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Medical 2-06-STD's


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Define pediculosis pubis
(pubic or crab lice)?
caused by Phthirus, a grayish, parasitic "crab" louse that lays eggs tha attach to the hair shaft
How is crab lice treated?
apply 1% permethrin creme rinse to affected area and wash it off after 10 minutes
Define scabies?
Sarcoptes scabiel is a parasitic itch mite; female burrows under skin to deposit eggs
How is scabies treated?
permethrin cream 5% applied to all body areas from neck down and washed off after 8 to 14 hours or lindane 1% shampoo (if pregnant, also add crotamiton 10% lotion)
Define viral hepatitis?
inflammatory process of liver caused by infection by viruses
Define pelvic inflammatory disease?
clinical syndrome of inflammatory disorders of upper female genital tract
Define trichomoniasis?
sexually transmitted
infection caused by T.
transmitted by shared bath
facilities, wet towels,
or wet swimsuits
pt asymptomatic or mild
more advanced symptoms are
yellow-green, frothy,
odorous discharge and
vulvular itching
woman may complain of dysuria
sometimes subeqithelial
hemorrhages on cervix
(strawberry-like red
spots)visible with colpo-
vaginal pH of 4.5 or higher
positive whiff test
How to treat trichomoniasis
metronidazole (Flagyl)administered in a single 2-g dose or, alternatively, metronidazole 500 mg twice daily for 7 days for both male and female sexual partners
avoid sex until cured
avoid alcohol with drug or
may cause abdominal pain,
nausea, flushing, tremors
(same as Antabuse)
Define chlamydial infection?
caused by C. trachomatis; most common bacterial STI in U.S.
How to treat Chlamydial infection?
single dose of azithromycin (works for noncompliance) 1 g orally; or Doxycycline (inexpensive) 100 g by mouth twice a day for 7 days (if pregnant, use erythromycin or amoxicillin)
Define gonorrhea?
infection caused by bacterium Neisseria gonorrhoeae
Gonorrheal treatment for nonpregnant women?
antibiotic therapy with:
levofloxacin orally plus
doxycycline or
administered orally if chlamydia has not been ruled out
Define herpes genitalis?
two serotypes HSV-1 and
HSV-2 (most common; also
called herpes genitalis,
and that's the focus of
these cards)
symptoms and treatment for
both are the same
recurrent lifelong infection
multiple blisterlike vesicles
in genital area
Define syphilis?
chronic infection caused by spirochete Treponema pallidum; divided into early and late stages
Define condylomata acuminata; also called genital or venereal warts?
caused by human papilloma virus; evidenced by single or multiple soft, grayish pink, cauliflower-like lesions in genital area
What is the treatment for gonorrhea if pregnant?
cefixime with erythromycin
or amoxicillin
What is vulvovaginal candidiasis?
organism Candida albicans
diagnosed by wet-mount
What is bacterial vaginosis?
organism Gardnerella vaginalis and Mycoplasma
hominis by wet-mount clue
Nonpregnant women may treat bacterial vaginosis with?
Pregnant women may treat bacterial vaginosis with?
metronidazole or clindamycin
What is herpes genitalis?
organism herpes simplex virus
by herpes culture or titer
Herpes genitalis may be treated by?
What is AIDS?
human immunodeficiency virus
by ELISA test and Western blot; treatment for AIDS varies
What are genital warts?
human papilloma virus
by virapap, biopsy, Pap smear, colposcopy
Genital warts in nonpregnant women may be treated by?
trichloroacetic acid (TCA)
Genital warts in pregnant women may be treated by?
trichloroacetic acid (TCA)
Pregnant women with trichomoniasis may be at increased risk for?
premature rupture of
preterm birth
low birth weight
How should pregnant women with trichomoniasis who are asymptomatic be treated?
with a single 2-g dose of metronidazole orally to relieve their symptoms
Immunotypes of chlamydia are responsible for what conditions?
lymphogranuloma venereum
trachoma (blindness)
What is trachoma?
caused by Chlamydia trachomatis bacteria;
world's leading cause of preventable blindness
Chlamydia is the leading cause of?
nongonococcal urethritis
(NGU)in men
in women, infection is
similar to gonorrhea
asymptomatic infections in
both genders
usually occurs in younger
Chlamydia in women can infect which body parts?
fallopian tubes
Bartholin's glands
Severe sequelae can result in women from untreated chylamydial infection. These conditions that follow and result from a disease (sequelae) are?
ectopic pregnancy
In men, chlamydial infections may result in?
Newborn exposure to chlamydia in the birth canal of the mother is the most common cause of?
ophthalmia neonatorum
(chlamydial pneumonia is
also found in newborns)
Chlamydial conjunctivitis responds to which medication?
erythromycin ophthalmic ointment but not to silver nitrate eye prophylaxis
Symptoms of chlamydia include?
thin or mucopurulent
cervical ectopia
friable cervix (bleeds
burning and frequency
of urination
lower abdominal pain
Gold standard test for chlamydia is?
culture cervical cells
Diagnosis is frequently made after treatment of a male partner for ____ or in a symptomataic woman with a negative ________ culture
NGU (nongonococcal
In chlamydia cases, the partners should be treated and the couple should abstain from intercourse for
_______ after taking the single-dose azithromycin treatment or for the entire _____ of doxycycline therapy
7 days
7 days
During pregnancies with chlamydial infections, use ______, NOT _________, although neither is highly effective, so take another culture ____ after completion
of medication
3 weeks
Screening (primary?) for chlamydia is recommended for the following?
ages 20-25, asymptomatic,
sexually active females
women over 25 taking risks
high risk pregnant women in
first and third trimester
In gonorrhea cases, _____ seek early treatment due to symptoms, while ______are asymptomatic (50%) until complications occur?
If a pregnant woman contracts gonorrhea in third month, what may happen to newborn?
the gonorrheal infection will remain localized in urethra, cervix, and B-glands until membranes rupture...possibly spreading upward to newborn. Newborn may contract ophthalmia neonatorum
What tests for gonorrhea might be run during prenatal visits?
cervical culture
high risk pts again in last
month of pregnancy
cervical cultures may also
be done on urethra,
throat, and rectum
For symptoms of gonorrhea, please refer to?
chlamydia flashcard
(add possible swelling and
inflammation of vulva to
gonorrhea list)
Gonoorrheal treatment for nonpregnant women consists of ________ _______ including the following drugs: (4 oral, 1 IM)
antibiotic therapy


