Sexually transmitted infections review

Question 1

what STI increases the risk of acquiring HIV if exposed?

Answer 1

Genital herpes

Question 2

if herpes serology IgG is positive, what should you do?

Answer 2

order a western blot (confirmatory test)

Question 3

if herpes serology IgG is negative, what should you do?

Answer 3

repeat it in 12 weeks

Question 4

what HIV test should be ordered for initial screening?

Answer 4

HIV 1/2 Antigen/antibody immunoassay AKA ELISA test

Question 5

what test should be ordered for SUSPECTED acute HIV infection?

Answer 5

NAT: HIV-1 nucleic acid test

Question 6

what STI is increasingly common in women?

Answer 6

syphilis

Question 7

what tests are used to screen syphilis?

Answer 7

RPR test also called EIA CIA

Question 8

what is the most frequently reported STI in the united states?

Answer 8

chlamydia

Question 9

what is the first line treatment for chlamydia ?

Answer 9

Doxycycline 100 mg BID for 7 days

Question 10

what is the first line treatment for gonorrhea?

Answer 10

Ceftriaxone 500 mg IM if less than 330 lbs

Ceftriaxone 1 g IM if over 330 lbs

Question 11

what is the treatment for trichomonas? for women

Answer 11

Metronidazole 500 mg PO BID for 7 days

Question 12

what is the treatment for trichomoniasis for men?

Answer 12

Metronidazole 2 gram orally in a single dose

Question 13

what STI is associated with a positive “chandelier test” ?

Answer 13

pelvic inflammatory disease

Question 14

what is the treatment for pelvic inflammatory disease?
think of treating gc, chlamydia, and bv

Answer 14

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

Question 15

what population are at highest risk for HIV?

Answer 15

HISPANIC men who have sex with men

Question 16

if a patient has a positive HIV ELISA test, what is the next lab to order?

Answer 16

HIV1/HIV2 antibody differentiation immunoassay (replaces western blot)

Question 17

clue cells are in reference to what?

Answer 17

bacterial vaginosis

Question 18

a “strawberry cervix” on exam is related to what sti?

Answer 18

trichomoniasis

Question 19

what is the recommended treatment for syphilis?

Answer 19

penicillin benzathine (Bicillin) 2.4 million units IM in adults

Question 20

what is the recommended treatment for syphilis with a penicillin allergy?

Answer 20

doxycycline 100 mg BID for 14 days or Tetracycline 500 mg Po TID for 14 days

Question 21

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

Answer 21

secondary syphilis

Question 22

what STIs are tested with NAAT?

Answer 22

gonorrhea and chlamydia

Question 23

what STIs are tested with a wet mount?

Answer 23

Trich, BV, and Candida

Question 24

Do minors need parental consent if the clinic visit is related to testing or treating STDs and birth control?

Answer 24

No state requires parental consent for STD care

Question 25

what sti organisms has flagella?

Answer 25

trichomoniasis

Question 26

what sti organism has spirochete?

Answer 26

syphilis

Question 27

what is the treatment for chlamydia in a pregnant female? Remember doxycycline is the first line but has teratogenic effects

Answer 27

Azithromycin 1g single dose

Question 28

what are the high risk HPV oncogenic types?

Answer 28

16 and 18

Question 29

when is it recommended to give the Gardasil ?

Answer 29

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.

Question 30

what is the recommended first line treatment for first episode of herpes outbreak?

Answer 30

valtrex 1 g BID for 7 days

Question 31

what is the recommended treatment for recurrent episode of herpes outbreak?

Answer 31

valacyclovir 500 mg po two times daily for 3-5 days