Infectious Diseases II: STI's

Question 1

Sexual partners should also be treated for most STI’s except….

Answer 1

Bacterial vaginosis

Question 2

syphilis

Answer 2

caused by spirochete, treponema pallidum

painless lesion on genitals, mouth or anus

Question 3

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

Answer 3

Pen G Benzathine (Bicillin L-A)

2.4 mil units IM x 1

Question 4

Alternative agents for primary, secondary, early latent (< 1 yr) syphilis

Answer 4

Doxycycline 100 mg BID
Tetracycline 500 mg QID
x 14 days

Question 5

DOC for pregnant pts

Answer 5

Pen G benzathine

If PCN allergy –> desensitize

Question 6

DOC for late latent (> 1 yr), tertiary syphillis

Answer 6

Pen G benzathine 2.4 mil units weekly x 3 weeks

Question 7

Alternative agents for late latent (> 1 yr), tertiary syphillis

Answer 7

Doxycycline 100 mg BID
Tetracycline 500 mg QID
x 28 days

Question 8

DOC for neurosyphilis

Answer 8

Pen G aqueous 3-4 mil units q4h
or continuous infusion 18-24 mil units/day
x10-14 days

Question 9

Alternative tx for neurosyphilis

Answer 9

Pen G procaine 2.4 mil units IM daily + probencid 500 mg QID x 10-14 days

Question 10

DOC for congenital syphilis

Answer 10

Pen G aqueous

Altn: Pen G procaine

Question 11

Gonorrhea

Answer 11

Caused by neisseria gonorrhoeae (Gram -)

Urethral, cervical, rectal, pharyngeal

Question 12

Drug treatment for gonorrhea

Answer 12

Ceftriaxone 250 mg IM x 1
\+
Azithromycin 1 g PO x1
OR
Doxycycline 100 mg BID x 7 days

Question 13

Chlamydia

Answer 13

caused by Chlamydia trachomatis (Gram -)

Question 14

DOC for chlamydia

Answer 14

Azithromycin 1 g x1
OR
DOxycycline 100 mg BID x 7

Question 15

Alternative treatment for chlamydia

Answer 15

Erythromycin
Levofloxacin
Ofloxacin
Amoxicillin 500 mg TID x 7 (used in pregnancy)

Question 16

Bacterial vaginosis

Answer 16

caused by many different organisms
causes “fishy” smell to vaginal secretions
Secretions pH > 4.5

Question 17

Bacterial vaginosis treatment

Answer 17

Metronidazole PO 500 mg BID x 7 days
Metronidazole gel x 5 days
Clindamycin 2% cream x 7 days

Question 18

Trichomoniasis

Answer 18

caused by trichomonas vaginalis (protozoa)

yellow-green vaginal discharge

Question 19

Trichomoniasis treatment

Answer 19

Metronidazole 2 g x1 (altn 500 mg BID x 7)
Tinidazole 2 g x 1

CDC recommends metronidazole during pregnancy, even during 1st trimester