STD Flashcards
Does syphilis cross the placenta?
yes
Syphilis screening test
VDRL
RPR
Syphilis confirmation test
TREPONEMAL testing
fluorescent treponemal antibody absorption (FTA-ABS)
microhemagglutination assay for antibody to treponema pallidum (MHA-TP)
pH change in BV
increased pH
Acyclovir can be used starting at what age?
6 months
Can HIV be transmitted through breast milk?
yes
HIV screening test
in infants
in older children and adult
infants - HIV polymerase chain reaction (PCR)
older children and adult - ELISA (VERY sensitive)
HIV confirmatory test
western blot
Two lab tests used to determine progression of HIV/AIDS
o absolute CD4 lymphocyte - “T” - normal >800 (want high)
o viral load - want zero or undetectable (want as low as possible)
What is the leading killer of AIDS patients?
PJP - pnuemocystis jirovecci pneumonia
what do HIV people take daily for prevention? Bactrim
After exposure, how long to seroconvert to HIV+?
3 weeks to 6 months
HIV prodrome
flu-like symptoms
Early symptoms of HIV
fever, night sweats, and weight loss
What differentiates AIDS from HIV?
CD4 < 200 cells/uL
and/or
opportunistic infection
What is a common co-morbidity with chancroid?
HIV
should test those presenting with chancroid
What does chancroid look like?
painful ulcer surrounded by erythmatous halo
What other clinical feature also accompanies chancroid?
bubo - swelling of lymph nodes
Treatment for chancroid?
azythromycin 1 gram PO – same as chlamydia
ceftriaxone 250 mg IV – same as gonorrhea
ciprofloxicin 500 mg PO
Most common STD in US?
chlamydia
Which two STDs cause dysuria?
gonorrhea
chlamydia
R/o UTI
Symptoms of chlamydia
asymptomatic often
dysuria
dysparunia (female)
thick, cloudy penile discharge
Major causes of dysparunia (4)
PID
menopause
trich
chlamydia
Treatment for chlamydia
azithromycin 1 gram PO
2nd - doxycycline x 7 days
Testing for chlamydia
EIA - enzyme immunoassay: low cost, fast (30 - 120 min)
culture - 3 to 9 days
The most common viral STD in the US
HPV / condyloma accuminata
Treatment for condyloma accuminata
o keratolytic agents - podophyllin, TCA, BCA
o cryo, laser, excision, electrocautery
What is the recommended treatment for condyloma in pregnant women?
laser
Treatment for gonorrhea
ceftriaxone IM
cotreat for chlamydia with azithromycin
Which STDs must be reported to the health department?
GCS
gonorrhea
chlamydia
syphilis
What should a patient exposed to hepatitis B receive?
HBIG within 14 days (sooner is better)
Is HBIG passive or active immunity?
passive
Is tetanus toxoid passive or active immunity?
active
What does initial herpes look like?
12 days of:
fever
malaise
dysuria
painful ulcers
treatment for herpes
acyclovir
valacyclovir - especially for asymptomatic viral shedding
What is lymphgranuloma venereum (LGV)?
Chlamydial infection of the lymph nodes
What might LGV be confused with and how to tell the difference?
ulcer and bubo may be confused with chancroid
but chancroid is painFUL
and LGV is painLESS
Treatment for LGV
doxycycline BID x 21 days
aspirate buboes to prevent ulcerations
Most common treatment for molluscum
cryo
Primary syphilis
painLESS chancre
Secondary syphilis
flu-like symptoms
rash on palms and soles
Latent syphilis
seropositive but asymptomatic
Tertiary syphilis
multi-system including
CV
neuro
Treatment for syphilis
Penicillin G
if allergic
doxy
erythromycin
