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Tint: Infectious Diseases > Chapter 153: Sexually Transmitted Disease > Flashcards

Chapter 153: Sexually Transmitted Disease Flashcards

1
Q

What consists of Reiter’s syndrome

A
  • urethritis
  • Conjunctivitis
  • rash
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2
Q

when to consider urethral chlamydial infection as differential diagnosis

A

(+) sterile pyuria

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3
Q

preferred test for diagnosing Clamydia

A

Nucleic acid amplification testing

*Encourage women to be retested approximately 3 months after treatment because of high incidence of recurrence

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4
Q

Treatment for Chlamydia

A

single-dose azithromycin 1 gram PO OR doxycycline 100mg 2x/day for 7 days

*Azithromycin is safe for pregnant women
*Amoxicillin is safe alternative in pregnancy
*Refer partners for testing and treatment if there was sexual contact in the last 60 days
*avoid sexual contact until 7 days have elapsed after completion of antibiotic treatment and their symptoms resolved

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5
Q

Second most commonly reported STI

A

Gonorrhea (caused by Neisseria gonorrhea) - gram-negative diplococcus

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6
Q

Most common presenting symptoms of Gonorrhea in men

A
  • Dysuria
  • profuse, purulent penile discharge
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7
Q

Signs and symptoms of disseminated gonococcal infection

A
  • petechial or pustular acral skin lesions on an erythematous base
  • asymmetric arthralgias
  • tenosynovitis/septic arthritis
  • fever/general malaise
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8
Q

gram stain result for gonorrhea

A

In men, a Gram stain of urethral secretions that demonstrates polymorphonuclear leukocytes with the classic intracellular diplococci confirms the diagnosis

*not recommended as screening tool. absence of this finding is not sufficient to rule out the gonococcal infection

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9
Q

Treatment for Gonorrhea

A

dual therapy :
1) Ceftriaxone 250mg IM
PLUS
2) Azithromycin 1 gram PO

*Disseminated gonorrhea: higher doses of ceftriaxone - 1 gram IM or IV every 24 hours for 1 to 2 days FOLLOWED BY Cefixime 400mg PO 2x/day for minimum of 1 week

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10
Q

nongonococcal urethritis is usually caused by

A

Chlamydia trachomatis

Others: Ureaplasma urealyticum, Mycoplasma genitalium, Trichomonas vaginalis, herpes simplex virus, and adenovirus

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11
Q

most sensitive and specific test for Trichomoniasis

A

Culture

*wet-mount microscopy - poor sensitivity

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12
Q

Treatment for Trichomonas infection

A

Metronidazole, 2 grams PO in a single dose or 500 milligrams PO twice daily for 7 days

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13
Q

Patients must avoid alcohol when taking metronidazole because of what reaction?

A

disulfiram-like reaction

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14
Q

Drug of choice for treating pregnant patients with Trichomonas

A

Metronidazole 2g single dose

*some avoid oral treatment in first trimester

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15
Q

Causative agent for Syphilis

A

Treponema pallidum

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16
Q

Stage of infection in syphilis characterized by absence of clinical manifestations but positive serologic testing

A

Latent syphilis

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17
Q

Stage of infection in syphilis: painless chancre with indurated borders on the penis which resolves spontaneously

A

Primary syphilis

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18
Q

Stage of infection in syphilis: characterized by rash and lymphadenopathy; non specific symptoms; resolves spontaneously

A

Secondary syphilis

19
Q

Stage of infection in syphilis: involvement of the nervous and cardiovascular systems, with widespread granulomatous lesions (gummata)

A

Tertiary syphilis

20
Q

TRUE OR FALSE: Diagnostic test for T. pallidum is culture

A

FALSE: T. pallidum cannot be cultured in the laboratory, and there is no single optimal test

*Direct visualization of the organism using darkfield microscopy is diagnostic however, failure to visualize the organism does not exclude syphilis
*VDRL and rapid plasma reagin tests -screening tests and also, once diagnosis is made, to assess disease activity and response to treatment

21
Q

non specific antibodies released as a result of Trichomonas infection

A

Cardiolipin

*for secondary syphilis, nontreponemal antibody tests are nearly 100% sensitive with high specificity

22
Q

TRUE OR FALSE: Patients who develop disease and have a reactive result on a specific treponemal antibody test will have a reactive test result for life regardless of disease activity or treatment

A

TRUE

23
Q

treatment for Syphilis

A

Primary and secondary: Penicillin G benzathine 2.4 million units IM in a single dose
*Doxycycline 2x/day for 2 weeks if allergic to penicillin

