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IPCS > ID Exam 3 > Flashcards

ID Exam 3 Flashcards

1
Q

Remdesivir MOA

A

Converted to monophosphate and phosphorylated to its active metabolite which interfered with the action of viral RNA causing a decrease in viral RNA production

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2
Q

Remdesivir route

A

IV

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3
Q

Remdesivir ADE

A

Nausea
Elevated ALT and AST

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4
Q

Remdesivir DDIs

A

Chloroquine phosphate or hydroxychloroquine sulfate
CYP 2C8, 2D6, 3A4

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5
Q

Paxlovid MOA

A

Acts as covalent inhibitor binding directly to catalytic cysteine interfering with the replication of SARS

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6
Q

Paxlovid ADME

A

High fat meal increase exposure

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7
Q

Paxlovid side effects

A

Dysgeusia
Diarrhea
HTN
Myalgia

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8
Q

Paxlovid contraindications

A

USE during pregnancy

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9
Q

Paxlovid DDIs

A

Cyp3A4

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10
Q

Molnupiravir MOA

A

Competitive inhibitor for viral RNA dependent RNA polymerase. Indices an antiviral effect via viral error catastrophe

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11
Q

Molnupiravir ADE

A

Maculopapular rash
BBW serious infections possible

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12
Q

Oseltamivir (prodrug) MOA

A

Inhibition of neuraminidase activity leading to viral aggregation at cell surface

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13
Q

Oseltamivir ADME

A

Rapid absorbed
Renal entirely excretion

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14
Q

Oseltamivir DDIs

A

Live attenuated flu vaccine (intranasal)

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15
Q

Zanamivir MOA

A

Inhibitor viral neuraminidase and causes viral aggregation at cell surface and reduced spread of virus within respiratory tract

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16
Q

Zanamivir ADME

A

Deposited in lower respiratory tract and oropharynx

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17
Q

Zanamivir DDIs

A

Love attenuated flu vaccine (intranasal)

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18
Q

Zanamivir ADE

A

Sinusitis, dizziness
Muscle and nerve aches

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19
Q

Amantadine and Rimantadine MOA

A

Inhibit viral replication
Interfere with viral assembly

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20
Q

Amantadine and Rimantadine ADME

A

Well absorbed
Large Vd
Dose adjust in renal patients

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21
Q

Amantadine and Rimantadine ADE

A

CNS/GI
Neurotoxic
Pregnancy category C

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22
Q

Viral infection depend on host cell metabolic process for survival and obligate intracellular what

A

Parasites

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23
Q

What are the 5 sites that could be a drug target

A

Attachment
Entry
Uncoating (replication and gene expression)
Assembly (plus budding if envelope)
Release

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24
Q

Pathogenesis of viral infections

A

Enter through mucosa of respiratory or GI through direct inoculation
Replicate at site of entry
Few spread through neural cells

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25
Q

Pathogenesis: viral shedding, cell injury, clinical illness

A

viral shedding: into environment to perpetuate virus, occurs from body surface
cell injury: destruction of infected cells
clinical illness: organ function, inflammatory response to tissue injury

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26
Q

What is the highest burden population for flu

A

Children younger than 5
Adults 75 years and older

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27
Q

What is the initial side of virus for flu

A

Nasopharyngeal
(Can cause pneumonia)

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28
Q

What is the flu life cycle

A

Adhesion of virus
Endocytosis and fusion
Uncoating
RNA replication
Packaging and Building
Release of progeny virus

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29
Q

What is antigenic drift

A

Small changes and mutation to in genes leading to changes to HA and NA (viral antigens)

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30
Q

What is antigenic shift

A

Abrupt acquisition of new hemagglutinin and neuraminidase by flu
Results in novel flu virus

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31
Q

Flu pathophysiology

A

Person to person from respiratory droplets
Incubation period of 1 and 7 days
Viral shedding can persist for weeks to months

