Podcast
Questions and Answers
Which diagnostic test is commonly used for detecting sexually transmitted infections?
Which diagnostic test is commonly used for detecting sexually transmitted infections?
What is the key reason to perform endocervical swab for GC/CHL testing before a bimanual exam?
What is the key reason to perform endocervical swab for GC/CHL testing before a bimanual exam?
Which condition is characterized by a painless chancre?
Which condition is characterized by a painless chancre?
What is a Nabothian cyst best described as?
What is a Nabothian cyst best described as?
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Which vaginal infection type is treated with antifungal medications?
Which vaginal infection type is treated with antifungal medications?
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What factor may lead to the formation of ectropion in the cervix?
What factor may lead to the formation of ectropion in the cervix?
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Which STI testing may include oral and rectal swabs based on exposure?
Which STI testing may include oral and rectal swabs based on exposure?
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What type of vaginal discharge is typically associated with viral infections like HSV?
What type of vaginal discharge is typically associated with viral infections like HSV?
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What is the primary mode of transmission for the Herpes Simplex Virus?
What is the primary mode of transmission for the Herpes Simplex Virus?
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Which of the following symptoms is most commonly associated with a primary Herpes Simplex outbreak?
Which of the following symptoms is most commonly associated with a primary Herpes Simplex outbreak?
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What is the recommended management for symptomatic relief during a primary HSV infection?
What is the recommended management for symptomatic relief during a primary HSV infection?
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What is a characteristic feature of Bartholin's Gland Cyst?
What is a characteristic feature of Bartholin's Gland Cyst?
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Which treatment is specifically recommended for syphilis infection?
Which treatment is specifically recommended for syphilis infection?
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What condition is often suggested by the presence of unilateral chanchre?
What condition is often suggested by the presence of unilateral chanchre?
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What test is recommended for diagnosing Treponema pallidum in primary syphilis cases?
What test is recommended for diagnosing Treponema pallidum in primary syphilis cases?
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What viral shedding characteristic is true of recurrent herpes infections?
What viral shedding characteristic is true of recurrent herpes infections?
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Which term refers to the accumulation of mucus due to a blocked Bartholin duct?
Which term refers to the accumulation of mucus due to a blocked Bartholin duct?
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Which option is essential for managing recurrent Herpes Simplex infections?
Which option is essential for managing recurrent Herpes Simplex infections?
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What is the significant risk associated with Bartholin's Gland Abscess?
What is the significant risk associated with Bartholin's Gland Abscess?
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How long does the incubation period for primary syphilis generally last?
How long does the incubation period for primary syphilis generally last?
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What consequence can occur from Herpes Simplex Virus during pregnancy?
What consequence can occur from Herpes Simplex Virus during pregnancy?
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Which is a common systemic symptom of primary HSV infection?
Which is a common systemic symptom of primary HSV infection?
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What should be tested for in individuals with a diagnosis of gonorrhea or chlamydia?
What should be tested for in individuals with a diagnosis of gonorrhea or chlamydia?
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Which of the following is considered an upper genital tract infection?
Which of the following is considered an upper genital tract infection?
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What is a common symptom observed in individuals with gonorrhea or chlamydia who have a penis?
What is a common symptom observed in individuals with gonorrhea or chlamydia who have a penis?
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What is the primary method of diagnosing gonorrhea and chlamydia?
What is the primary method of diagnosing gonorrhea and chlamydia?
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Which of the following should be included in the treatment regimen for PID?
Which of the following should be included in the treatment regimen for PID?
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Which population is considered at high risk for gonorrhea and chlamydia infections?
Which population is considered at high risk for gonorrhea and chlamydia infections?
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What finding is associated with mucopurulent cervicitis on examination?
What finding is associated with mucopurulent cervicitis on examination?
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What is a recommended follow-up procedure for women diagnosed with gonorrhea or chlamydia after treatment?
What is a recommended follow-up procedure for women diagnosed with gonorrhea or chlamydia after treatment?
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Which symptom could indicate the presence of Fitz-Hugh-Curtis Syndrome?
Which symptom could indicate the presence of Fitz-Hugh-Curtis Syndrome?
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Why might hospitalization be warranted for a patient with PID?
Why might hospitalization be warranted for a patient with PID?
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What does the CDC recommend regarding annual screening for sexually active females?
What does the CDC recommend regarding annual screening for sexually active females?
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Which finding is NOT associated with a diagnosis of PID?
Which finding is NOT associated with a diagnosis of PID?
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What is the appropriate management for non-responsive PID patients after initial outpatient treatment?
What is the appropriate management for non-responsive PID patients after initial outpatient treatment?
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What is a common symptom associated with a Bartholin Gland Abscess?
What is a common symptom associated with a Bartholin Gland Abscess?
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Which organism is most commonly responsible for vulvovaginal candidiasis?
Which organism is most commonly responsible for vulvovaginal candidiasis?
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What is the primary treatment goal for bacterial vaginosis (BV)?
What is the primary treatment goal for bacterial vaginosis (BV)?
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What type of discharge is typically associated with trichomonas vaginalis infection?
What type of discharge is typically associated with trichomonas vaginalis infection?
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Which examination finding is most indicative of bacterial vaginosis?
