PID Diagnosis and Implications Quiz

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Questions and Answers

Which symptom is least indicative of a diagnosis of PID?

  • Dysuria with negative urinalysis (correct)
  • Elevated C-reactive protein
  • Moderate bilateral lower abdominal pain
  • Abnormal cervical mucopurulent discharge

What percentage of infertility is associated with one episode of PID?

  • 50%
  • 25%
  • 18%
  • 12% (correct)

Which diagnostic method is considered the gold standard for diagnosing PID?

  • Clinical diagnosis
  • Saline microscopy
  • Transvaginal Doppler ultrasound
  • Laparoscopy (correct)

What is the increased risk of ectopic pregnancy after one or more episodes of PID?

<p>Eightfold (C)</p> Signup and view all the answers

What is a common clinical sequel associated with PID that affects 18% of women?

<p>Chronic pelvic pain (C)</p> Signup and view all the answers

How accurate is clinical diagnosis for PID compared to laparoscopy or transvaginal Doppler ultrasound?

<p>65% to 90% sensitive (D)</p> Signup and view all the answers

Which method is NOT used for diagnosing PID?

<p>Endometrial biopsy (D)</p> Signup and view all the answers

What is the primary method suggested to reduce the incidence of PID?

<p>Actively screening for Chlamydia (B)</p> Signup and view all the answers

What was the original name given to bacterial vaginosis (BV) before it was clearly defined as a syndrome?

<p>Haemophilus vaginitis (C)</p> Signup and view all the answers

Which of the following sexually transmitted pathogens was differentiated in the 1960s?

<p>Herpes simplex virus (HSV) type 2 (A)</p> Signup and view all the answers

What is a major consequence of Neisseria gonorrhoeae infection in women?

<p>Pelvic inflammatory disease (PID) (A)</p> Signup and view all the answers

Which of the following infections can lead to disseminated gonococcal infection (DGI)?

<p>Oropharyngeal infection (D)</p> Signup and view all the answers

Which sexually transmitted virus was recognized as a significant pathogen in the 1980s?

<p>Human immunodeficiency virus (HIV) (C)</p> Signup and view all the answers

What type of infection can disseminated gonococcal infection (DGI) lead to?

<p>Endocarditis (A)</p> Signup and view all the answers

Which population is more likely to transmit hepatitis C virus (HCV) through sexual contact?

<p>Men who have sex with men (MSM) coinfected with HIV (C)</p> Signup and view all the answers

What is the causal organism of gonorrhea?

<p>Neisseria gonorrhoeae (C)</p> Signup and view all the answers

What are common signs and symptoms of rectal gonorrhea?

<p>Anorectal pain and mucopurulent discharge (A)</p> Signup and view all the answers

Which of the following pathogens should be tested for in a patient suspected of having rectal Chlamydia?

<p>N.gonorrhoeae and C.trachomatis (B)</p> Signup and view all the answers

What is the recommended first-line treatment for anorectal gonorrhea?

<p>Ceftriaxone 250 mg IM as a single dose (B)</p> Signup and view all the answers

What alternative treatment may be used for patients with isolated anal gonorrhea who cannot receive cephalosporins?

<p>Desensitization before treatment (A)</p> Signup and view all the answers

Which of the following conditions should be differentiated from proctitis in homosexual males?

<p>Proctocolitis (D)</p> Signup and view all the answers

What additional infection should patients with pharyngeal gonorrhea be tested for?

<p>HIV (D)</p> Signup and view all the answers

Which of these options should NOT be used as a first-line agent for anorectal gonorrhea?

<p>Oral cefixime (D)</p> Signup and view all the answers

What symptom might indicate asymptomatic pharyngeal gonorrhea upon examination?

<p>Pharyngeal exudates (D)</p> Signup and view all the answers

What common symptom is associated with vulvovaginal candidiasis (VVC)?

<p>Thick, white vaginal discharge (A)</p> Signup and view all the answers

How can VVC be differentiated from other vaginal infections based on discharge characteristics?

<p>A viscous, nonodorous, white discharge (C)</p> Signup and view all the answers

Which method can increase the visibility of Candida in a vaginal discharge sample?

<p>Wet-mount preparation with 10% KOH (B)</p> Signup and view all the answers

What should be done if a wet mount for Candida is negative?

<p>Culture the vaginal discharge for Candida (C)</p> Signup and view all the answers

Which of the following statements is true regarding normal vaginal flora?

<p>Candida is part of normal vaginal flora for a small percentage of women. (C)</p> Signup and view all the answers

What is the typical vaginal pH associated with VVC?

<p>Above 4.5 (A)</p> Signup and view all the answers

What is the role of nonprescription home screening tests in diagnosing VVC?

<p>They can indicate pH changes but have low specificity. (C)</p> Signup and view all the answers

Which condition could delay appropriate treatment if incorrectly diagnosed as VVC?