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32
Q

Who is at high risk for flu complications

A

Pregnant women
Children over 6 months
Elderly
People with aphasia
Immunocompromised
Chronic disease pts
Obese
Health care workers

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33
Q

Non pharmacotherapy for flu

A

Sleep
Rest and prevent spread
Fluids

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34
Q

Who to treat for flu

A

Hospital with flu
Outpatient (illness, high risk, under 2 over 65, pregnancy)

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35
Q

Oseltamivir indication, age, dose

A

treatment: any age
prophylaixs: >3 months
dose: 75mg bid x5d w/in 48 hours of symptoms onset
reduction of 1.5 days of improvement
drug of choice in severe flu

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36
Q

Zanamivir indication, age, dose

A

treatment: >7 years
prophylaixs: >5 years
10 mg inhaled bidx5d w/in 48 hours of symptoms onset
reduction of 1.5 days of improvement
not for asthma or COPD

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37
Q

Peramivir indication, age, dose

A

treatment: >2 years
600 mg IVx1 infused 15 min w/in 48 hours of symptoms onset
reduction of 1 day of improvement
only IV

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38
Q

Baloxavir indication, age, dose

A

treatment: >12 yrs
weight based:
40-79 kg 40 mg
>80 kg 80 mg
w/in 48 hours of symptoms onset
reduction of 1.5 days of improvement
no dairy, not for high risk

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39
Q

What is the main genera within the subfamily virology of corona

A

betacoronavirus

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40
Q

What does the alpha and beta CoV genera known to infect? what about gamma and sigma

A

alpha and beta: infect mammals
gamma and sigma: infect birds

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41
Q

What has a higher affinity SARS-CoV-2 spike or SARS-CoV spike

A

SARS-CoV-2 spike

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42
Q

What are the three phases of disease progression of COVID

A

Stage 1: viral response (inhibit viral replication)
Stage 2: pulmonary phase
Stage 3: host response hyperinflammation (immune modulation)

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43
Q

Stages of clinical presentation of COVID

A

stage 1: cold like, smell disorders, lymphopenia, one week from onset
stage 2: respiratory distress and coughing, one week to 10 days
stage 3: ARDS, SIRS/shock, cardiac failure, after 10 days

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44
Q

HSV presentation

A

eye
skin
brain
neonatal transmission

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45
Q

EBV presentation

A

infectious mononucleosis (fever, sore throat)
contagious
no treatment
nasopharyngeal carcinoma and burkitts lymphoma

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46
Q

CMV presentation

A

problem in immunosuppressed host (transplant, HIV)
CNS, retina, lungs
treatment: ganciclovir, valganciclovir
prophylaxis: letermovir, ganciclovir, valganciclovir

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47
Q

Varicella Zoster

A

primary form of infection (contagious)
chickenpox
-rash, malaise, pruritis, scabs
infectious up to 5 days after vesicles crusted

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48
Q

Chicken Pox presentation

A

first exposure to varicella zoster
full body rash
highly contagious
common in children
live virus vaccine

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49
Q

Shingles presentation

A

reactivation of varicella zoster
local rash
post herpetic neuralgia
>50 yo
recombinant vaccine

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50
Q

Chickenpox treatment

A

itching: cut nails, calamine, benadryl, burows soln
fever: apap
virus: acyclovir

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51
Q

Herpes Zoster shingles cause and effects

A

shingles can occur w/out chickenpox
thoracic and lumbar regions most common place
can effect eyelids (could lead to eyesight loss)

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52
Q

Shingles treatment

A

pain precedes eruption of lesions
lesion crust over 3-5 d and resolve in 14 d
painful
acyclovir and valacyclovir treatment started w/in 72 h

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53
Q

How to prevent herpes zoster

A

vaccine
>50 yo
>19 if immunocompromised
can vaccinate if had singles

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54
Q

What is the most common otitis media pathogens

A

strep pneumoniae***
haemophilus influenzae
moraxella catarrhalis

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55
Q

What disease most commonly occurs following a brief, upper respiratory illness, including the “common cold”

