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Treatment: Fluconazole

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Presentation on theme: "Treatment: Fluconazole"— Presentation transcript:


2 Treatment: Fluconazole
Cottage Cheese Discharge Candida Candida Treatment: Fluconazole

3 Candida Vulvovaginitis
Antibiotic use Think DIABETES in older children w/o risk factors Symptoms: Dysuria, dyspareunia, pruritis Thick cheesy vaginal discharge Diagnosis: KOH budding yeast and pseudohyphea Low vaginal pH Treatment: Fluconazole

4 What is the bug? Condylomata acuminata HPV Condylomata acuminata

5 Human Papillomavirus Most common STD in females HPV 6 and 11 – warts
HPV 16, 18, 31, 33, 35 – cervical cancer Treatment Podofilox, Imiquimod cream Cryotherapy Surgical removal

6 Syphilis Does this hurt??? Chancre - syphilis

7 Syphilis Treponema Pallidum Primary Know testing Painless chancre
1st: nontreponemal test VDRL RPR 2nd: treponemal test FTA-ABS TP-PA These may be + for life regardless of treatment

8 Secondary Syphilis

9 Syphilis Secondary Tertiary Latent Treatment Palmar rash
Mucocutaneous lesions Lyphadenopathy PALMS and SOLES – nickel and dime Tertiary Cardia Opthalmic and auditory Gummatous lesions Latent + test with no clinical symptoms Early – within past year Late – after 1st year of infection Treatment PCN G IM x 1

10 Neurosyphilis Adolescent with hearing loss
Cognitive dysfunction, motor or sensory deficits CSF VDRL is diagnostic Very specific Usually diagnose based on: Clinical suspecion Elevate WBC, protein Treatment Peniciliin G IV for 2 weeks

11 Genital Herpes Wright-Giemsa stain – multi nucleated giant cells

12 Genital Herpes – usually Type 2
Clusters of vesicular ulcers, erythematous base Tender Inguinal Adenopathy, fever, myalgia Diagnosis: Physical exam Wright-Giemsa stain Treatment: Acyclovir 7 days (oral)

13 Trichomonas infection
Strawberry cervix

14 Trichomonas Vaginalis
“Strawberry Cervix” Symptoms: Assymptomatic in males Burning, itching, abnormal odor “frothy yellow discharge” Tests: Flagellated organisms wet prep Treatment: Metronidazole – 2 gm Treat partners

15 Bacterial Vaginosis CLUE CELLS BV

16 Gardnerella Vaginalis - BV
Caused by disruption of vaginal flora Test: Whiff test – fishy amine odor Clue cells Treatment Metronidazole

17 Gonorrhea GC Bartholin Gland Abscess

18 Gonorrhea Commonly assymptomatic Males Females Dysuria and discharge
Can progress to epididymitis (unilateral pain and swelling of scrotum) Females Urethritis and cerivicitis Dysuria and malodorous discharge Fitz-Hugh-Curtis – perihepatitis *normal LFTs RUQ pain

19 Dis GC

20 GC Con’t THINK GC for any arthritis in adolescents GC pharyngitis
Patchy, erythematous, pustular lesions on palate Diagnosis – throat culture Disseminated GC Usually don’t have local symptoms anymore Most common arthritis and rash Can develop meningitis and endocarditis Diagnosis: culture – GRAM - DIPLOCOCCI *DON’T FORGET, TREAT ALL GC CASES FOR CHLAMYDIA

21 Chlamydia Most common treatable STD Symptoms: Diagnosis: Treatment:
Men – urethritis Women - cervicitis Diagnosis: Nucleic acid amplification test Treatment: Azithromycin 1 gm x 1 Doxycyclin 100 mg BID x 7 days or Erythromycin 500mg BID x 7 days Don’t forget – You need a TOC in pregnancy

22 PID Complication of lower genital tract infection Risk Factors:
Adolescent, multiple sexual partners, previous PID Symptoms: Ill apperaing fever, shaking chills, lower abdominal pain Cervical motion tenderness Diagnosis: Culture, U/S (fluid in cul-de-sac) Treatment: Can try outpt but need to reexamine within 24 hours Hospitalization Ceftriaxone and Doxycycline Complications: Ectopic pregnancy

23 Pregnancy ½ of all pregnancies occur with 6 mos of first intercourse
1/5 in first month Testing All pregnant women have to be tested for HIV 1st visit labs: syphillis, Chlamydia, GC, Hep B, Hep C, Pap

24 How about a few Pictures??

25 Imperferate Hymen Imperferate hymen

26 Mom complains of constant scratching of bottom!!!
Pin worms Scotch tape Test!!!

27 Urethral Prolapse Common Presentation: Vaginal bleeding

28 Genital Trauma Genital Trauma

29 Irriatant Vulvovaginitis
**Think if they mention “bubble baths” Irriatant vulvovaginitis

30 Lichen Sclerosis Lichen sclerosis

31 Strep Vulvovaginitis Usually very painful!! Sharp demarcation

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