Cervicitis

Question 1

What is the clinical significance of cervicitis?

Answer 1

can ascend and cause endometritis, PID, pathogens can be transmitted to partners, and may cause pregnancy and/or neonatal complications

Question 2

Most common pathogens identified with cervicitis?

Answer 2

chlamydia and gonorrhea

Question 3

Cervicitis is usually asymptomatic but what are common symptoms when present?

Answer 3

Purulent or mucopurulent vaginal discharge and Intermenstrual or postcoital bleeding

Question 4

cardinal finding of acute cervicitis

Answer 4

mucopurulent discharge on the ectocervix and/or exuding from the endocervical canal

Question 5

nonspecific sign suggestive of coexistent PID on physical exam

Answer 5

cervical motion tenderness

Question 6

Diffuse vesicular lesions/ulceration on cervix suggest which pathogen?

Answer 6

HSV

Question 7

punctate hemorrhages (“strawberry cervix”) on the cervix are characteristic of which pathogen?

Answer 7

trichomonas

Question 8

What is next step in evaluation if clinical diagnosis suggests cervicitis based on (1) purulent or mucopurulent cervical exudate and/or (2) sustained endocervical bleeding (friability) easily induced by gently touching the area?

Answer 8

Testing for chlamydia, gonorrhea, bacterial vaginosis and trichomoniasis. Exclude PID with bimanual exam

Question 9

How long should patients and their sex partners should abstain from sexual intercourse?

Answer 9

until treatment has been completed (seven days after a single-dose regimen or after completion of a seven-day regimen)

Question 10

Treatment for gonorrhea cervicitis

Answer 10

Ceftriaxone (Rocephin) 250 mg intramuscularly as a single dose

Question 11

Treatment of chlamydia cervicitis

Answer 11

azithromycin (zithromax) 1 g orally once

Question 12

When should a patient who has been treated for chlamydia or gonorrhea return for repeat testing given high rates of recurrent infection?

Answer 12

three to six months after a diagnosis