Amine test
The amine test (or "whiff" test) is performed by adding a drop of 10% KOH on a vaginal fluid specimen placed on a slide and mixing with a wooden applicator or swab. Sniff for a "fishy" odor. In the presence of bacterial vaginosis and sometimes trichomoniasis, the fishy odor is due to the release of volatile amines.
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Anal squamous intraepithelial lesions
A general term for the abnormal growth of squamous cells on the anus. The changes in the cells are described as low grade (LSIL) or high grade (HSIL), depending on how abnormal the cells are.
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Anogenital squamous cell carcinomas
Cancer that begins in squamous cells, lining the anogenital region, such as anal cancer, vaginal cancer, vulvar cancer, penile cancer, or cervical cancer.
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Antimitotic
Refers to a type of drug that inhibits or prevents mitosis, which refers to nuclear cell division involved in cell reproduction.
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Bacterial vaginosis
Overgrowth of bacteria species normally present in vagina, but at low levels, such as Gardnerella, Bacteroides, Mycoplasma hominis, Mobiluncus, Peptostreptococcus. BV correlates with loss of protective (peroxide-producing) lactobacilli, which are normally present in vagina:
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Biologic false positive
Biologic false positive (BFP) non-treponemal test results can occur with febrile illness, recent immunization, injection drug use, and chronic conditions including lupus and other collagen diseases. BFP is established when the non-treponemal test is positive and the treponemal (confirmatory) test is negative.
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Benzathine penicillin
Most common treatment for syphilis. It provides low but persistent serum levels of penicillin, which has proven to be a highly effective treatment. No penicillin resistance has been reported for T. pallidum.
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Butcher's warts
Warts caused by cutaneous HPV types, such as HPV type 7, typically found on the hands of butchers who handle meat.
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Calymmatobacterium granulomatis
The bacterium which causes Granuloma inguinale (Donovanosis).
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Cervical dysplasia
A general term for the abnormal growth of squamous cells on the cervix. The changes in the cells are described in cytological reports as low grade or high grade, depending on how abnormal the cells are.
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Cervical intra-epithelial neoplasia (CIN)
A general term for the abnormal growth of squamous cells on the cervix. The changes in the cells are described in histological reports as CIN 1, CIN 2, or CIN 3, depending on how abnormal the cells are.
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Cervical motion tenderness
(CMT) refers to pain of the cervix and/or uterine fundus elicted as a result of lateral movement of the cervix by the clinician during bimanual examination. CMT is a clinician sign of pelvic inflammatory disease.
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Chancroid
An infectious venereal ulcer caused by Haemophilus ducreyi, . Endemic in tropical countries including Kenya, Thailand and South Africa. It is less common in the US, though several epidemics have occurred since 1981.
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Chancroid culture
Method of growing the causative agent of chancroid, Haemophilus ducreyi, generally employing enriched chocolate agar supplemented with vancomycin. Culture is generally performed with swabs obtained directly from the ulcer site. Culture plates should be incubated in a water-saturated atmosphere with 5% carbon dioxide at a temperature of 33° C.
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Chlamydia
A highly infectious infection caused by an intracellular bacteria, Chlamydia trachomatis. It is passed during sexual contact, most commonly infecting the cervix, vagina, urethra, and rectum in women; and infecting the urethra and rectum in men.
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Chlamydia trachomatis
The bacteria that causes Chlamydia. There are 15 serotypes. Three produce lymphogranuloma venereum (LGV). Four cause endemic trachoma in SE Asia, the Middle East and North Africa, including the most common cause of preventable blindness in the world today. The remaining serotypes cause (in women) cervicitis, pelvic inflammatory disease, endometritis, perihepatitis and urethral syndrome; (in men) nongonococcal urethritis and epididymitis and (in neonates) inclusion conjunctivitis and pneumonia.