A

otitis media

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56
Q

Otitis media may be recognized in kids that do what

A

tug on ears
hearing may be muffles (louder volumes on toys, tv)

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57
Q

Diagnosis of otitis media is dependent upon PE of what

A

bulging tympanic membrane + onset + pain
otorrhea may be present

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58
Q

What are the three indications for antibiotics of otitis media

A

children aged 6 months or older w/ severe symptoms (toxic) pain >48 hr or temp >102.2 F
children aged 6 months or older with otorrhea
children btw 6-23 months w/ bilateral otitis media

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59
Q

First line therapy for otitis media

A

amoxicillin (BID)
augmentin (BID, used if other criteria present)
2nd/3rd gen cephalosporins (PCN allergy)

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60
Q

Therapy for otitis media if failure at 48-72 hours

A

ceftriaxone IM
augmentin (use if not already used)

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61
Q

What is the specific criteria for using augmentin as first line therapy for otitis media

A

recent amoxicillin use w/in 30 days
concurrent purulent conjunctivitis
history of recurrent infections unresponsive to amoxicillin

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62
Q

Duration of treatment for Otitis Media

A

5-10 days
10 days for children <2 or complicated course

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63
Q

The vast majority of sinusitis diagnosis is _____ in nature

A

viral

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64
Q

What is the common pathogens for acute bacterial rhinosinusitis

A

s. pneumoniae***
h. influenzae
m. catarrhalis

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65
Q

The majority of acute bacterial rhinosinusitis cases initiate as a respiratory tract infection what is the pathophysiology

A

respiratory infection causes mucosal inflammation
inflammation allows bacteria to migrate
outflow of sinus cavity becomes impaired

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66
Q

Hallmark symptoms of bacterial rhinosinusitis

A

last for 10 d w/out clinical improvement (pain, pressure)
fever >102.2 F
worsening symptoms (new fever, headache, increase nasal discharge)

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67
Q

First line therapy for acute bacterial rhinosinusitis

A

augmentin (BID)
clindamycin + cephalosporin (TID, PCN allergy)
Levofloxacin (PCN allergy)
Moxifloxacin (PCN allergy)
Doxycyclin (BID, for adults

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68
Q

What are the hospital therapies to use for acute bacterial rhinosinusitis

A

amp/sub
ceftriaxone
levofloxacin

69
Q

Duration of therapy for acute bacterial rhinosinusitis

A

uncomplicated infection: 5-7
children and complicated infection: 10-14

70
Q

What is the most common pathogen and the incubation period for pharyngitis

A

group A strep (GAS)
2-5 days

71
Q

Pharyngitis: GAS symptoms

A

sore throat
painful swallowing
fever
headache, GI
enlarged lymph node
swollen uvula, petechiae, spots on soft palate

72
Q

Pharyngitis: Viral symptoms

A

conjunctivitis
cough

73
Q

First line therapy for pharyngitis

A

pen V (BID), pen G (IM)
amoxicillin (1 qd)
cephalosporins (PCN allergy)
clindamycin (TID, PCN allergy)
macrolides: azithromycin, clarithomycin (PCN allergy)

74
Q

Pharyngitis therapy for eradication of GAS

A

augmentin (TID)
clindamycin (TID)
pen V + rifampin
pen g + rifampin

75
Q

What disease occurs in winter months or in presence of irritating substances (pollution, cig smoke)

A

Bronchitis

76
Q

What are the common pathogens of bronchitis

A

m. pneumoniae***
s. pneumoniae
h. influenzae

77
Q

What is the clinical presentation of acute bronchitis

A

cough***
increase sputum production
fever
nasopharyngeal symptoms

78
Q

What is the treatment for acute bronchitis

A

antipyretics
antitussives (little evidence)
antibiotics (symptoms >4-6 d, immunocompromised, elderly)
- 2nd or 3rd gen ceph + macrolide or doxycycline