In gonorrheal cases, if chlaymdia has not been ruled out, please give the patient which meds as well as the gonorrheal drugs?
doxycycline or azithromycin
Which two infections commonly occur together?
gonorrhea and chlamydia
If the cultures for chlamydia and gonorrhea remain positive _____ to _____days after completion of treatment, the patient will be required to take additional treatment?
For chlamydia and gonorrhea infections, pregnant women should be treated with what meds?
usually ceftriaxone IM
or cefixime orally to
cover the gonorrheal
combine these with erythromycin or amoxicillin to cover the chlamydial infection as well

reculture after a couple of weeks to verify cure
Signs that a chlamydial/gonorrheal infection is worsening include?
sharp abdominal pain
HSV-2 is also called?
herpes genitalis
and at least 50 million people in US have been diagnosed with it;
most people remain undiagnosed
First outbreak (primary episode) of herpes genitalis lasts the longest and is the most severe and is characterized by what symptoms and in which parts of the reproductive system?
single or multiple blisterlike vesicles, in genital area and sometimes in:
vaginal walls
Herpes genitalis (HSV-2) vesicles may appear within a _______ ______ to _____ ____
after exposure and rupture spontaneously to form very painful, open, ulcerated lesions.
few hours
20 days
How does HSV-2 (herpes genitalis) affect the renal system?
can cause difficult urination and urinary retention...this is due to inflammation and pain secondary to the lesions
How does HSV-2 (herpes genitalis) affect lymph system?
there may be enlargement of INGUINAL lymph nodes
How does HSV-2 (herpes genitalis) affect the respiratory system?
may cause flu-like symptoms
How does HSV-2 (herpes genitalis)affect the groin area?
may be genital pruritis or tingling
Lesions from HSV-2 (herpes genitalis) heal spontaneously in what amount of time?
2 to 4 weeks
What is unique about the healing of lesions in HSV-2 (herpes genitalis)?
the virus enters a dormant phase, residing in the nerve ganglia of the affected area

(ganglion are a mass of nervous tissue composed of neuron cell bodies and lying outside brain or spinal cord)

this leaves the patient open for less severe regular recurrences
Less severe than the primary episode (first outbreak), regular recurrences of HSV-2 seem to be triggered by?
frequent or vigorous inter-
poor health status
generally run-down physical
tight clothing
Diagnosis of HSV-2 may be made by?
PAP smear
lesion culture
Polymerase chain reaction
(PCR) i.d.
blood testing for antibodies?
Is there a known cure for HSV-2?
No, only medications for pain relief in secondary infection cases.
Recommended treatment for the first episode of genital herpes (HSV-2) is?

((try to treat before lesions appear (prodromal phase))
oral acyclovir
(pregancy use for the latter two not well-documented so acyclovir is more commonly used...)

(lower dosages used for regular recurrent episodes)
What are the benefits of using acyclovir during pregnancy?

((the virus cycles (acyclovir) out of affected ganglia to cause recurrent episode))?
used in primary episode (first outbreak) or severe recurrent herpes...
may reduce need for Cesarean section if used in third trimester
Self-care suggestions for herpes genitalis (HSV-2)?
cleansing with povidone-
iodine (Betadine)solution
to prevent secondary
cleanse with Burow's solution
to relieve discomfort
use Vitamin C or lysine to
prevent recurrence
2% lidocaine (Xylocaine) used
to decrease lesion pain;
apply to lesion site
keep genital area clean and
wear loose clothing
take sitz baths
wear cotton underwear or none
at all..will promote
How does herpes genitalis (HSV-2) affect the newborn?
if lesions are in genital tract during childbirth, it can be devastating, even fatal, on newborn

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