<p>Bacterial vaginosis (BV) (A)</p> Signup and view all the answers

What is the primary method used for culturing bacteria in suspected gonorrhea cases?

<p>Thayer–Martin medium (D)</p> Signup and view all the answers

Which of the following is a common symptom of gonorrhea in women?

<p>Vaginal discharge (D)</p> Signup and view all the answers

What complication can arise in women with untreated acute gonococcal infection?

<p>Pelvic inflammatory disease (PID) (D)</p> Signup and view all the answers

What percentage of women with acute gonococcal infections may experience complications like PID?

<p>10% to 20% (C)</p> Signup and view all the answers

Which diagnostic test is recommended for detecting N.gonorrhoeae in urogenital sites?

<p>Nucleic acid amplification tests (NAATs) (C)</p> Signup and view all the answers

What is a significant risk associated with gonorrhea during pregnancy?

<p>Spontaneous abortion (B)</p> Signup and view all the answers

How might the symptoms of gonorrhea differ in pregnant women compared to non-pregnant women?

<p>Symptoms are mild but may lead to complications (A)</p> Signup and view all the answers

What is a primary reason for thoroughly testing pregnant women for gonorrhea?

<p>To prevent complications like acute chorioamnionitis (B)</p> Signup and view all the answers

What organism is responsible for causing syphilis?

<p>Treponema pallidum (A)</p> Signup and view all the answers

What was the primary reason for the increase in syphilis rates in the late 1980s?

<p>Crack cocaine use (D)</p> Signup and view all the answers

What significant trend occurred with the rates of primary and secondary syphilis from 1990 to 2000 in the US?

<p>They sharply decreased by 89.7%. (C)</p> Signup and view all the answers

What does the Healthy People 2020 goal set for primary and secondary syphilis among men?

<p>6.8 cases per 100,000 individuals (A)</p> Signup and view all the answers

Which treatment is considered the mainstay for syphilis?

<p>Penicillin (C)</p> Signup and view all the answers

What was the effect of increased awareness and treatment on the incidence of severe forms of syphilis?

<p>It led to a decrease in the incidence of severe forms. (C)</p> Signup and view all the answers

What finding is consistent with syphilis infection in a laboratory test?

<p>Positive rapid plasma reagin (RPR) test (D)</p> Signup and view all the answers

In the patient case described, which symptom is not typically associated with syphilis?

<p>Chronic cough (A)</p> Signup and view all the answers

Flashcards

Sexually Transmitted Diseases (STDs)

A group of infections that are spread through sexual contact.

Gonorrhea

A bacterial infection that can cause infections in the cervix, urethra, rectum, and throat.

Disseminated Gonococcal Infection (DGI)

The spread of Neisseria gonorrhoeae to the blood, joints, and other tissues.

Pelvic Inflammatory Disease (PID)

An inflammation of the pelvic organs, often caused by sexually transmitted infections like gonorrhea.

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Bacterial Vaginosis (BV)

A common STD that can cause vaginal discharge, itching, and odor.

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Genital Herpes

A viral infection that causes painful blisters on the genitals.

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Human Immunodeficiency Virus (HIV)

A chronic viral infection that weakens the immune system, making the body more vulnerable to other infections.

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Human Papillomavirus (HPV)

A viral infection that can cause skin cancer, especially in individuals with weakened immune systems.

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Rectal Gonorrhea

A sexually transmitted infection (STI) that affects the rectum, often caused by unprotected anal sex. Symptoms include rectal pain, discharge, bleeding, and constipation.

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Treatment for Gonorrhea

The most common way to treat gonorrhea is with a single injection of ceftriaxone.

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Pharyngeal Gonorrhea Symptom

A common symptom of pharyngeal gonorrhea, which is an infection of the throat, is a sore throat.

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Pharyngeal Gonorrhea Cure Difficulty

Pharyngeal gonorrhea is harder to cure compared to other types of gonorrhea.

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Gonorrhea Locations

Gonorrhea can affect various parts of the body, including the rectum, throat, and urethra.

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Gonorrhea Transmission

Gonorrhea can spread through unprotected sexual contact with an infected person.

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Proctitis

Inflammation of the rectum, often accompanied by pain, discharge, and bleeding.

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Proctocolitis

Inflammation that extends beyond the rectum, often caused by specific bacteria or parasites.

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Thayer–Martin medium

A type of enriched agar used to grow Neisseria gonorrhoeae in the lab, containing vancomycin, colistimethate, and nystatin to inhibit other bacterial growth.

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Gonorrhea in women

A sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae, often presenting with vaginal discharge, cervical abnormalities, or asymptomatic infection.

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Incubation period for gonorrhea

The time between exposure to Neisseria gonorrhoeae and the appearance of symptoms. This period can vary from person to person.