79
Q

What disease is classified by chronic cough productive of sputum lasting more than 3 months for 2 consecutive years without an underlying etiology of bronchietasis or tuberculosis

A

Chronic Bronchitis

80
Q

What are the risk factors for Chronic Bronchitis

A

smoking
continuous exposure to airway irritants
recurrent respiratory tract infections in childhood

81
Q

What disease state is classified as an acute viral infection that affects children, peak during winter through spring, and RSV is the main cause

A

bronchiolitis

82
Q

What is the treatment for bronchiolitis

A

supportive care
ribavirin or prophylaxis with RSA immunoglobulin or palivizumab in infants with underlying disease

83
Q

What are the risk factors for CAP

A

> 65 yo
COPD
alcohol/tabacco abuse
asplenia
DM
pulmonary, CV, renal, liver disease

84
Q

What is the diagnostic criteria for CAP

A

chest x-ray**
-cough
- >100.4F
-sputum production
-pleuritic chest pain
+/- microbio data

85
Q

What patients are blood cultures are recommended for CAP

A

inpatients with severe disease
inpatients receiving MRSA/PsA treatment
perviously infected MRSA/PsA
hospitalized and received parenteral antibiotics w/in previous 90 days

86
Q

What are the most common pathogens in CAP

A

s. pneumoniae
h. influenzae
s. aureus

87
Q

What are the most common pathogens in atypical pneumonia

A

m. pneumoniae
c. pneumoniae
l. pneumophila

88
Q

What is CURB-65

A

confusion
urea >7
RR >30
SBP <90 or DBP <60
>65 yo

89
Q

What is the 3 risk groups for CURB-65

A

1: 0-1 criteria, 1.5% death
2: 2 criteria, 9.2% death, admission or outpatient
3: 3-5 criteria, 22%, admission

90
Q

Treatment for CAP in low risk outpatients

A

amox
doxycycline
macrolide (DONT USE)

91
Q

Treatment for CAP for outpatients with risk factors for MRSA or PsA

A

option 1:
augmentin OR cephalosporin
AND macrolide OR doxycycline
option 2:
levofloxacin or moxifloxacin (po)

92
Q

Treatment for non-severe inpatient CAP

A

option 1:
beta lactam + macrolide
option 2:
levofloxacin or moxifloxacin (IV)

93
Q

What is the severe CAP major criteria

A

1 major or 3 or more minor
-septic shock w/ need for vasopressors
-respiratory failure requiring mechanical ventilation

94
Q

Treatment for severe CAP

A

option 1:
beta lactam + macrolide
option 2:
beta lactam + levofloxacin or moxifloxacin (IV)

95
Q

Treatment for cap with prior history of MRSA

A

vanco
linezolid
ceftroline
(NOT dapto)

96
Q

Treatment for cap with prior history of PsA

A

pip-taz
aminoglycoside
carbapenem

97
Q

What is HAP

A

occurs at least 48 hours of inpatient admission but not present at time of admission

98
Q

What is VAP

A

occurs at least 48 hours following endotracheal intubation

99
Q

What are the HAP and VAP risk factors

A

aspiration
COPD, ARDS, coma
antacids, h2ra, ppi
supine position
enteral nutrition, ng tube
re-inubation, trache, pt transport
prior antibiotic exposure
head trauma, ICP monitoring
>60 yo

100
Q

What is the diagnosis for HAP and VAP

A

chest x ray
AND
>100.4 F, leukocytosis, purulent secretions, decline in o2

101
Q

What are the HAP and VAP multidrug resistant (MDR) pathogens

A

PsA
ESBL + kleb and e.coli
serratia sp
acinetobacter sp
stenotrophomonas maltophilia
PCN resistant strep pneumoniae
MRSA

