Sexually Transmitted Infections (STIs) Flashcards
STIs
What are the 5 P’s approach for healthcare providers?
- partners
- practices
- protection from STIs
- past history of STIs
- pregnancy intention
Herpes
What is the presentation of HSV-1 infection?
mouth and lip herpes infection, obtained by non-sexual contact
Herpes
What is the presentation of HSV-2?
genital herpes infection
Herpes
What is the clinical presentation of first clinical episode/outbreak of genital herpes?
- prolonged illness
- possible flu-like symptoms
- genital ulcers, painful located around genitals, mouth, or anus
- neurologic involvement
Herpes
What is the clinical presentation of a recurrent outbreak of genital herpes?
- fewer lesions
- less severe symptoms
- shorter duration of symptoms
Herpes
What is the treatment for the first clinical outbreak of genital herpes?
- acyclovir PO TID x 7-10 days
- famciclovir PO TID x 7-10 days
- valacyclovir PO BID x 7-10 days
Herpes
What is the treatment for eposodic genital herpes?
- acyclovir PO BID x 5 days
- famiciclovir PO BID x 5 days, or 1000mg once
- valacyclovir PO BID x 3 days
Herpes
What is suppressive therapy for genital herpes?
- acyclovir PO BID
- famciclovir PO BID
- valacyclovir PO daily
Herpes
What is the treatment for severe genital herpes?
acyclovir 5-10 mg/kg IV Q8H x 10 days
Syphilis
What are the stages of syphilis?
- primary= single painless ulcer at the site of infection
- secondary= rash, mucocutaneous lesions, lymphadenpathy
- latent= no symptoms; early latent: within 1 year of infection, late latent: > 1 year after infection
- tertiary= manifestations in other organ systems
Syphilis
What is the treatment for primary and secondary syphilis?
benzathine penicillin G IM x 1 dose
Syphilis
What is the treatment for latent syphilis?
- early= benzathine penicillin G IM x 1 dose
- late= benzathine penicillin G IM once weekly for 3 weeks
Syphilis
What is the treatment for tertiary syphilis?
benzathine penicillin G IM once weekly for 3 weeks, if neurosyphilis, ocular syphilis, or otosyphilis= aqueous crystalline penicillin G daily for 10-14 days
Syphilis
What is Jarisch-Herxheimer reaction?
a reaction that occurs with initial treatment (within 2-4 hours) of syphilis that presents with acute fibrile illness, headaches, and myalgias, and may aggrevate lesions
treatment= antipyretics, analgesics, rest
What organisms cn cause urethritis and cervicitis?
- chlamydia trachomatis
- neisseria gonorrhoeae
When may expedited partner therapy (EPT) be implimented?
chlamydia and gonorrhea infections
if allowed by state
Herpes
What are important counseling points for genital herpes?
- education on management of life long condition
- testing of sexual partners
- abstain from sexual acts when ulcers are present
- HIV testing
Syphilis
What are the important counseling points for syphilis?
- inform sexual partners
- management of sexual partners
- follow-up after treatment
- HIV testing
How is chlamydia and gonorrhea diagnosed?
NAATs, gram stain, or cultues
What are the important counseling points of chlamydia or gonorrhea?
- abstain from sexual intercourse until treatment is completed for themselves and partners
- follow-up
- testing for HIV and syphilis
What is the empiric treatment for urethritis and cervicitis?
ceftriaxone 500mg IM once PLUS doxycycline 100mg PO BID x 7 days
What is the targeted treatment for chlamydia trachomatis?
Doxycycline 100mg PO BID x 7 days
What is the targeted treatment for neisseria gonorrhoeae?
ceftriaxone 500mg IM x 1 dose
What is the cause of bacterial vaginosis?
displacement of the vaginal normal flora (lactobacillus spp.) with anaerobic organisms: gardnerella vaginalis, prevotella spp., mobilincus spp., mycoplasma spp. in which the patient presents with white discharge that coats the vaginal walls and “fishy” odor
What are the important counseling points for bacterial vaginosis?
- abstain from sex during treatment
- testing for HIV and other STDs
- follow-up generally unnessary
- treatment of sexual partners not needed typically
What is the treatment for bacterial vaginosis?
- metronidazole
- clindamycin
- secnidazole
- tinidazole
What pathogen is respondsible for trichomoniasis?
trichomonas vaginalis
What are the important counseling points for trichomoniasis?
- follow-up within 3 months
- risk of HIV infection
- other STI testing
- partners of women more likely to be infected
- abstain from sex until treatment is completed for themselves and their partners
- current partners need treatment as well
What is the treatment for trichomoniasis?
- metronidazole
- tinidazole
What pathogen is respondsible for vulvovaginal candidiasis?
candida albicans and other candida spp.
How may vulvovaginal candidiasis be classified?
complicated or uncomplicated
What are the important counseling points for vulvovaginal candidiasis?
- follow-up not recommended
- partners do not need to be tested
- topical treatments may decrease efficacy of latex barriers
What is the clinical presentation of vulvovaginal candidiasis?
- thick, curdy white vaginal discharge
- pruritis
- vaginal soreness
- vulvar edema
- dyspareunia
- dysuria
What is uncomplicated vulvovaginal candidiasis?
sporadic or infrequent infection that is mild and likely to be C. albicans and the patient is immunocompetent
What is the duration of treatment for uncomplicated vulvovaginal candidiasis?
1-14 days
topical or systemic, short couse very effective
What is complicated vulvovaginal candidiasis?
recurrent infections (3 or more episodes within 12 months) or severe infection of non-C. albicans, or infection in women with uncontrolled DM, immunocompromised, or pregnant
What is the duration of treatment for complicated vuvlovaginal candidiasis?
7-14 days
topical or systemic, antifungals may be considered
What topical preparations can be used to treat vulvovaginal candidiasis?
- clotrimazole
- miconazole
- tioconazole
- butoconazole (RX)
- terconazole (RX)
first 3 are OTC products
What are the oral treatment options for vulvovaginal candidiasis?
fluconazole
