral labia swelling/pain
Lower abdominal pain
Menstrual irregularities
Rectal pain/discharge
dysuria
fever
N/V
joint pain/swelling |
|
|
Term
|
Definition
Culture
Nucleic Acid Hybridization
NAAT |
|
|
Term
| Complications of Gonorrhea |
|
Definition
PID
Increased risk of HIV transmission
Pelvic/Bartholin's abscess
DGI: bacteremia, pustules, arthritis |
|
|
Term
|
Definition
Ceftriaxone 125 mg IM x 1 (Preferred tx)
Cefixime 400 mg po x 1 |
|
|
Term
| Causative agent of Trichomonas |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
85% asymptomatic
profuse, frothy-green discharge
fishy odor discharge
pruritis
lower abd tenderness
dysuria
dyspareunia
strawberry cervix
CMT |
|
|
Term
|
Definition
Culture
pH discharge > 4.5
Saline wet prep: motile trichomonads
Positive whiff test |
|
|
Term
|
Definition
Increased risk of HIV transmission
PID
PROM PTL |
|
|
Term
| Pregnancy complications of gonorrhea |
|
Definition
| Blindness, Joint or Blood infection in baby |
|
|
Term
| Pregnancy complications w/Trich |
|
Definition
PROM
Low birth weight
Pneumonia |
|
|
Term
| Causative agent Chlamydia |
|
Definition
|
|
Term
|
Definition
| Oral, anal and vaginal intercourse |
|
|
Term
| Clinical sx Chlamydia infection |
|
Definition
often asymptomatic
dysuria, polyuria
mucoid/purulent discharge
CMT
Adnexal tenderness |
|
|
Term
|
Definition
|
|
Term
|
Definition
PID
infertility
ectopic pregnancy
cervicitis
increased risk of HIV transmission |
|
|
Term
| Pregnancy complications Chlamydia |
|
Definition
conjunctivitis in newborns
pneumonia in newborns |
|
|
Term
|
Definition
Metronidazole 2 g po x 1
Metronidazole 500 mg bid x 7d
Tinidazole 2 g po x 1 |
|
|
Term
|
Definition
Ceftriaxone 250 mg IM x 1 +
Doxycline 100 mg po bid x 14d +
Metronidazole 400 mg po bid x 14d |
|
|
Term
|
Definition
Azithromycin 1 g po x 1
Doxycycline 100 mg po bid x 7d (no preg)
Amoxicillin 500 mg po bid x 7d (preg) |
|
|
Term
| Causative agent Molluscum Contangiosum |
|
Definition
| molluscum contangiosum virus |
|
|
Term
|
Definition
sexual or direct skin to skin contact
Touching objects in contact w/lesions
spread by scratching/touching lesions |
|
|
Term
|
Definition
Small papules w/umbilicated centers
Central area of lesion cheesy discharge |
|
|
Term
|
Definition
| clinical presentation and physical exam |
|
|
Term
|
Definition
giant lesions
inflamed red sores
scarring |
|
|
Term
| Pregnancy complications of MC |
|
Definition
Vaginal birth CI
Podophyllotoxin CI in pregnancy |
|
|
Term
|
Definition
Cryotherapy, surgical/laser removal
Curreting lesions
Oral Cimetidine
Topical Podophyllotoxin cream
Topical Podopfilox
Topical Imiquimod |
|
|
Term
|
Definition
most easily spread during active outbreak
skin to skin contact
genital to genital contact
Oral to genital contact
anal to genital contact |
|
|
Term
|
Definition
genital pain
dyspareunia
dysuria
itching/burning at site
fatigue, fever, HA, myalgia
swollen nodes
tender lesions |
|
|
Term
|
Definition
| Culture of lesion during vesicular stage |
|
|
Term
|
Definition
pneumonitis
hepatitis
Disseminated infection
Encephalitis, meningitis |
|
|
Term
| Pregnancy complications of herpes |
|
Definition
C/S if outbreak during labor
Tx w/ acyclovir and valacyclovir in last few weeks of pregnancy |
|
|
Term
| Treatment for Primary infection of herpes |
|
Definition
Valacyclovir 1 g po bid x 7-10d
Acyclovir 400 mg po tid x 7-10d
Acyclovir 200 mg po 5x/day x 7-10d
Famcyclovir 250 mg po tid x 7-10d |
|
|
Term