102
Q

What are the VAP and HAP MDR pathogen risk factors

A

prior IV antibiotic use w/in 90 days (both)
septic shock at time of VAP
ARDS preceding VAP
5 or more days hospitalization prior to VAP
acute renal replacement therapy prior to VAP

103
Q

What is the high risk of mortality for VAP and HAP

A

septic shock or need for ventilatory support due to pneumonia

104
Q

What are the MRSA risk factors for VAP and HAP

A

prior IV antibiotic use w/in 90 days
OR
MRSA prevalence >20%

105
Q

HAP treatment for not at risk of mortality, no MRSA risk

A

PsA drugs
pip-taz
cefepime
levofloxacin
imipenem-cilastatin
meropenem

106
Q

HAP treatment for low risk of mortality, MRSA risk factors present

A

PsA drug
AND
vanco or linezolid

107
Q

HAP treatment for high risk mortality, IV antibiotics received in past 90 days (MRSA/MDR risk)

A

Two or more PsA drugs (pip-taz, cefepime, cipro, etc.)
AND
Vanco or linezolid

108
Q

What are the antipseudomonal beta lactams (category A for VAP treatment)

A

pip-taz
cefepime
ceftazidime
imipenem-cilastatin
meropenem
aztreonam

109
Q

What are the antipseudomonal non beta lactams (category B for VAP treatment)

A

cipro
levofloaxcin
genta
tobra
amikacin
colistin
polymyxin B

110
Q

VAP treatment: if patients has no VAP MDR risk factors and <10% gram negative resistance to monotherapy agents

A

group A: antipseudomonal beta lactams
OR
group B: antipseudomonal non beta lactams

111
Q

VAP treatment: pt has no VAP MDR risk factors and >10% gram negative resistance to monotherapy agents

A

group A: antipseudomonal beta lactams
AND
group B: antipseudomonal non beta lactams

112
Q

VAP treatment: if MRSA prevalence >10-20%

A

group A: antipseudomonal beta lactams
AND
group B: antipseudomonal non beta lactams
AND
dapto or linezolid

113
Q

VAP treatment: if MRSA prevalence <10-20%

A

pip-taz
cefepime
levofloxacin
imipenem
meropenem

114
Q

VAP treatment: if patient has a VAP MDR risk factor

A

group A: antipseudomonal beta lactams
AND
group B: antipseudomonal non beta lactams
AND
dapto or linezolid

115
Q

What disease is classified as non-infectious etiology resulting from the introduction of stomach/bile acids into respiratory tract

A

aspiration pneumonia

116
Q

Aspiration pneumonia clinical presentation and treatment

A

mimic bacterial infections, increase fever, increase WBC
NO antibiotics

117
Q

There is no anaerobes in pneumonia, you only consider adding anaerobic coverage if what

A

empyema
pulmonary abscesses evident on exam/imaging

118
Q

Acyclovir and valacyclovir MOA

A

inhibits viral DNA synthesis

119
Q

Acyclovir and valacyclovir ADME

A

valacyclovir has higher bioavailability
crosses placenta
dose adjust in renal patients

120
Q

Acyclovir and valacyclovir ADEs

A

renal insufficiency or neurotoxicity

121
Q

Acyclovir, Valacyclovir, and Famciclovir DDIs

A

probenecid

122
Q

Famciclovir MOA

A

competitive inhibitor of viral DNA polymerase

123
Q

Famciclovir ADME

A

> 90% excreted unchanged in urine
dose adjust in renal patients

124
Q

Famciclovir ADEs

A

elderly - rash, hallucination
topical site reactions

125
Q

Does chlamydia trachomatis infect intracellular or extracellular

A

intracellular
cannot replicate extracellularly
incubation period 7-21 days

126
Q

What are the disnosis tests for Ct and GC

A

NAAT
urogenital
-urine (both)
-vaginal swab (F)
-urethral swab (M)
rectal swab (both)
orophayngeal throat swab (both)