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Nucleic acid amplification test (NAAT)

A type of diagnostic test that uses a specific type of DNA amplification to detect the presence of Neisseria gonorrhoeae in urine, vaginal swabs, or other samples.

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Endometritis

Inflammation of the lining of the uterus, cervix, and fallopian tubes, typically caused by an infection, often with Neisseria gonorrhoeae or Chlamydia trachomatis.

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Conjunctivitis

Inflammation of the conjunctiva, the clear membrane covering the white part of the eye and lining the inside of the eyelid.

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Ophthalmia neonatorum

A serious eye infection in newborns who are infected with gonorrhea during childbirth, potentially causing blindness.

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What is Pelvic Inflammatory Disease (PID)?

A group of conditions resulting from inflammation of the upper reproductive tract in women; infections most often affecting the uterus, fallopian tubes, and ovaries.

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How is PID diagnosed clinically?

A clinical diagnosis of PID can be made based on various symptoms, including fever, cervical or vaginal mucopurulent discharge, pelvic pain, and abnormal vaginal secretions.

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What are the gold standard methods for diagnosing PID?

Laparoscopy and transvaginal Doppler ultrasound are highly specific and considered "gold standard" methods, but are not always readily available, especially for acute cases.

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How can PID affect fertility?

Inflammation of the fallopian tubes, often a result of PID, can lead to tubal occlusion and fibrosis, increasing the risk of infertility.

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What are some long-term complications of PID?

Chronic pelvic pain, ectopic pregnancy, and chronic pelvic pain are common complications of PID due to the inflammation and potential damage to the reproductive organs.

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What is ectopic pregnancy?

Ectopic pregnancy, a potentially life-threatening condition, occurs when a fertilized egg implants outside the uterus, often in the fallopian tube.

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How can PID be prevented?

Active screening for Chlamydia in young, sexually active women can help prevent PID, as Chlamydia infections are a common cause.

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Does H.C. have PID? What is the recommended treatment?

H.C. likely has acute PID based on her symptoms, including severe pelvic pain, fever, cervical exudate, and elevated WBC count. Treatment involves antibiotics, typically a regimen of ceftriaxone and doxycycline.

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Syphilis

A bacterial infection caused by the spirochete Treponema pallidum that is characterized by distinct stages with varying symptoms.

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Primary Syphilis

The initial stage of syphilis, characterized by a painless chancre (sore) at the site of infection, which usually appears 3 weeks to 3 months after exposure.

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Secondary Syphilis

The second stage of syphilis, characterized by a rash, fever, headache, fatigue, and swollen lymph nodes, which usually appear 4 to 10 weeks after the chancre heals.

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Tertiary Syphilis

The late stage of syphilis, which can occur years after the initial infection and may lead to serious complications such as neurosyphilis, cardiovascular syphilis, and gummatous syphilis.

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Neurosyphilis

Syphilis that affects the nervous system, potentially leading to symptoms such as headaches, seizures, and paralysis.

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Cardiovascular Syphilis

Syphilis that affects the cardiovascular system, potentially leading to symptoms such as chest pain, shortness of breath, and heart failure.

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Gummatous Syphilis

Syphilis that affects the skin and soft tissues, potentially leading to the formation of gummas (soft, rubbery tumors).

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Congenital Syphilis

The transmission of syphilis from a pregnant woman to her fetus, which can lead to serious health problems for the baby.

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Common symptoms of VVC

A thick, white vaginal discharge that appears curd-like, along with vulvar and vaginal itching, soreness, burning, and pain during intercourse.

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Vulvovaginal Candidiasis (VVC)

A vaginal infection caused by an overgrowth of Candida yeast, often C. albicans. It can cause varying degrees of vaginal discharge, itching, and pain.

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What is the appearance of VVC discharge?

A vaginal infection that can cause a white, nonodorous, viscous discharge ranging from curd-like to watery. It often involves vulvar redness.

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Why is it important to differentiate VVC from other vaginal infections?

To ensure proper treatment, VVC should be distinguished from other vaginal infections. Otherwise, using over-the-counter antifungal medication could delay the correct treatment for other infections.

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How can the appearance of discharge help diagnose VVC?

A vaginal discharge that is characteristically viscous, nonodorous, white, and curd-like, along with a normal vaginal pH level (above 4.5), can be indicative of VVC.

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What microscopic examination can be used to confirm VVC?

A wet-mount preparation with 10% KOH or a Gram stain of the vaginal discharge can be used to microscopically identify Candida in women with VVC.

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How does 10% KOH help in diagnosing VVC?

Using a wet mount preparation with 10% KOH can improve the visualization of yeast or pseudohyphae in the vaginal discharge.

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Why isn't Candida always associated with VVC?

Candida is a normal part of the vaginal flora in 10% to 20% of women. Only its overgrowth, causing symptoms like those of vulvovaginitis, necessitates treatment.

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