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Colposcopy
Refers to close examination of the vagina and/or cervix by means of a magnified scope. Diluted acetic acid (3-5%) is applied to the epithelial surface to aid in the identification of abnormalities.
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Common warts
Warts caused by cutaneous HPV types that are typically found on the hands.
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Cytokines
Substances made in the body and synthetically that play a role in the immune response (e.g. tumor necrosis factor (TNF), interferon).
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Darkfield microscope
A light microscope with the addition of a special dark-field condenser. This has the effect of making the organism appear as a bright object against a dark background. Typically used to detect motile treponemes indicative of Treponema pallidum, the causative organism of syphilis.
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Darkfield microscopy
A quick and direct method of diagnosing primary and secondary syphilis. Darkfield microscopy allows for the direct visualization of the T. pallidum from moist lesions, which cannot be seen using standard stains.
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DFA
Direct Fluorescent Antibody test. A laboratory culture antibody test for detecting Treponema pallidum from lesions samples using fluorescent microscopy. This technique may also be used to detect other organisms when a different antibody is used (for example, Chlamydia trachomatis).
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Donovanosis (Granuloma inguinale)
A genital ulcer disease caused by the intracellular Gram-negative bacterium Calymmatobacterium granulomatis. It is endemic to some tropical areas, including India, Papua, New Guinea, central Australia and southern Africa and rare in the United States. Symptoms include painless, progressive ulcerative and highly vascular lesions, which bleed easily on contact.
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Ecthyma
Pyogenic infection of the skin characterized by the formation of adherent crusts beneath which ulceration occurs, most commonly localized on the buttocks, thighs and legs; usually caused by infection with streptococci or staphylococci, or both. The initial lesion is a vesicle or vesiculopustule with an erythematous base which is soon surmounted by a hard crust.
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Efficacy
Refers to the effectiveness of a drug or treatment.
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Epidermodysplasia verruciformis
Refers to numerous flat warts on the hands and feet, sometimes familial, due to human papillomavirus infection.
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First void urine
The first urine of the morning.
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Flat warts
Refers to flat type of wart, also called verruca plana.
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FTA-ABS
Fluorescent Treponemal Antibody-Absorption Test. An indirect fluorescent antibody test used to confirm a diagnosis of syphilis. A technically difficult and highly specific test.
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G0
Gravida zero. Gravida refers to the number of previous/current pregnancies. Para: refers to the number of deliveries after 20 weeks of gestation or of a fetus of more than 500 grams. Aborta: number of induced or spontaneous abortions of a fetus under 500 gm or under 20 weeks of gestation. So this patient would be GoPoAo.
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Gonorrhea
A common infectious disease caused by the bacterium Neisseria gonorrhea. It can infect mucosal surfaces, including genitals, eyes, and rectum. Most infected men develop and seek treatment for urethritis. Most infected women are asymptomatic or have mild and nonspecific symptoms, and thus go untreated longer.
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Gram stain
The most common diagnostic tool used for gonorrhea, as well as other bacteria in some situations. With this test, bacteria either stain purple (gram-positive) or red (gram-negative). When treated with a decolorizer, gram-positive organisms retain their color; gram-negative organisms do not.
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Granuloma inguinale (Donovanosis)
A genital ulcer disease caused by the intracellular Gram-negative bacterium Calymmatobacterium granulomatis. It is endemic to some tropical areas, including India, Papua, New Guinea, central Australia and southern Africa. It is rare in the United States. Symptoms include painless, progressive ulcerative and highly vascular lesions, which bleed easily on contact.
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Haemophilus ducreyi
The bacteria that causes chancroid.
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Herpes simplex virus (HSV)
A virus, defined as either type 1 or type 2, that can cause several types of viral infections. HSV-1 typically causes vesicles found around the mouth and lips (oral herpes or cold sores). HSV-2 usually infects the genitals, resulting in lesions on or near the genitals. Both types are relatively easily transmitted and may be latent for decades. Initial infections tend to be the most severe, though many infected patients are asymptomatic.
