Nephrology ✨

Human immunodeficiency virus(Immunosuppression occurs with the progressive loss of CD4 T-lymphocytes.—-Stage 1 (acute stage):highly infectoius —stage 2 asymptomatic—-stage 3 diagnosed when the CD4 count is less than 200 cells/mm3—-the first diagnostic is serology(antibody againt viral RNA) and the second is western blot———Pharmacologic drug classes include: ✓ Nucleoside reverse transcriptase inhibitors (NRTIs) ✓ non-nucleoside reverse transcriptase inhibitors (NNRTIs_——)

Genital wart (Human papilloma virus infection(Types 6 and 11 are non-oncogenic and are responsible for about 90% of anogenital warts. ▪️ Other subtypes including 16 and 18 account for cervical cancer and other types of anogenital cancer including vulvar, vaginal, anal, and penile cancers—.Giant condyloma acuminatum(سببها نوعين 6 and .,,The goal of treatment is removal of the warts; treatment will not eradicate the infection

Chancroid(Hemophilus ducreyiمهم—anogenital ulceration and lymphadenitis with progression to bubo formation.)

Syphilis (Treponema pallidum, a coiled spiral spirochete—Primary syphilis:The chancre is usually painless, single, and indurated—Secondary syphilis:a maculopapular rash and condyloma Lata—Tertiary Syphilis:35% of individuals with late latent syphilis will develop the late manifestations of syphilis, which include neurosyphilis, cardiovascular syphilis, and gummatous syphilis—screened by VDRL and RPR

Herpes simplex virus (HSV)(latency)Painful papules progressing to vesicles, then ulcer with local lymphadenitis. Possible complications include aseptic meningitis—Cell cultures and PCR of swabs taken from the base of genital ulcer

مين بيعمل Genital ulcer Herpes simplex virus. ▪️ Syphilis. ▪️ Chancroid. ▪️ Donovanosis.

Trichomonas vaginalis (Metronidazole -tinidazole —)flagellated parasite—fishy odour)

فيهم كلهم دور على الباقي اللي بيعمل STDs

Mycoplasma genitalium/recurrent persistent urethritis—NAAT is the only available diagnostic test

Chlamydia Trachomatis/scanty morning discharge—incubation period of 3 – 14 days—NAATs using first-catch urine are the most sensitive test for detecting C. trachomatis infections in men.

Gonococcal urethritis a gram-negative diplococcus that lives intracellularly -In female’s urethritis is often asymptomatic.—incubation period of 3 – 14 days.—NAAT is quicker and more sensitive, so they are the preferred diagnostic tool nowadays.

Local anaesthetics: Lidocaine and/or prilocaine as spray, gel, or cream are effective in delaying ejaculation.

start stop technique. a technique for PE

Lifelong PE: Hyposensitivity of the 5-HT2c and/or hypersensitivity of the 5-HT1a

انواع Lifelong (primary PE): r. Acquired (secondary PE): Variable PE: i. Subjective PE: perceived early ejaculation with normal ejaculation time

Subjective PE:perceived early ejaculation with normal ejaculation time.

premature-ejaculation that always or nearly always occurs prior to or within 1 minute of vaginal penetration (lifelong PE), or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE).

خد بالك ان SSRI زى Dapoxetine و paroxetine و citalopram بيعالجوا premature ejaculation مش erection