IC18 STD Flashcards
Which STDs can be spread through pregnancy? (2)
Syphilis and HIV
Which STDs can be spread through childbirth? (3)
Chlamydia, gonorrhea, herpes
(remember, childbirth - CGH)
Which STDs can be spread through breastfeeding? (1)
HIV
How can gonorrhea be tested for? (3)
Gram stain of genital discharge
Culture
NAAT
What are the symptoms of gonorrhea and chlamydia? (3)
purulent genital discharge, dysuria, frequency
same for chlamydia but milder
What are possible complications if gonorrhea or chlamydia is left untreated?
General: disseminated disease
Men: epididymitis, prostatitis, urethral stricture, pelvic inflammatory disease
Women: ectopic pregnancy, infertility
What is the first line treatment for gonorrhea? (2)
IM Ceftriaxone 500mg single dose (1g if above 150kg) (with)
PO Doxycycline 100mg BD x 7 days (to cover for chlamydia)
What is the alternative treatment for gonorrhea if ceftriaxone is not available?
IM Gentamicin 240mg single dose (with)
PO Azithromycin 2g single dose
How is chlamydia diagnosed? (1)
NAAT
What is the first line treatment for chlamydia?
PO Doxycycline 100mg x 7 days
What are alternatives in chlamydia treatment? (2)
PO Azithromycin 1g single dose
PO Levofloxacin 500mg OD x 7 days
Should test of cure be done for gonorrhea?
Yes, in 14 days
Should test of cure be done for chlamydia?
No, unless the patient is pregnant, non-adherent or if symptoms persist
How is syphilis diagnosed?
Darkfield microscopy of exudates from lesions
What are the two treponemal tests
TPHA and TPPA
What is the treponemal test used for?
Diagnosis
What are the two non-treponemal tests?
VDRL and RPR
What is the non-treponemal test used for?
It is used as a screening tool or to confirm infection
Which test is more specific, treponemal or non-treponemal?
Treponemal
What are treatment options for primary, secondary or early latent syphillis? (2)
IM Benzathine Penicillin G 2.4 MU single dose
PO Doxycycline 100mg BD x 14 days
What are treatment options for tertiary or late latent syphillis? (2)
IM Benzathine Penicillin G 2.4 MU o.w. x 3 wks
PO Doxycycline 100mg BD x 28 days
What are treatment options for neurosyphilis? (3)
IV/IM Ceftriaxone 2g OD x 10-14 days
IV Crystalline Penicillin G 3-4 MU q4h x 10-14 days
IM Procaine Penicillin G 2.4 MU OD (with) PO Probenecid 500mg QDS x 10-14 days
How often should non-treponemal tests be repeated?
6, 12, 24 months
What should be assessed for treatment success in syphilis?
VDRL or RPR
Titre decreasing by at least 4 fold
(ie. 1:64 to 1:16)
How often should CSF cultures be repeated for neurosyphilis?
6 months until CSF normal
How does herpes present? (4)
Multiple painful lesions or vesicles, local itching, tender lymphadenopathy, flu-like symptoms