Sexually transmitted infections review Flashcards
what STI increases the risk of acquiring HIV if exposed?
Genital herpes
if herpes serology IgG is positive, what should you do?
order a western blot (confirmatory test)
if herpes serology IgG is negative, what should you do?
repeat it in 12 weeks
what HIV test should be ordered for initial screening?
HIV 1/2 Antigen/antibody immunoassay AKA ELISA test
what test should be ordered for SUSPECTED acute HIV infection?
NAT: HIV-1 nucleic acid test
what STI is increasingly common in women?
syphilis
what tests are used to screen syphilis?
RPR test also called EIA CIA
what is the most frequently reported STI in the united states?
chlamydia
what is the first line treatment for chlamydia ?
Doxycycline 100 mg BID for 7 days
what is the first line treatment for gonorrhea?
Ceftriaxone 500 mg IM if less than 330 lbs
Ceftriaxone 1 g IM if over 330 lbs
what is the treatment for trichomonas? for women
Metronidazole 500 mg PO BID for 7 days
what is the treatment for trichomoniasis for men?
Metronidazole 2 gram orally in a single dose
what STI is associated with a positive “chandelier test” ?
pelvic inflammatory disease
what is the treatment for pelvic inflammatory disease?
think of treating gc, chlamydia, and bv
Ceftriaxone 500 mg IM in a single dose PLUS doxycycline 100 mg po bid for 14 days WITH Flagyl 500 mg BID for 14 days
what population are at highest risk for HIV?
HISPANIC men who have sex with men
if a patient has a positive HIV ELISA test, what is the next lab to order?
HIV1/HIV2 antibody differentiation immunoassay (replaces western blot)
clue cells are in reference to what?
bacterial vaginosis
a “strawberry cervix” on exam is related to what sti?
trichomoniasis
what is the recommended treatment for syphilis?
penicillin benzathine (Bicillin) 2.4 million units IM in adults
what is the recommended treatment for syphilis with a penicillin allergy?
doxycycline 100 mg BID for 14 days or Tetracycline 500 mg Po TID for 14 days
what stage of syphilis is this?
Rash that is bilaterally symmetrical, polymorphic, nonpruritic, frequently on soles and palms, and usually persists for 2-6 weeks; then spontaneously resolves
secondary syphilis
what STIs are tested with NAAT?
gonorrhea and chlamydia
what STIs are tested with a wet mount?
Trich, BV, and Candida
Do minors need parental consent if the clinic visit is related to testing or treating STDs and birth control?
No state requires parental consent for STD care
what sti organisms has flagella?
trichomoniasis
what sti organism has spirochete?
syphilis
what is the treatment for chlamydia in a pregnant female? Remember doxycycline is the first line but has teratogenic effects
Azithromycin 1g single dose
what are the high risk HPV oncogenic types?
16 and 18
when is it recommended to give the Gardasil ?
at age 11-12 yrs and only two doses required (6-12 months apart) and for adolescents aged 15 yrs or 26m three doses will be needed at 0, 1-2 months apart, and 6 months.
what is the recommended first line treatment for first episode of herpes outbreak?
valtrex 1 g BID for 7 days
what is the recommended treatment for recurrent episode of herpes outbreak?
valacyclovir 500 mg po two times daily for 3-5 days