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Incident
Refers to initial infection after exposure to virus.
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Immunocompromised host
Person with decreased immune system, such as HIV or transplant recipient.
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Intralesional
Refers to injection of medication directly into the lesion being treated.
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Invasive cancer (carcinoma)
Typically refers to the local spread of cancer by infiltration or destruction of adjacent tissue.
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Jarisch-Herxheimer
An allergic reaction in some patients treated for syphilis, particularly in the secondary phase. It induces inflammation in syphilitic tissue, believed to be due to a rapid release of treponemal antigen, causing an allergic reaction in the patient. Most cases are relatively mild and can be conservatively managed with non-steroidal anti-inflammatory agents.
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Keratotic
Lesions on the surface of the epidermis marked by overgrowths of a horny layer.
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LGV
Lymphogranuloma venereum (LGV) is a genital ulcer disease caused by three serovars of Chlamydia trachomatis (L1, L2 & L3). LGV is endemic in India, East & West Africa, the Caribbean and parts of Southeast Asia. The diagnosis is difficult and frequently relies upon serologic testing.
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Metrorrhagia
vaginal bleeding occurring between periods
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"MIC"
Minimal inhibitory concentration (MIC) is the lowest concentration of the drug that prevents growth of a pathogen.
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Mittelschmertz
(Which is German for "middle pain") refers to pain associated with ovulation. Ovulation pain is caused by stimulation of the nerves that innervate the ovary due to the increased size of the ovary and/or bleeding and fluid release from the ruptured follicle.
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Mycoplasma genitalium
Mycoplasma genitalium is an organism which has been associated with acute symptomatic urethritis and may be implicated in some cases of chronic or recurrent NGU.
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Natural history
The progression of an illiness, from acquisition of an organism or beginning of pathology, to its resolution.
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Neisseria gonorrhoeae
The bacteria that causes gonorrhea.
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Non-treponemal tests
Serologic tests for syphilis that measure IgM and IgG antibody directed against a cardiolipin-lecithin-cholesteral antigen. These tests are not specific for T. pallidum, and need to be confirmed with a treponemal test for initial diagnosis of syphilis. Commonly used tests include VDRL (Venereal Disease Research Laboratory), RPR (Rapid Plasma Reagin), TRUST (Toluidine Red Unheated Serum Test) and USR (Unheated Serum Reagin). Sensitivity varies with stage of syphilis infection. False negative non-treponemal test results occur in up to 25% of primary syphilis cases; the non-treponemal tests are almost 100% sensitive in secondary syphilis. They are inexpensive and easy to perform. The result can be quantitated, so that these test results can be used evaluate for possible treatment failure or re-infection.
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Pedunculated
A term to describe something attached by a stem-like or stalk base similar to that of a mushroom, often used to describe skin tags.
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Pelvic inflammatory disease (PID)
Pelvic inflammatory disease comprises a spectrum of upper genital tract inflammation, including any combination of endometritis, salpingitis, tubo-ovarian abscess and pelvic peritonitis. It is generally caused by a contiguous spread of organisms ascending from the cervix via the endometrial cavity to the fallopian tubes and beyond. Such a canalicular spread of organisms seems the most common mechanism for the development of PID.
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Persistent HPV 16 infection
Refers to 2 or more follow-up visits in which HPV 16 was detected among women enrolled in the vaccine trial.
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Plantar warts
Refers to warts on the sole of the foot.
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Polymerase chain reaction (PCR)
A test that amplifies the nucleic acids (DNA or RNA) of several organisms (depending on the assay). Organisms that can be detected in this fashion include Treponema pallidum, Hemophilus ducreyi and herpes simplex. PCR amplifies the DNA present so that a small number of organisms may still be detected. The specificity for T. pallidum is close to 100%.
