Sexually Transmitted Diseases 2 Flashcards
T/F: Women are more affected by syphillis then men
False: Men are more often affected by syphillis then women
What are the stages of syphilis
Primary, secondary, latent, tertiary
When does the primary stage of syphilis occur, what are symptoms of primary syphilis
3 weeks after exposure, single painless ulcer appears but will clear up 2-8 weeks regardless of treatment
When does the secondary stage of syphilis occur, what are the symptoms
4 to 8 weeks after chancre appears/ rash, alopecia, low grade fever, malaise, weight loss, pain in bones and joints
T/F: A patient can receive a latent syphilis infection from a partner and it is found by its significant symptoms
False: Latent syphilis occurs do untreated primary/secondary infection and is usually only found by serological testing
What are the types of latent syphilis infections
Early latent infection:acquired within 12 months of inspection and the patient is still infectious
Late latent infection: acquired over 1 year or for an unknown direction but is no loner infectious
How long does a patient have to have syphillis to be required as teritary syphillis, what are some complication
10-30 years, cardovascular and gummatous lesions
T/F: Neurosyphilis can occur in syphilis patients and can have side effect of meningitis, nerve dysfunction, and stroke
True
What are the two types of serological test for syphilis, if syphilis is eradicated how should the ratio change
RPR and EIA, The RPR should drop by 4 fold
T/F: The higher the RPR titer the more likely someone is infected with syphilis while the EIA will always be positive once infected
True
What type of penicillin is used to treat neurosyphillis
Penicillin G IV
What is the treatment regimen for someone who has primary, secondary, or early latent syphilis/ what if they have penicillin allergy
Benzathine penicillin G 2.4 million units IM for 1 dose with 1.2 million units injected in each butt cheek/ Doxycycline 100 mg twice daily for 14 days
What is the treatment regimen for someone who has late latent or tertiary syphilis
Benzathine penicillin G 2.4 million units IM weekly for three weeks BUT if a patient misses a dose the treatment is started over
T/F: If a patient has late latent or tertiary syphilis with a penicllin allergy they can receive doxcycline 100 mg BID for 14 days
If a patient has late latent or tertiary syphilis with a penicillin allergy they can recieve doxycycline 100 mg BID for 28 days
When should serological evaluation be done to know whether or not all of the syphillis is eradicated
6 and 12 months, 24 months and beyond
What is Jarisch-Herxihemer reaction
acute febrile reaction and other symptoms that occur within the first 48 hours of syphilis treatment
What are important counseling points for syphilis treatment
Jarisch-Herxihemer reaction, consider HIV test, sex partners within the past 90 days should be assessed
What is HSV-1 and HSV-2
oral herpes and genital herpes
What is the primary infection of herpes
5 days after exposure one or more blisters occur and break leaving a PAINFUL sore that takes weeks to healt
T/F: Because herpes is incurable a patient will likely have recurrent infections with prodromal symptoms including burning, itching,and tingling at the site of the infection before the lession occurs in 12-24 hours
True
What cause reactivation of Herpes in patients
Stress, UV light, menses, trauma, illness
What test is used to know if someone has herpes
PCR
What are the medications that should be given for the first Herpes outbreak episode, when should they be used
Acyclovir 400mg TID OR Valacyclovir 1 gram BID for 7 to 10 days, 24 hours within the first outbreak
What are the medications that should be given for episodic herpes treatment
Acyclovir 400 mg TID or Valacyclovir 1 gram BID for 5 days
T/F: Topical treatment for herpes is not viable and offers minimal to no clinical benefit
True
What are benefits of suppresive treatment of herpes, the key diasdvantage
Reduces herpes outbreaks by 70-80%, recurrent outbreaks diminish over time, Decrease HSV transmission/ can result in disease resistance
What are the medications used to suppress herpes
Acyclovir 400 mg BID, Valacyclovir 1 gram every day
What are key counseling points for Herpes
Initiate treatment for recurrent disease at prodromal symptoms or first blister, transmission can occur during asymptomatic periods, no sexual contact when lesions or prodromal symptoms present, suppresive treatment reduces risk of transmission
What are general principles for counseling on STDs
Abstain from sex until partner is treated effectively, risk of acquiring and transmitting HIV, screen for STDs, condom use
