Exam 4 - STIs Flashcards
Congenital/neonatal infections:
______ can be transmitted transplacentally
Syphillis
Congenital/neonatal infections:
Opthalmia neonatorum result from what infections?
chlamydia and gonorrheal infections
Congenital/neonatal infections:
Neurologic impairment caused by what infections?
syphilis or herpes
Congenital/neonatal infections:
which infections are acquired at birth?
C. trachomatis
N. gonorrhoeae
herpes simplex virus
Gonorrhea Presentation:
in Men?
in Women?
Men: urethritis (purulent discharge and dysuria)
Women: usually asymptomatic (urethritis tho too)
Gram stain of Neisseria gonnorheae?
Gram NEGATIVE diplococci
Treating Gonnorheae:
what is the most common coexisting infection?
chlamydia
Treating Gonnorheae:
If negative for chlamydia — still treat for it?
yup still do dual therapy (can help prevent resistance!)
what is the drug of choice gonnorheae?
ceftriaxone
Treating Gonnorheae:
how to treat uncomplicated gonococcal infections?
Ceftriaxone IM one dose
Azithromycin 1 gram PO single dose
(doxycycline BID x7 days if azith allergy!)
High or Low resistance seen in gonorrhoeae?
FQs
high
High or Low resistance seen in gonorrhoeae?
Cefixime
low (getting lower but because being used less..)
High or Low resistance seen in gonorrhoeae?
Ceftriaxone
LOW! why we use it
High or Low resistance seen in gonorrhoeae?
Azithromycin
getting higher
Treating Gonnorheae:
how to treat uncomplicated gonococcal infections if ceftriaxone is not available?
cefixime PO single dose
PLUS
Azith PO single dose
(doxyccline BID x7)
Treating Gonnorheae:
how to treat uncomplicated gonococcal infections AND severe cephalosporin allergy?
Spectinomycin 2 g IM x1
or
Azithromycin 2 grams PO x1 PLUS gentamicin 240 mg IM x1
what bug causes syphilis?
treponema pallidum (spirochete)
Clinical presentation of Syphilis:
Primary Syphilis?
Painless lesion (chancre -- dull/red/macule) it will disappear spontaneously without treatment (in about 3 -6 weeks)
Clinical presentation of Syphilis:
Secondary Syphilis?
Lesions are anywhere on body — PALMS OF HANDS AND SOLES OF FEET
and more systemic sxs
Latent Syphilis:
Divided into ______ latent stage and ______ latent stage
early and late….
Latent Syphilis:
Early or late — person is considered infectious?
early
Latent Syphilis:
Early latent stage is defined as _____ from the onset of infections
1 year
What are signs of Neurosyphilis?
headache
meningismus
increased CSF leukocyte count and protein
Drug of choice for syphilis?
Penicillin G (parenteral)
How to treat primary or secondary or tertiary syphilis?
BENZATHINE PCN IM x 1 dose
How to treat early latent or late latent syphilis of unknown duration?
BENZATHINE PCN IM x 1 dose
How to treat syphilis if penicillin allergic (non neurosyphilis)
Doxycycline BID x 28 days
or tetracycline 500 mg PO QID x 28 days
How to treat neurosyphilis?
IV AQUEOUS PCN!!!! (NOT benzathine IV – ya kill em)
How to treat pregnant patients with syphilis?
PCN!!! only!!
if allergic desensitize them and give them PCN
what is Jarisch-herxheimer rxn
happens 2 - 4 hours after initiating therapy of PCN for syphilis— flu like symptoms
this is not a penicillin allergy!!
Clinical Presentation for Chlamydia:
In males?
In females?
Males: urethritis stuff
Females: usually asymptomatic (can cause PID tho)
________ is the most common cause of neonatal eye infection and afebrile interstitial pneumonia
Chlamydia
Treatment for Chlamydia?
Azithromycin 1 gm PO single dose
Doxy BID x 7
How to treat a pregnant women for Chlamydia?
Azithromycin 1 gm PO single dose
NOT DOXY!! no tetracyclines!!
How to treat Mycoplasma genitalium?
Z-PAK!
(maybe Moxiflox too)
NO DOXY—super low cure rate
Symptoms of a herpes infection?
Flu like symptoms!
Painful or itching etc
Treatment of first clinical episode of genital herpes?
for 7 - 10 days
Acyclovir, Famiclovir, Valacyclovir
Regimen for recurrent herpes??
Best to start in _____ or within ____ day(s)
Acyclovir, Famiclovir, Valacyclovir x 5 days
start in prodrome/start within 1 day of lesion
Do daily suppressive therapy for herpes when patients have recurrences _______ times per year
6 times per year
How to do suppressive therapy for pregnant women with genital herpes??
Start at 36 weeks gestation!
Acyclovir and Valacyclovir
How to treat trichamonas?
metronidazole 2 g PO single dose (not best for dudes tho)
metronidazole 500 mg BID x 7 days
Treatment options for pelvic inflammatory disease?
Clindamycin + Gentamicin (not best tho)
————————
IM/PO option
Ceftriaxone + Doxy +/- Metronidazole