127
Q

What women to screen for Ct and GC

A

annual screen for sexually active women <25yo (highest incidence) and >25 have increased risk
pregnant at first prenatal visit and 3rd trimester
rectal and throat based on reported sexual activity

128
Q

What men to screen for Ct and GC

A

men with women only (low risk, dont screen)
MSM (annual test)

129
Q

Ct men presentation for urethritis, epididymitis, anorectal, oropharyngeal

A

urethritis: asymptomatic
epididymitis: symptoms (scrotal pain)
anorectal: asymptomatic
oropharyngeal: asymptomatic

130
Q

Ct women presentation for cervicitis, urethritis, PID, anorectal, oropharyngeal

A

cervicitis: asymptomatic
urethritis: asymptomatic
PID: symptoms (ab pain, vaginal discharge)
anorectal: asymptomatic
oropharyngeal: asymptomatic

131
Q

Ct treatment for urogenital, rectal, and pharyngeal

A

Doxycycline 100 mg po BID x7
alternatives:
azithromycin 1 g PO x1 (pregnancy)
levofloxacin 500 mg po q24h x7d

132
Q

Chlamydia follow up for urogenital, rectal, and pharyngeal

A

repeat testing at 2 months
retest only for recurrence of symptoms

133
Q

What to do for Ct partners

A

evaluate and treat all w/in last 60 days from onset
last partner >60 d, evaluate and treat
no sex for 7 days after end of treatment

134
Q

What is neisseria gonorrhoeae

A

gram negative diplococci
use cephalosporins
(pen and fluoroquinolones resistance increasing)

135
Q

GC presentation men for urethritis, epididymitis, anorectal, oropharyngeal

A

urethritis: symptoms (discharge)
epididymitis: symptoms (scrotal pain)
anorectal: asymptomatic
oropharyngeal: asymptomatic

136
Q

Ct women presentation for cervicitis, urethritis, PID, anorectal, oropharyngeal

A

cervicitis: asymptomatic
urethritis: asymptomatic
PID: symptoms (ab pain, vaginal discharge)
anorectal: asymptomatic
oropharyngeal: asymptomatic

137
Q

GC alone treatment for urogenital, rectal, or pharyngeal

A

Ceftriaxone 500 mg IM x 1 dose
(use 1000 mg if wt over 150)
alternative:
genta 240 mg IM + azithromycin 2 gm po (use if highly allergic)

138
Q

Treatment for GC when chlamydia is not excluded

A

Ceftriaxone 500 mg IM x1 + doxycycline 100 mg BID x7

139
Q

Treatment for disseminated GC (spread over multiple areas)

A

Ceftriaxone 1 g IM or IV q24h
Ceftotaxime 1 g IV q8h

140
Q

Treatment for GC in pregnancy

A

Ceftriaxone 500 mg IM x1
Chlamydia not excluded: add azithromycin 1000 mg POx1

141
Q

GC follow up

A

urogenital or rectal:
repeat test at 3 months
pharyngeal:
test-of-cure recommended between 7-14d
*only retest for recurrent symptoms

142
Q

GC partners

A

evaluate and treat all partners w/in last 60 days from onset or diagnosis
last partner >60d evaluate and treat
no sex for 7 days after treatment

143
Q

Syphilis main pathogen

A

treponema pallidum

144
Q

Syphilis screening tests

A

non-specific:
-measure IgM/IgG antibodies specific to cellular breakdown products
-VDRL
-RPR
specific:
-measure antibody specific to t. pallidum
-FTA
-TP-PA

145
Q

What is primary syphilis

A

incubation period 10-90 days
chancre appears at site of spirochete penetration
-painless and resolves spontaneously w/in 1-8 wks
-highly infectious

146
Q

What us secondary syphilis

A

develop 4-8 wks after onset of primary
-hematogenous or lymphatic spread resulting in rash
-lymphadenopathy
-malaise, fever, non-specific symptoms
-resolves 4-6 weeks