Tertiary: Penicillin G benzathine 2.4 million units IM weekly for 3 weeks

*follow all patients for repeat serologic testing at 6 and 12 months

24
Q

TRUE OR FALSE: Pregnant women should be treated with parenteral penicillin G; if allergic, medication should be discontinued and proceed with alternative medication

A

FALSE: Pregnant women should be treated with parenteral penicillin G; if allergic, they should be desensitized and then given this medication

25
Q

characterized by an acute febrile reaction associated with headache and myalgias seen in treatment of early syphilis within the first 24 hours after treatment of Syphilis

A

Jarisch-Herxheimer reaction

26
Q

TRUE or FALSE: Treatment for HSV is curative

A

Treatment shortens the duration of outbreaks but is not curative.

Antiviral medications decrease the time until all lesions are crusted and healed, decrease pain and constitutional symptoms, and decrease the period of viral shedding by several days

27
Q

Treatment for first clinical episode genital herpes

A

Treat the first clinical episode of genital herpes
- Acyclovir, 400 milligrams PO three times daily × 7–10 d
- OR Acyclovir, 200 milligrams PO five times daily × 7–10 d
- Valacyclovir, 1 gram PO two times daily × 7–10d
- Famciclovir, 250 milligrams PO three times daily × 7–10 d

28
Q

treatment for HSV proctitis or oral infections

A

use higher doses: (acyclovir, 400 milligrams five times a day for 7 to 10 days)

  • for hospitalized patients: acyclovir, 5 to 10 milligrams/kg IV every 8 hours, for at least 2 days before transitioning to oral therapy
29
Q

Treatment for episodic recurrent infection

A
  • Acyclovir, 400 milligrams orally twice a day for 5 days
  • OR Valacyclovir 500-1000 milligrams orally once a day (500 milligrams may not be as effective as 1000)
  • OR Famciclovir 250 milligrams orally twice a day
30
Q

disease characterized by painful genital ulcers and lymphadenitis that is caused by the pleomorphic gram-negative bacillus Haemophilus ducreyi

A

Chancroid

31
Q

treatment for Chancroid

A
  • Azithromycin 1 gram PO single dose OR (Pregnant)
  • Ceftriaxone 250 mg single dose Or (pregnant)
  • Ciprofloxacin 500 mg IM for 3 days OR
  • Erythromycin base 500mg PO 3x/day for 7 days

*Azithromycin and Ceftriaxone used in patients without HIV, ciprofloxacin as alternative

32
Q

causative agent for Lymphogranuloma venerum

A

Chlamydia trachomatis (L1, L2, L3)

33
Q

groove sign (Scarring of inguinal masses that may cause linear depressions parallel to the inguinal ligament) is seen in what disease

A

Lymphogranuloma venerum

34
Q

TRUE or FALSE: Diagnosis of Lymphogranuloma venerum is based on clinical suspicion, epidemiologic data, and exclusion of other causes

A

TRUE

35
Q

treatment for Lymphogranuloma venerum

A

Doxycycline, 100 milligrams PO two times daily × 21 d

  • Alternative erythromycin base
36
Q

causative agent for Granuloma inguinale (donovanosis)

A

Klebsiella granulomatis

37
Q

Painless, beefy red, bleeding ulcers

A

Granuloma inguinale (donovanosis)

38
Q

Treatment of choice for Granuloma inguinale (donovanosis)

A

Azithromycin 1 gram PO weekly or 500 mg PO daily for at least 3 weeks and until all lesions have healed

alt: Doxycycline, ciprofloxacin, erythromycin base, and trimethoprim-sulfamethoxazole

CI in pregnancy: Doxycycline, ciprofloxacin, and sulfonamides are contraindicated in pregnancy

39
Q

oncogenic, high-risk sub types of HPV

A

HPV types 16 and 18 - cervical, vulvar, penile, anal, and oropharyngeal cancers

40
Q

non oncogenic subtypes of HPV

A

types 6 and 11 - cause genital warts

41
Q

TURE or FALSE: Diagnosis for HPV is culture

A

FALSE: clinical

42
Q

most common method of transmission of HIV worldwide

A

Sex with an infected partner (male-to-male sexual contact accounts for 78% of new infections)

43
Q

pearly, umbilicated papules, which may be scattered or in clusters

A

Molluscum contagiosum

Tint: Infectious Diseases (5 decks)

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