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