Which examination finding is most indicative of bacterial vaginosis?
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In managing a Bartholin Gland Cyst that is asymptomatic, what is the recommended approach?
In managing a Bartholin Gland Cyst that is asymptomatic, what is the recommended approach?
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What pH value is indicative of bacterial vaginosis when measured?
What pH value is indicative of bacterial vaginosis when measured?
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What is the standard first-line treatment for a Trichomonas vaginalis infection?
What is the standard first-line treatment for a Trichomonas vaginalis infection?
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What symptom is typically NOT associated with vulvovaginal candidiasis?
What symptom is typically NOT associated with vulvovaginal candidiasis?
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What is the most common diagnostic test for Trichomonas vaginalis?
What is the most common diagnostic test for Trichomonas vaginalis?
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Which condition is primarily associated with vulvitis but may also involve vaginitis?
Which condition is primarily associated with vulvitis but may also involve vaginitis?
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Which of the following statements accurately describes the role of estrogen in normal vaginal physiology?
Which of the following statements accurately describes the role of estrogen in normal vaginal physiology?
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What is the purpose of the ‘whiff test’ in diagnosing bacterial vaginosis?
What is the purpose of the ‘whiff test’ in diagnosing bacterial vaginosis?
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Study Notes
Discharges and Infections in Gynecology
- Instructional objectives include differentiating, diagnosing, and treating various STIs, recognizing history and physical exam needs, and comparing diagnostic tests (pap smear, KOH prep, wet mount).
- Key conditions include Vaginitis, Cervicitis, Bartholin’s Cyst/Abscess, Endometritis, and Pelvic Inflammatory Disease.
- Infection pathways are particularly relevant in gynecology due to the short tract from external to internal sites.
- Assess cervical/vaginal discharge through external inspection, speculum examination, pH testing, wet prep, STD testing, and considering HPV testing.
Cervical Disease and STD Testing
- Nucleic Acid Amplification Test (NAAT) is crucial for identifying STDs.
- Endocervical swabs for GC/Chl and Trich should be performed before bimanual exams to avoid contamination.
- The cervix shows variations; Nabothian cysts and ectropion occur often due to hormonal changes.
Herpes Simplex Virus (HSV)
- HSV is transmitted through skin/mucous contact; genital HSV-1 is rising due to increased oral-genital contact.
- Symptoms include fever, chills, and painful vesicular lesions.
- Primary infections are most symptomatic; future episodes are usually less severe but can still result in shedding.
- Diagnosis often involves culture (PCR for specific types), and management includes oral antivirals like acyclovir.
Syphilis
- Syphilis is caused by Treponema pallidum, with increasing rates reported in the U.S.; primary lesions are typically painless ulcers.
- Diagnosis relies on serology or darkfield examination of chancres.
- Treatment is mainly via Benzathine Penicillin; partners should also be treated.
Bartholin’s Gland Cyst/Abscess
- The Bartholin's glands, located at the 4 and 8 o'clock positions of the vulva, secrete lubricating fluid and can develop cysts or abscesses.
- Cysts are often asymptomatic, while abscesses cause severe pain and require incision and drainage.
- Management includes monitoring asymptomatic cysts, draining symptomatic abscesses, and culture if necessary.
Vaginitis and Vulvovaginitis
- Vulvitis often accompanies vaginitis; both conditions can stem from similar irritants.
- Normal vaginal physiology involves a pH of 4.0-4.5, promoting beneficial flora and defensive against infections.
- Trauma, pH shifts, and decreased immunity can lead to infections like yeast or BV.
Vulvovaginal Candidiasis
- Often caused by Candida albicans; symptoms include pruritis and thick, white discharge.
- Diagnosis involves examination and wet prep showing hyphae.
- Treatments include OTC antifungals and prescription therapies like fluconazole.
Bacterial Vaginosis (BV)
- Represents a shift in normal flora with increased anaerobic bacterial growth; often asymptomatic but may produce a fishy odor.
- Diagnosed based on Amsel Criteria: thin discharge, high vaginal pH, and presence of clue cells.
- First-line treatment includes Metronidazole and Clindamycin.
Trichomonas Vaginalis
- A protozoal infection, presenting with yellow/green discharge and causing vulvar discomfort.
- Diagnosis via wet prep showing motile organisms; treatment involves Metronidazole for both patient and partner.
Cervicitis and PID
- Cervicitis can result from several infections, including Trichomonas and STIs leading to potential upper genital tract infections.
- Gonorrhea and Chlamydia are common causes; both can often present asymptomatically, especially in women.
- Diagnosis usually involves NAAT and clinical examination; high-risk populations should be screened regularly.
Pelvic Inflammatory Disease (PID)
- Diagnosed through specific criteria, including imaging and biopsy.
- Treat with broad-spectrum antibiotics to cover multiple pathogens.
- Hospitalization criteria include severe illness or non-responsiveness to treatment; follow-up is critical to ensure recovery.
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Description
This quiz assesses your understanding of the diagnosis, treatment, and laboratory tests related to sexually transmitted infections in gynecology. It covers the differentiation of various vaginal infections as well as the use of diagnostic methods such as pap smears and KOH prep. Test your knowledge on recognizing clinical signs and appropriate treatments.