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Positive predictive value
Positive predictive (PPV) value refers to the probability of disease among persons who have a positive test (or other diagnostic criteria). Negative predictive value (NPV) refers to the probability of no disease among persons who have a negative test (or other diagnostic criteria).
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Primary lesions
The lesions associated with syphilis in the primary stage. These are typically one to two cm ulcers with a raised, indurated margin. They are associated with mild to moderate regional lymphadenopathy and most often seen on genitalia.
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Prophylactic
Refers to something being used to prevent disease or acquisition of infection.
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Prozone reaction
Phenomenon producing a false negative result on a non-treponemal test. This can occur when the antibody-antigen reaction is overwhelmed by excess antibody in the specimen, inhibiting the agglutination reaction. The specimen must be diluted to at least 4 dilutions before a "false negative" because of the prozone reaction will be recognized. A prozone reaction occurs in about 1% of secondary syphilis cases.
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Randomized placebo-controlled clinical trials
Refers to studies in which participants are systematically randomized by person or site to receive a treatment/drug verses a placebo.
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Recurrent respiratory papillomatosis
Refers to a condition in which warts grow on the back of the throat and may cause respiratory compromise, typically caused by HPV types 6 or 11, in either children or young adults. In juvenile onset recurrent respiratory papillomatosis, the infection is vertically transmitted from mother to baby.
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RPR
Rapid Plasma Reagin test, a nontreponemal serological test for syphilis. An antigen containing cardiolipin, lecithin & cholesterol with charcoal is used in this flocculation test. RPR is fast, easy, inexpensive and often used for syphilis screening. It can be quantified by its titer. By itself, it does not confirm the presence of Treponema pallidum.
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Sensitivity
The performance of a test (or other diagnostic criteria) among persons with disease. Ex.: Among 100 persons known to have a disease, how many will have a positive test (or other diagnostic criteria). The probability of a positive test among persons with disease.
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Sensitive urine pregnancy test
sensitive urine pregnancy tests can detect ß-HCG levels as low as 10-25 mIU/ml.
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Secondary lesions
The lesions associated with syphilis in the secondary stage. They are typically large, raised, grey to white lesions found in warm, moist areas such as the mouth or perineum. They generally occur in areas near the primary chancre. The most commonly seen are also referred to as condyloma lata.
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Serofast status
Low-titer positive non-treponemal test result that persists after adequate treatment for syphilis. Serofast status is more likely to occur after treatment for late syphilis than for early syphilis.
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Serovars
A subdivision of a species or subspecies distinguished by a common set of antigens.
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Specificity
The performance of a test (or other diagnostic criteria) among persons without disease. Ex.: Among 100 persons known to have no disease, how many will have a negative test (or other diagnostic criteria). The probability of a negative test among persons without disease.
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Squamous cell carcinoma
Cancer that begins in squamous cells, which are thin, flat cells. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body (e.g. cervix and anus), and the passages of the respiratory and digestive tracts (e.g. esophagus).
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Squamous intraepithelial lesion (SIL)
A general term for the abnormal growth of squamous cells. The changes in the cells are described as low grade (LSIL) or high grade (HSIL), depending on how abnormal the cells are.
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Syphilis
A sexually transmitted infection caused by the spirochete Treponema
pallidum. Infected patients usually present with either dermatologic
findings or asymptomatically (diagnosed only by a reactive syphilis
serology).
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Titer
The concentration of an antibody in solution. Often used in screening tests for various infections and to quantify the response to treatment, especially in syphilis.
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TPPA
Treponema pallidum Particle Agglutination assay. This is a test which detects the presence of treponemal antibodies, and is used to confirm results of a clinical impression or nontreponemal test.
