STD Flashcards
What bacteria is gonorrhoea caused by?
Neisseria gonorrhoeae
How is gonorrhoea transmitted?
- sexual contact
- mother-to-child during childbirth
Common presentation of gonorrhoea?
Can be asymptomatic.
If symptomatic, for
Males: purulent urethral discharge, dysuria, urinary frequency
Females: mucopurulent vaginal discharge, dysuria, urinary frequency
Treatment for uncomplicated urogenital gonococcal infections?
Ceftriaxone 500mg IM in a single dose.
If chlamydial infection has not been excluded, treat for chlamydia with doxycycline 100mg PO BD x 7 days.
Alternative regimen:
Gentamicin 240mg IM in single dose +
Azithromycin 2g orally in a single dose
What bacteria is chlamydia caused by?
Chlamydia trachomatis
What is the presentation like for chlamydia?
Similar to gonorrhoea.
How is chlamydia transmitted?
- Sexual contact
- mother to child during childbirth
Treatment for chlamydia?
Doxycycline 100mg PO BD x 7 days
Alternative: azithromycin 1g PO in single dose or Levofloxacin 500mg PO OD x 7 days
What bacteria is syphilis caused by?
Treponema pallidum
How is syphilis transmitted?
- sexual contact
- mother to child * transplacental during pregnancy
What are the different stages of syphilis?
- primary
- secondary
- latent
- tertiary
- neurosyphilis
What is the treponemal test for?
Used for diagnosis of syphilis.
What is nontreponemal test for?
Commonly used non treponemal tests are VDRL and RPR.
Used to monitor response to treatment.
Treatment for syphilis?
Primary, secondary and early latent (<1year duration):
IM Benzathine penicillin G 2.4 million units x 1 dose
If penicillin allergic, PO Doxycycline 100 mg bid x 14 days
Late latent (>1year) or unknown duration or tertiary: IM benzathine penicillin G 2.4 million units once a week x 3 doses Penicillin allergy: PO Doxycycline 100mg BD x 28 days
Neurosyphilis: IV crystalline penicillin G 3-4 million units q4h or 18-24 million units/day as continuous infusion x 10-14 days OR
IM procaine penicillin G 2.4MU daily + PO probenecid 500mg QID x 10-14 days
If penicillin allergy: IV/IM ceftriaxone 2g daily x 10-14 days
How to monitor for therapeutic response of syphilis?
Treatment success is where there is decrease of VDRL or RPR titre by at fourfold.
What type of virus is herpesvirus?
- double stranded DNA virus
- persists lifelong in infected hosts (latent infection)
- periodic reactivations, especially in immuonocompromised hosts
What is HSV type 1?
Affects young children, transmitted through contact, commonly presented as cold sores.
Usually self limiting, can use PO acyclovir or valacylovir.
What is herpesvirus 3?
Varicella zoster virus.
Treatment for varicella or shingles?
Start within 24-48 hours of rash to reduce duration and severity of symptoms.
Acyclovir dose: PO 800mg 5 times daily x 7 days.
Valacyclovir dose: PO 1g 3 times a day x 7 days
Herpes simplex virus 2?
Causes genital herpes, a STI.
How is genital herpes transmitted?
- transfer of body fluids
- intimate skin to skin contact
Antiviral therapy for first episode of genital herpes?
Acyclovir: 400mg TDS x 7-10 days
Valacyclovir: 1 g BD x 7-10 days
Chronic suppressive therapy for genital herpes?
Acyclovir 400mg PO BD
Valacyclovir 500mg or 1g PO OD
Episodic therapy for genital herpes?
Acyclovir 800mg PO BD x 5 days
Valacyclovir 500mg PO BD x 3 days
