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RDS Test 3 > B8.053 Update on Sexually Transmitted Diseases > Flashcards

B8.053 Update on Sexually Transmitted Diseases Flashcards

1
Q

criteria that justify routine screening

A
  1. serious health disorder that can be detected before symptoms develop
  2. treatment more beneficial when begun before symptoms develop
  3. reliable, inexpensive, acceptable screening test
  4. costs of screening are reasonable in relation to anticipated benefits
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2
Q

sites/sources of screening for STDs

A 
cervix
urine
vaginal (self collected)
serum
saliva (HIV)
male urethra
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3
Q

technologies for STD screening

A

antibody response: syphilis
NAAT: chlamydia, HSV
culture: help with resistance panels for gynococci
microscopy

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4
Q

vaccines for STDs

A

HBV
HPV
mayyybe GC (coming)

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5
Q

characterize chlamydia trachomatis

A

gram indeterminate (most closely related to gram -)
unique biphasic life cycle
-elementary bodies transmit the disease
-reticular body infective form (intracellular growth within host cells)

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6
Q

diseases caused by chlamydia

A

urethritis
cervicitis
PID

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7
Q

long term sequelae of chlamydia

A

fallopian tube damage
infertility
ectopic pregnancy

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8
Q

why is chlamydia the silent epidemic

A

most are asymptomatic

don’t need symptoms to still suffer from long term sequelae

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9
Q

how is chlamydia trending in the US?

A

going up

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10
Q

who should be screened for chlamydia

A

women under 25 presenting for a regular office visit

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11
Q

recommended treatment of chlamydia

A

azithromycin 1g PO single dose

doxycycline 100 mg po BID for 7 days

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12
Q

alternative ttx for chlamydia

A

erythromycin 500 mg po QID for 7 days
ofloxacin 300 mg po BID for 7 days
levofloxacin 500 mg po q d for 7 days

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13
Q

does screening help prevent chlamydia associated sequelae?

A

yup

canadian study

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14
Q

what % of women who should be screened for chlamydia actually get screened

A

50ish percent or less

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15
Q

gonorrhea on gram stain

A

gram neg diplococci

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16
Q

gonorrhea discharge

A

white, purulent

women can be asymptomatic

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17
Q

culture medium for gonorrhea

A

thayer-martin
chocolate
look for abx resistance

18
Q

is gonorrhea going up in the US

A

yup

19
Q

what is stressful about treating gonorrhea

A

rapidly develops resistance
when we use one antibiotic a lot, we can’t use it indefinitely
dont want to hit 5% elevated MIC

20
Q

treatment of gonorrhea

A 
ceftriaxone 250 mg in a single IM dose
PLUS
azithyomycin 1 g PO in a single dose
OR
doxycycline 100 mg PO BID for 7 days
21
Q

characterize HPV

A

small DNA virus

>100 types, 20 infect genital tract

22
Q

cancer causing HPV

A

16, 18

23
Q

wart causing HPV

A

6, 11

24
Q

description of HPV genital warts

A

raised, dry
no exudate
not much induration

25
Q

patient applied treatment for genital warts

A

podofilox, imiquimod, or sinecatechins

26
Q

provider applied treatment for genital warts

A

podophyillin
cryotherapy
trichloroacetic acid

27
Q

syphilis primary chancre

A 
8-10 mm sore
indurated
firm
lots of lymphocytes
no exudate "clean"
28
Q

who do you see syphilis chancres on?

A

men

women are usually inside vagina or on cervix, not visualized and asymptomatic

29
Q

secondary syphilis sign

A

palmar, plantar rash

blanches with pressure (vasculitis)

30
Q

what does the increase in congenital syphilis parallel

A

increase in women with primary and secondary syphilis

31
Q

treatment of syphilis

A

benzathine penicillin G

  1. 4 million units IM
    - long acting depo
    - spirochetalcidal level for several weeks
32
Q

traditional syphilis screening sequence

A

RPR > TP-PA

33
Q

reverse syphilis screening sequence

A

EIA or CIA > qualitative RPR > if negative TP-PA

34
Q

guidelines for prevention of congenital syphilis

A

screening
-first prenatal visit, 28 weeks, delivery
-take action on positives
treatment with penicillin
-accept no substitutes; do desensitization for allergies
education

35
Q

STD from most to least prevalent

A 
HPV
HSV2
trichomoniasis
chlamydia
HIV
HBV
gonorrhea
syphilis
36
Q

characterize genital herpes

A

due primarily to HSV2, but genital HSV1 increasing
herpesvirus family (dsDNA, enveloped)
latency and reactivation

37
Q

genital ulcers in herpes

A

multiple
small
painful
serous

38
Q

chanroid genital ulcers

A 
multiple
large
painful
dirty
presents with lymphadenopathy
39
Q

noninfectious genital ulcers

A

lichen planus
Behcet syndrome
Crohn’s disease

40
Q

treatment for first episode of genital herpes

A

acyclovir 400 mg PO 3 times a day
acyclovir 200 mg PO 5 times a day
valacyclovir 1 g BID
-all for 7-10 days

RDS Test 3 (15 decks)

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