7 - STIs

Question 1

A positive “whiff” test is associated with what type of condition?

Answer 1

• bacterial vaginosis

Question 2

What first line medical treatment of genital warts?

Answer 2

Trichloroacetic acid (TCA)

Question 3

What phase of syphilis is this?

You see a maculo-papular rash on palms, condyloma latum and systemic symptoms. The onset is around 6 months after primary and lasts about 2-6 weeks.

Answer 3

• Secondary syphilis

Question 4

What phase of syphilis is this?

Multiple systems are affected. You see gumma on the skin. Tabes Dorsalis, Argyl-Robertson pupil, blindness, paresis.

Answer 4

Tertiary syphilis

Question 5

A patient presents with a cc of intense pruritus and a low-grade fever and malaise. What is the diagnoses?

Answer 5

• Pubic Louse “crabs”

Question 6

What is the outpatient antibiotic treatment for PID?

Answer 6

• Ceftriaxone 250 mg IM

- AND Doxycycline x 14d

Question 7

What is the cause of bacterial vaginosis?

Answer 7

• lack of hydrogen peroxide producing lactobacilli results in an increase in pH (>4.5)

Question 8

What phase of syphilis is this?

You see painless ulcer with raised edges, almost always single. Highly infectious. It lasts about 3-6 weeks.

Answer 8

• Primary syphilis

Question 9

A patient presents with a cc of intense pruritus that worsens at night. On physical exam you notice a papular rash with linear burrows. What is the diagnoses?

Answer 9

• Scabies

Question 10

Genital warts is more common in what population?

Answer 10

immunocompromised

Question 11

A “strawberry red” cervix is consistent with this infection.

Answer 11

trichomoniasis

Question 12

What are the the treatment options for chlamydia?

Answer 12

• Azithromycin 1g PO x 1d
• OR Doxycycline 100 mg PO x 7d

(also prescribe to partner = EPT)

Question 13

How are chlamydia and gonorrhea diagnosed?

Answer 13

Nucleic Acid Amplification Test (NAAT)

Question 14

How is candidiasis (yeast) treated?

Answer 14

• Fluconazole 150 mg PO x 1

* other vaginal creams also available

Question 15

What virus causes genital herpes?

Answer 15

HSV-1 or HSV-2

Question 16

A patient presents for a regular check-up. She has no symptoms. When performing the pelvic exam you see mucopurulent discharge. What do you suspect the diagnosis could be?

Answer 16

• chlamydia

* asymptomatic*

Question 17

What is usually the main treatment for molluscum contagiosum?

Answer 17

• nothing, allow to regress

Question 18

The hallmark sign of this diagnosis is papular, centrally umbilicated lesions.

Answer 18

molluscum contagiosum

Question 19

A 24 yo female presents to the clinic complaining of a thin discharge and a “fishy” odor. On physical exam you notice a milky vaginal discharge. What do you suspect the diagnoses is?

Answer 19

• bacterial vaginosis

Question 20

What is the treatment for primary initial HSV infection?

Answer 20

• antivirals and topical lidocaine

Question 21

What is the first line treatment for syphilis?

Answer 21

Penicillin G

Question 22

What is the first line treatment for gonorrhea?

Answer 22

• Ceftriaxone 500 mg IM x 1d

- AND Azithromycin unless chlamydia excluded

Question 23

How is trichomoniasis treated?

Answer 23

• metronidazole PO

Question 24

How is bacterial vaginosis treated?

Answer 24

• metronidazole or clindamycin

Question 25

What is the inpatient antibiotic treatment for PID?

Answer 25

- Cefotetan IV - OR Cefoxitin IV - AND Doxycycline PO/IV 14d (treat until 24 hr after clinical improvement)

Question 26

What is the diagnostic criteria that has to be met for PID?

Answer 26

- sexually active + < 25 yo - AND history of STI OR multiple sex partners - AND tenderness on pelvic exam - AND no other etiology can be found

Question 27

The CDC recommends annual screening of all sexually active women < _____ yo.

Answer 27

< 25 yo

Question 28

What is argyll robertson pupil?

Answer 28

- pupils that accomodates but does not react to light

Question 29

A patient presents with vaginal itching and burning. She states last time she had intercourse with her partner it was very painful. On physical exam you notice a thick white discharge that looks like "cottage cheese". What do you suspect the diagnoses is?

Answer 29

Candidiasis (yeast)

Question 30

What is tabes dorsalis?

Answer 30

- loss of propioception, vibration, and fine touch d/t demyelination of the dorsal columns

Question 31

What is the treatment for both scabies or pubic louse?

Answer 31

- permethrin cream (Nix)

Question 32

A patient presents with vaginal itching, burning, and dysuria. On physical exam you notice a frothy, white or grey discharge. What do you suspect the diagnoses is?

Answer 32

Trichomoniasis

Question 33

What is the sequelae of chlamydia or gonorrhea that we try to prevent?

Answer 33

pelvic inflammatory disease

Question 34

A patient presents with PHARYNGITIS. She has no other notable symptoms. When performing the pelvic exam you see mucopurulent discharge. What do you suspect the diagnosis could be?

Answer 34

- Gonorrhea