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Treponemal tests
Serologic tests for syphilis that measure antibody (IgM and IgG) directed against T. pallidum. These tests are specific to T. pallidum, and are used to confirm reactive non-treponemal test results for an initial diagnosis of syphilis. Commonly used tests include TP-PA (Treponema pallidum-particle agglutination), FTA-ABS (fluorescent antibody absorption) and Captia EIA (enzyme immunoassay). The test result is qualitative, and once reactive, usually remains so for life. Hence these tests are used to confirm a reactive non-treponemal result in making the diagnosis of syphilis, but are not useful in evaluating response to treatment or possible re-infection.
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Trichomoniasis
A vaginal infection caused by a flagellated anaerobic protozoan, Trichomonas vaginalis. Almost always sexually transmitted; fomite transmission is rare. When present, signs and symptoms consist of "frothy" gray or yellow-green vaginal discharge, pruritus, cervical petechiae ("strawberry cervix" - a classic presentation, but occurs in minority of cases).
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Type-specific serology for HSV
A test to measure antibodies to HSV that can be used in the diagnosis of suspected HSV or to define prior infection with HSV. Type-specific antibodies to surface glycoproteins (gG2 and gG1) are identified to distinguish HSV-2 and HSV-1, respectively. This test represents a more accurate method of seroepidemiologic surveying than was previously available.
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Tzanck preparation
A method for quick diagnosis of herpes simplex virus, using slides with lesion scrapings stained with Giemsa or Wright stain preparations. Infection with either HSV or varicella-zoster virus are indicated by the presence of multinucleated giant cells.
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Uterine or adnexal tenderness, or cervical motion tenderness
Here is how to perform the pelvic examination:
Palpate the cervix, noting its position, shape, consistency, regularity, mobility, and tenderness. Normally, the cervix can be moved somewhat without pain. Palpate the fornices 180º for abnormalities, pain, or other unusual findings (i.e., foreign body, retained tampon).
Place your other hand on the abdomen about midway between the umbilicus and the symphisis pubis. While you elevate the cervix and uterus with your pelvic hand, slowly press your abdominal hand down, trapping the uterus between your two hands. Assess the size, shape, consistency, position, and mobility. Identify any tenderness or masses.
Slide both fingers of your pelvic hand into the anterior fornix and palpate the body of the uterus between your hands. If you are unable to identify the uterus with either of these maneuvers, the uterus may be tipped posteriorly retroverted. In this case, slide your pelvic fingers into the posterior fornix and identify the uterus abutting against your fingers.
Place your abdominal hand on the right lower quadrant, your pelvic hand in the right lateral fornix. Press your abdominal hand in and down, trying to push the adnexal structures toward your pelvic hand. Identify the right ovary or any adjacent adnexal structures between your fingers, if possible, and note their size, shape, consistency, mobility, and tenderness. Repeat the procedure on the left side. Ovaries are normally approximately the size of an almond (<3 cm) and somewhat tender. They are usually palpable in slender, relaxed women, but are difficult or impossible to recognize in others who are obese or poorly relaxed.
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Vaccine
A suspension of infectious agents or some part of them, given for the purpose of establishing resistance to an infectious disease. It stimulates development of specific defensive mechanisms in the body which result in more or less permanent protection against a disease.
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Vaginal pH
The vaginal pH among women of reproductive age with a normal vaginal environment is between 3.8 and 4.2. For determination of vaginal pH, touch pH paper to vaginal wall or to discharge in speculum. Avoid contact with cervical mucus because it has a high pH. Match pH paper to color scale to determine the pH value.
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VDRL
Venereal Disease Research Laboratory test. A relatively easy, fast and inexpensive serologic test used for syphilis screening. It is a slide microflocculation test which measures antibodies and can be used to follow patients' treatment response. It can be quantified by its titer. VDRL does not confirm an infection with Treponema pallidum by itself.
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Virus-like particles (VLP)
Particles often used in the development of vaccines, which are made to resemble true virus with some of the same expressed proteins as the virus, but not capable of causing disease, only an immune response.
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Vulvodynia
Refers to pain on the vulva and may occur after incision is made on the vulva or from infection/inflammation on the vulva.
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