Office GYN

Question 1

What is the recommended treatment for Gonorrhea?

Answer 1

Ceftriaxone 500 mg IM x 1

increase to 1g if > 150 kg

Question 2

What is the first line treatment for chlamydia?

Answer 2

Doxycycline 100 mg bid x 7 days (TOC 3 months)

Pregnancy: Azithromycin 1g PO x 1 (TOC 3-4 weeks)

Consider concurrent gonorrhea treatment if it hasn’t been ruled out and at high risk

Question 3

What is the treatment for trichomonas?

Answer 3

Metronidazole 500 mg PO bid x 7 days

Recommend TOC in 3 months

Question 4

What is the outpatient treatment regimen for PID?

Answer 4

Damaged My Cervix

Doxycycline 100 mg PO bid x 14 days
Metronidazole 500 mg PO bid x 14 days
Ceftriaxone 500 mg IM x 1

Question 5

What is the inpatient treatment regimen for PID?

Answer 5

Damaged My Cervix

Doxycycline 100 mg PO or IV q12h
Metronidazole 500 mg PO or IV q12h
Ceftriaxone 1 g IV q 24h

Question 6

Lymphogranuloma venerum

1. How does it present?
2. What is the diagnostic test?
3. What is the treatment?

Answer 6

1. Presentation:
   - painless non-indurated ulcer at site of infection
   - inguinal bubo
   - cervicitis, urethritis
2. Diagnostic test: NAAT of lesion (test for Chlamydia trachomatis)
3. Treatment
   - Doxycycline 100 mg PO bid x 21 days

Question 7

Granuloma Inguinale

1. What is the causative organism?
2. How does it present?
3. What is the diagnostic test?
4. What is the treatment?

Answer 7

1. Klebsiella granulomatis
2. Presentation
   - painless nodule/papule –> beefy red, vascular ulcer
   - subcutaneous granulomas (“pseudobuboes”)
   - NO lymphadenopathy
3. Clinical diagnosis
4. Azithromycin 1g q week until all lesions completely healed (at least 3 weeks)