147
Q

What is latent syphilis

A

positive serologic test
no other signs of disease related to other stages
can develop tertiary disease

148
Q

What is tertiary syphilis: gumms, neurosyphilis, CV

A

affect any organ of body
gummas
-granulomatous lesion often affecting bone, skin, upper resp tract
neurosyphilis
-general paresis, deafness, optic atrophy and blindness, occur at any stage
CV
-aortic insufficiency, aortic aneurysms

149
Q

Treatment for primary, secondary, and early latent (<1 yr) syphilis

A

Benzathine PCN G 2.4 MU IM x1

150
Q

Treatment for tertiary and late latent or unknown duration of latency syphilis

A

Benzathine PCN G 2.4 MU IM qw x3

151
Q

Treatment for neurosyphilis

A

aqueous PCN G 3-4 MU q4h (4-6wk)
continuous infusion possible

152
Q

Treatment for pregnancy syphilis

A

PCN
desensitize to PCN if allergic

153
Q

Syphilis follow up

A

resolution of signs/symptoms
primary and secondary:
-check RPR at 6 and 12 months
latent:
-check RPR 6, 12, 24 months
RPR titel drop >4 fold

154
Q

What to do for partners of syphilis for pri/sec/early latent and latent

A

pri/sec/early latent:
-evaluate and treat all partners w/in 90 days
-last partner >90 days evaluate and treat if positive serology
latent:
evaluate and treat based on serology
no sex 7 days after treatment

155
Q

When to use Doxy PEP (post exposure for chlamydia, gonorrhea, and syphilis)

A

MSM and transgender female who have condomless vaginal, anal, or oral sex
at least one STI in last 12 months

156
Q

What are the issues with doxy PEP

A

well tolerated
counsel for usual ADR and DDI

157
Q

What is the most common cause of genital ulcerations

A

herpes simplex

158
Q

What is herpes simplex primary infection

A

lesion appear 2-14 days after exposure
lesions painful (most pain 7-10 days)
can have systemic symptoms
most contagious when symptoms present
viral shedding when asymptomatic

159
Q

Latency herpes simplex

A

in root of sensory or autonomic nerve ganglia

160
Q

Recurrent herpes simplex

A

emotional or physical stress
duration is shorter than primary
no systemic effects
have tingling, itching, local tenderness
occur 12-24 hours prior to lesion

161
Q

Treatment for herpes simplex initial episode

A

Acyclovir 400 mg po tid
Acyclovir 200 mg po 5x/d
Famciclovir 250 mg po tid
Valacyclovir 1 g po bid x7-10d

162
Q

Treatment for herpes simplex episodic/recurrent

A

Acyclovir 400 tid x5
Acyclovir 800 bid x5
Valacyclovir 500 mg bid x3
Valacyclovir 1 g d x5
Famciclovir 125 mg bid x5
Famciclovir 1000 mg bid x1

163
Q

What is trichomonas vaginalis

A

motile protozoan
more common in women
half asymptomatic
vaginal discharge (malodorous)

164
Q

Treatment for trichomonas

A

Metronidazole 2 g po x1
(pregnant and non-pregnant)

165
Q

Human Papillomavirus (HPV): low risk and high risk

A

non-oncogenic (low):
genital warts, cervical cellular changes
oncogenic:
associated with cancer mainly cervical (majorly associated with 16 and 18)

166
Q

Self applied treatment for HPV genital warts

A

prdofilox 0.5%
imiquimod 5%
sinecarechins 15%

167
Q

Physician applied treatment for HPV genital warts

A

cryotherapy with liquid nitrogen or cyroprobe
podophyllin resin 10-25% in compound tincture of benzoin
trichloroacetic acid (TCA) or bichloroacetic acid (BCA) 80-90%

168
Q

HCP prevention

A

vaccine
(9-valent HPV is only one currently available)
-recommended for 9-26 yo
-shared decision making 27-45yo

IPCS (9 decks)

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