| Treatment for Recurrent Herpes |
|
Definition
Acyclovir 800 mg tid x 2 d
Acyclovir 800 mg bid x 5 d
Acyclovir 400 mg tid x 5 d
Famcyclovir 125 mg po bid x 5 d
Famcyclovir 1 g po bid x 1 d
Valacyclovir 1 g po x 5 d
Valacyclovir 500 mg bid x 3-5 d |
|
|
Term
| Treatmeant for Suppressive Herpes |
|
Definition
Valacyclovir 500 mg po qd
Valacyclovir 1 g po qd
Acyclovir 400 mg po bid
Famcyclovir 250 po bid |
|
|
Term
| Causative agent of condylomata acuminata |
|
Definition
|
|
Term
| Clinical sx condylomata acuminata |
|
Definition
flesh colored papillary swellings
pruritis
postcoital bleeding |
|
|
Term
| Diagnosis condylomata acuminata |
|
Definition
| by physical exam and inspection |
|
|
Term
| Complications from condylomata acuminata |
|
Definition
|
|
Term
| pregnancy complications from condylomata acuminata |
|
Definition
podophylling tx CI
cryotherapy and acetic acid safe
rapid proliferation of lesions |
|
|
Term
| Tx for condylomata acuminata: patient applicable |
|
Definition
Bathe w/oatmeal solution
keep clean, dry and cotton underwear
-Imiquimod 5% cream HS 3x/week wash off with soap and water after 6-10 hours
-Podofilox 0.5% apply to warts bid x 3 days then no tx x 4 days and repeat up to 4 times |
|
|
Term
| Tx for condylomata acuminata by provider |
|
Definition
cryotherapy 1-2 weeks
Trichloroacetic acid q week
Bichloroacetic acid q week
surgical/laser lesion |
|
|
Term
|
Definition
| overgrowth of normal hydrogen peroxide producing lactobacilli |
|
|
Term
|
Definition
Multiple sex partners
douching
lesbian partners
lack of vaginal lactobacilli
previous hx of BV |
|
|
Term
|
Definition
fishy odor
increased, thin, white/gray discharge
urinary discomfort
50% asymptomatic |
|
|
Term
|
Definition
Amsel Criteria
-white, adherent discharge
-wet mount w/KOH; + whiff test OR clue cells
-pH >4.5 |
|
|
Term
|
Definition
LBW
PTL
Miscarriage
Chorioamnionitis/Postpartum endometritis
PID
Increased risk of HIV transmission |
|
|
Term
|
Definition
Metronidazole
500 mg po bid x 7 days
250 mg po tid x 7 days
0.75% gel 1 app qd x 5d
Clindamycin
2% cream 1 app qHS q 7 d |
|
|
Term
|
Definition
|
|
Term
| Risk factors for VVC infection |
|
Definition
Repeated antibiotic use
Pregnancy
Diabetes, Obesity
Use of corticosteroids
Hx of douching
Multiple sex partners
Tight fitting clothing |
|
|
Term
|
Definition
pruritis
painful urination
dryness
dyspareunia
thick, lumpy white discharge |
|
|
Term
|
Definition
KOH wet prep shows yeast or hyphae OR
+ culture
pH normal or < or equal to 4.5 |
|
|
Term
|
Definition
-Probiotics
-Clotrimazole (Preg!)
100 mg IT per vagina HS x 7 d
2T per vagina HS x 3 d
1% cream: 1 app HS x 7d
-Miconazole
100 mg per vagina HS x 7d
200 mg per vagina HS x 3 d
2% cream 1 app per vagina HS x 7d
1200 mg vaginal suppository x 1
Diflucan
150 mg po x 1 |
|
|
Term
|
Definition
Previous STIs
History of PID or BV
Multiple partners
Douching
Insertion of IUD |
|
|
Term
|
Definition
lower abdominal pain
heavy discharge w/odor
irregular bleeding
dyspareunia
dysuria
fever, fatigue, diarrhea, vomiting
asymp. w/no pain is most common = chlamydia |
|
|
Term
|
Definition
| -min. criteria: uterine tenderness OR adnexal tenderness OR CMT |
|
|
Term
|
Definition
young age
multiple sex partners
immunosuppressed
uncircumcision |
|
|
Term
| Gardasil protects against what HPV types |
|
Definition
|
|
Term
| Vaccine schedule for HPV vaccine |
|
Definition
2nd vaccine 2 months after the 1st
3rd vaccine 6 months after the 1st |
|
|
