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Therapeutics 3 > Sexually Transmitted Infections (STIs) > Flashcards

Sexually Transmitted Infections (STIs) Flashcards

1
Q

STIs

What are the 5 P’s approach for healthcare providers?

A
  • partners
  • practices
  • protection from STIs
  • past history of STIs
  • pregnancy intention
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2
Q

Herpes

What is the presentation of HSV-1 infection?

A

mouth and lip herpes infection, obtained by non-sexual contact

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3
Q

Herpes

What is the presentation of HSV-2?

A

genital herpes infection

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4
Q

Herpes

What is the clinical presentation of first clinical episode/outbreak of genital herpes?

A
  • prolonged illness
  • possible flu-like symptoms
  • genital ulcers, painful located around genitals, mouth, or anus
  • neurologic involvement
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5
Q

Herpes

What is the clinical presentation of a recurrent outbreak of genital herpes?

A
  • fewer lesions
  • less severe symptoms
  • shorter duration of symptoms
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6
Q

Herpes

What is the treatment for the first clinical outbreak of genital herpes?

A
  • acyclovir PO TID x 7-10 days
  • famciclovir PO TID x 7-10 days
  • valacyclovir PO BID x 7-10 days
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7
Q

Herpes

What is the treatment for eposodic genital herpes?

A
  • acyclovir PO BID x 5 days
  • famiciclovir PO BID x 5 days, or 1000mg once
  • valacyclovir PO BID x 3 days
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8
Q

Herpes

What is suppressive therapy for genital herpes?

A
  • acyclovir PO BID
  • famciclovir PO BID
  • valacyclovir PO daily
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9
Q

Herpes

What is the treatment for severe genital herpes?

A

acyclovir 5-10 mg/kg IV Q8H x 10 days

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10
Q

Syphilis

What are the stages of syphilis?

A
  • 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
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11
Q

Syphilis

What is the treatment for primary and secondary syphilis?

A

benzathine penicillin G IM x 1 dose

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12
Q

Syphilis

What is the treatment for latent syphilis?

A
  • early= benzathine penicillin G IM x 1 dose
  • late= benzathine penicillin G IM once weekly for 3 weeks
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13
Q

Syphilis

What is the treatment for tertiary syphilis?

A

benzathine penicillin G IM once weekly for 3 weeks, if neurosyphilis, ocular syphilis, or otosyphilis= aqueous crystalline penicillin G daily for 10-14 days

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14
Q

Syphilis

What is Jarisch-Herxheimer reaction?

A

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

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15
Q

What organisms cn cause urethritis and cervicitis?

A
  • chlamydia trachomatis
  • neisseria gonorrhoeae
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16
Q

When may expedited partner therapy (EPT) be implimented?

A

chlamydia and gonorrhea infections

if allowed by state

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17
Q

Herpes

What are important counseling points for genital herpes?

A
  • education on management of life long condition
  • testing of sexual partners
  • abstain from sexual acts when ulcers are present
  • HIV testing
18
Q

Syphilis

What are the important counseling points for syphilis?

A
  • inform sexual partners
  • management of sexual partners
  • follow-up after treatment
  • HIV testing
19
Q

How is chlamydia and gonorrhea diagnosed?

A

NAATs, gram stain, or cultues

20
Q

What are the important counseling points of chlamydia or gonorrhea?

A
  • abstain from sexual intercourse until treatment is completed for themselves and partners
  • follow-up
  • testing for HIV and syphilis
21
Q

What is the empiric treatment for urethritis and cervicitis?

A

ceftriaxone 500mg IM once PLUS doxycycline 100mg PO BID x 7 days

22
Q

What is the targeted treatment for chlamydia trachomatis?

A

Doxycycline 100mg PO BID x 7 days

23
Q

What is the targeted treatment for neisseria gonorrhoeae?

A

ceftriaxone 500mg IM x 1 dose

24
Q

What is the cause of bacterial vaginosis?

A

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

25
Q

What are the important counseling points for bacterial vaginosis?

A
  • abstain from sex during treatment
  • testing for HIV and other STDs
  • follow-up generally unnessary
  • treatment of sexual partners not needed typically
26
Q

What is the treatment for bacterial vaginosis?

A
  • metronidazole
  • clindamycin
  • secnidazole
  • tinidazole
27
Q

What pathogen is respondsible for trichomoniasis?

A

trichomonas vaginalis

28
Q

What are the important counseling points for trichomoniasis?

A
  • 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
29
Q

What is the treatment for trichomoniasis?

A
  • metronidazole
  • tinidazole
30
Q

What pathogen is respondsible for vulvovaginal candidiasis?

A

candida albicans and other candida spp.

31
Q

How may vulvovaginal candidiasis be classified?

A

complicated or uncomplicated

32
Q

What are the important counseling points for vulvovaginal candidiasis?

A
  • follow-up not recommended
  • partners do not need to be tested
  • topical treatments may decrease efficacy of latex barriers
33
Q

What is the clinical presentation of vulvovaginal candidiasis?

A
  • thick, curdy white vaginal discharge
  • pruritis
  • vaginal soreness
  • vulvar edema
  • dyspareunia
  • dysuria
34
Q

What is uncomplicated vulvovaginal candidiasis?

A

sporadic or infrequent infection that is mild and likely to be C. albicans and the patient is immunocompetent

35
Q

What is the duration of treatment for uncomplicated vulvovaginal candidiasis?

A

1-14 days

topical or systemic, short couse very effective

36
Q

What is complicated vulvovaginal candidiasis?

A

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

37
Q

What is the duration of treatment for complicated vuvlovaginal candidiasis?

A

7-14 days

topical or systemic, antifungals may be considered

38
Q

What topical preparations can be used to treat vulvovaginal candidiasis?

A
  • clotrimazole
  • miconazole
  • tioconazole
  • butoconazole (RX)
  • terconazole (RX)

first 3 are OTC products

39
Q

What are the oral treatment options for vulvovaginal candidiasis?

A

fluconazole

40
Q
A

Therapeutics 3 (14 decks)

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