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PHM 603 Immunology Therapeutics Week 7 > Sexually Transmitted Infections > Flashcards

Sexually Transmitted Infections Flashcards

1
Q

Syphilis is more common in _____________________ than ___________________

A

Men; Women

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2
Q

Which parasite causes syphilis?

A

Spirochete Treponema pallidum (Tree-po-ne-ma pallidum)

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3
Q

How is syphilis transmitted?

A

By direct mucocusol contact

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4
Q

Characteristics of the primary stage of Syphilis

A

-Chancre (a painless ulcer) at site of inoculation: penis, vagina, anus, rectum, lips, or in the mouth
-Symptomatic, or completely asymptomatic
-30% to 40% of primary cases are diagnosed during this stage

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5
Q

Characteristics of the secondary stage of syphilis

A

-25% of patients
-Occurs w/in 6 months
-Hematogenous dissemination = 75%
-Presentation: rash, fatigue, malaise, sore throat, lymphadenopathy, fever, organ involvement

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6
Q

Characteristics of the third stage of syphilis

A

Early Latency:
-Occurs w/in 1 year (CDC) or 2 years (WHO)
-Asymptomatic

Late Latency (formerly “tertiary”):
-Progressive organ involvement:
-CV complications
- Gummoatous lesions
-Neurosyphilis of brain and spinal cord

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7
Q

When should asymptomatic syphilis patients be screened?

A

-When there is high risk factor for acquisition and transmission such as in cases of pregnancy

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8
Q

What are the 2 presumptive diagnostics tests used in syphilis for symptomatic pts?

A
  • Treponemal: fluorescent treponemal antibody and T. pallidum particle agglutination
  • Nontreponemal: Venereal Disease Research Laboratory (VDRL) or Rapid Plasma Reagin (RPR)
    —Also used for disease monitoring
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9
Q

Primary and Secondary syphilis treatment for adults

A

Benzathine penicillin G 2.4 million units IM single dose

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10
Q

Neurosyphilis and ocular syphilis treatment for adults

A

Aqueous crystalline penicillin G 18-24 million units IV daily (3-4 million units Q4H or continuous infusion) for 10-14 days
OR
Aqueous procaine penicillin G 2.4 million units IM QD plus probenecid 500mg PO QID both for 10-14 days

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11
Q

Early latent syphilis treatment for adults

A

Benzathine penicillin G 2.4 million units IM single dose

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12
Q

Late latent or tertiary with normal CSF syphilis treatment for adults

A

Benzathine penicillin G 2.4 million
units IM once a week for 3 successive weeks

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13
Q

Syphillis treatment for children

A

Children with primary, secondary, or latent infection —> dose of benzathine penicillin G 50,000 units/kg

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14
Q

In women, C. trachomatis commonly affects the cervix. What are the characteristics of it?

A
  • 75% asymptomatic
  • 50% endometritis
  • Some Urethritis, PID
  • Cervicitis: vaginal discharge, abnormal vaginal bleeding, purulent endocervical discharge, pain, and minor bleeding
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15
Q

In men, C. trachomatis is a common cause of nongonococcal urethritis. What are the characteristics of it?

A
  • Majority are asymptomatic
  • If symptoms: mucoid or watery urethral discharge and dysuria.
  • Possible cause of epididymis or prostatitis
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16
Q

Chlamydia is more common in _____________________ than ________________

A

Women; Men

17
Q

Recommended Chlamydia treatment

A

Recommended Chlamydia treatment

18
Q

Alternative Chlamydia treatment

A
  • Azithromycin 1g PO x 1
  • Levofloxacin 500mg PO QD x 7 days
19
Q

Pregnancy Chlamydia treatment

A

Azithromycin 1gm PO x 1 or Amoxicillin 500 mg PO TID x 7d

20
Q

(T/F) Some gonorrhea is asymptomatic.

A

True

21
Q

(T/F) Gonorrhea symptoms appear in 5 days.

A

False, they appear in 10 days

22
Q

What are the characteristics of the presentation of gonorrhea? (4)

A

Urethritis, cervicitis, pharyngitis and PID

23
Q

Untreated gonorrhea can lead to:

A

-Bacteremia, Arthritis (tenosynovitis or purulent arthritis) and meningitis

24
Q

Currently, gonorrhea rates are higher in __________________ than _____________________

A

Men; women

25
Q

Recommended Gonorrhea treatment

A

Ceftriaxone 250mg IM x1

26
Q

Alternative Gonorrhea treatment if Ceftriaxone is unavailable

A

Cefixime 800mg PO x1

27
Q

Less preferred Gonorrhea treatment

A

-Cefotaxime 500 mg IM PLUS Azithromycin 1g orally x 1
-Cefoxitin 2 g IM PLUS Azithromycin 1 g orally x 1

28
Q

Gonorrhea treatment if the patient has PCN allergy

A

-Azithromycin 2g PO x1 PLUS Gentamicin 240mg IM x1

29
Q

Gonorrhea treatment during pregnancy

A

-Ceftriaxone 250 mg IM x1 PLUS Azithromycin

30
Q

Disseminated gonorrhea infection treatment

A

-Ceftriaxone 1g IM or IV Q24h > 7days then PO Cefixime 400mg BID PLUS PO Azithromycin 1g x1

31
Q

Characteristics of PID

A

-Medically Urgent
—Up to 20% mortality with treatment
—High birth complications
-Risk with any STI

32
Q

What is expedited partner therapy?

A

-Expedited Partner Therapy is a practice that allows health care providers to provide a patient with either antibiotics or a written prescription, intended for the patients’ sexual partner(s)
-In New York State, EPT is used for treatment of exposure to Chlamydia trachomatis infection
-EPT can not be used as an option to treat other sexually transmitted diseases (STDs). It can not be considered for treatment of exposure to chlamydia when your patient is also infected with gonorrhea, syphlis and/or HIV

33
Q

What is the preferred EPT treatment of sexual partners of patients with chlamydia, but not gonorrhea?

A

A single dose of 1g Azithromycin orally

34
Q

What is the preferred EPT treatment of sexual partners of patients with gonorrhea regardless of chlamydia?

A

-Cefixime (Suprax) 400mg orally in a single dose plus Azithromycin (Zithromax) 1g orally in a single dose

35
Q

Proper dispensing protocol for EPT

A

-The medication for EPT may be dispensed or prescribed
-The preferred method is dispensing in a unit-use dose as part of a partner packet that includes medication, informational materials, and a clinic referral
-If dispensing is not an option, prescriptions can be provided in a partner packet instead of medication

36
Q

If a prescription is provided for EPT:

A

-Individual prescriptions are given for each partner
-The prescription should be made out in the partner’s name, if possible
-If the partner’s name is unknown, the prescription is made out to “Expedited Partner Therapy”
—In this instance, use January 1st of the current year as the date-of-birth

37
Q

Chylamida and Gonorrhea Diagnosis and Screening

A

-Any sexually active individual with signs and symptoms
-NAATs (nucleic acid amplification tests) from infection site
—Can be taken by patient or provider
-N. gonorrhoeae causes similar clinical syndromes as C. trachomatis and also coexists in a significant proportion of patients. Thus, any testing for C. trachomatis should also prompt testing for N. gonorrhoeae

PHM 603 Immunology Therapeutics Week 7 (2 decks)

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