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Oral board studying Prep book > Office- Infections & antibiotics, Syphillis > Flashcards

Office- Infections & antibiotics, Syphillis Flashcards

1
Q

What is the treatment for gonorrhea?

A

Ceftriaxone 500mg IM

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2
Q

What is the treatment for chlamydia?

A

Doxycycline 100mg BID for 7 days

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3
Q

What is the treatment for trichomonas?

A

flatly 500mg BID for 7days

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4
Q

What is the treatment for endometritis/PID outpatient?

A

Ceftriaxone 500mg IM + doxycycline 100mg BID for 14 days + flagyl 500mg BID for 14 days

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5
Q

What is the treatment for endometritis/PID inpatient?

A

Ceftriaxone 1g q 24hrs + doxycycline 100mg BID + flagyl 500mg BID
or
Cefoxitin 2g q6hr + doxy
or
Cefotetan 2g q12hr + doxy

Send home to complete 14 day course of doxy and flagyl

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6
Q

What is the treatment for BV infection?

A

Flagyl 500mg BID for 7 days
Metrogel for 5 days
Clindamycin cream 5gm x 7 days intravaginally

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7
Q

What is the treatment for UTI?

A

Bactrim 100/800mg BID for 3 days
or
Macrobid 100mg BID for 7 days
or
Fosfomycin 3gm x 1

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8
Q

What is the treatment for pyelonephritis?

A

Ceftriaxone 1gm IV q24hrs, then po meds for 7-10 days

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9
Q

What is the treatment for primary syphillis?

A

Benzathine penicillin 2.4mil IM x 1

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10
Q

What is the treatment for unknown syphillis?

A

Benzathine penicillin 2.4mil u IM week x 3 weeks

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11
Q

What is the criteria to diagnose PID?

A

Lower abdominal pain/pelvic pain in a sexually active female and 1 major criteria

Cervical motion tenderness
Uterine tenderness
Adnexal tenderness

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12
Q

What are minor or supporting evidence for PID diagnosis?

A

Fever >38
Mucopurulent discharge
Positive GC/Chlamydia
Gram + diplococci on gram stain
WBC count >10
elevated C reactive protein
Elevated ESR
WBC on wet prep

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13
Q

When do you give inpatient management for PID?

A

Cannot excluded surgical emergencies
Pregnant
No response to outpatient therapy
Patient unable to follow or tolerate outpatient regime
Patient has severe illness, N/V, high fever
TOA

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14
Q

What is the potential longterm sequela of PID?

A

Chronic pelvic pain
Infertility
Increased risk of ectopic pregnancy

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15
Q

What is the presentation for primary syphillis?

A

Cold painless ulcer with clear margins and punched out crater like appearance

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16
Q

What is the presentation for secondary syphillis?

A

Condylomata lata
Maculopapular rash (torso, palms, soles)

17
Q

What is the presentation for tertiary syphillis?

A

Lesions (Gumma, cardiac lesion)
Tabes dorsalis
Argyll Robinson pupil

18
Q

What is the incubation period for primary syphillis?

A

Days to weeks

19
Q

What is the incubation period for secondary syphillis?

A

Weeks to months

20
Q

What is the incubation period for tertiary syphillis?

A

years

21
Q

What is the screening test for syphillis?

A

VDRL
STS
RPR

22
Q

What is the confirmatory test for syphillis?

A

FTA antibody
TPHA
TPI

23
Q

What are the causes of a false positive RPR?

A

Autoimmune disease
Small pox vaccination
Malaria
Mycoplasma pneumonia
Aging

24
Q

What happens to the screening test after treatment for syphillis?

A

Typically return normal but can remain positive for life

25
Q

What happens to the confirmatory test after treatment for syphillis?

A

Remain positive for life

26
Q

What is the treatment for syphillis If there is a PCN allergy?

A

Erythromycin unless pregnant then desensitize

27
Q

What causes syphillis?

A

Infection with treponema palladium

28
Q

What causes chancroid?

A

Infection with hemophilus ducreyi

29
Q

What is the difference between a chancroid and primary syphillis ulcer?

A

Chancroid has multiple lesions
Lesions are painful
Lymph nodes are painful
lesion is hot
Vague margins

30
Q

What is the differential for a vulvar ulcer?

A
  1. HSV
  2. Syphilis
  3. Chancroid
  4. LGV
  5. Granuloma inguinale
  6. Bechets
  7. Vulvar carcinoma
31
Q

What is the management for bartholin abscess?

A

Incision and drainage
word catheter 4-6 weeks

32
Q

When should you biopsy or excise the gland in case of bartholin abscess?

A

Patient >40 years old
Recurrent cysts or infections

33
Q

What are the alternative treatments for bacterial vaginosis?

A

Clindamycin 300mg PO BID for 7 days
Clindamycin ovules 100mg intravaginally for 3 days
Secnidazole 2g x 1 dose
Tinidazole 2g PO daily for 2 days
Tinidazole 1g PO daily for 5 days

34
Q

What is the treatment for cervicitis?

A

Recommended: doxycylcine 100mg BID for 7 days

Alternative: Azithromycin 1g PO x 1 dose

35
Q

What is the alternative treatment for Chlamydia infection in adults and adolescents?

A

Azithromycin 1g PO x 1 dose
Levofloxacin 500mg daily for 7 days

36
Q

What is the treatment for chlamydia in pregnancy?

A

Recommended: Azithromycin 1g PO x 1 dose

Alternative: Amoxicillin 500mg PO TID for 7 days

37
Q

What is the alternative treatment for gonorrhea infection?

A

If a allergy: Gentamicin 240mg IM + azithromycin 2g PO x 1 dose

If not available: Cefixime 800mg x 1 dose

38
Q

What is the alternative treatment for trichomonas?

A

Tinidazole 2g PO x 1 dose

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