STD

Question 1

STIs ______ (facilitate/impede) HIV transmission

Answer 1

Facilitate

Question 2

Where are Americans most likely to go for STD care?

A) The emergency room
B) A family planning clinic
C) Their primary health care provider
D) STD clinic

Answer 2

C) Their primary health care provider

Question 3

What are two differentials for a patient presenting with genital ‘sores’?

Answer 3

Syphilis
Gential Herpes (HSV 1 & 2)

Question 4

What are two differentials for a patient presenting with discharge?

Answer 4

Gonorrhea
Chlamydia
Trichomonas
Bacterial Vaginosis
Candidiasis

Question 5

Are each of the following painful or painless…..

Syphilis
Gential Herpes

Answer 5

Syphilis: Painless

Genital Herpes: Painful

Question 6

What is the incubation period of syphilis?

Answer 6

10-90 days

Question 7

How is a syphilis lesion described?

Answer 7

Chancre…….

Painless, indurated ulcer with a clean base and smooth, firm borders

Question 8

How often does a chancre go unnoticed in syphilis patients?

Answer 8

15-30% of the time

Question 9

How quickly does a chancre resolve in a syphilis paitent?

Answer 9

1-5 weeks

Question 10

T/F: Syphilis is not contagious

Answer 10

False

It is HIGHLY contagious

Question 11

How does secondary syphilis manifest?

Answer 11

Whole body rash including soles, palms, and mucous membranes
Condylomata lata (highly infectious)
Constitutional Sx

***resolves in 2-10 weeks

Question 12

Genital Herpes is contracted through direct contact most commonly during _________ (asymptomatic/symptomatic) shedding

Answer 12

Asymptomatic

Question 13

How is a genital herpes lesion often described?

Answer 13

Vesicle that turns to a painful ulceration and ultimately crusts

Question 14

T/F: Genital herpes simplex is most often asymptomatic

Answer 14

True

Question 15

How is genital herpes simplex diagnosed?

Answer 15

PCR
Cx
Serology (Type-specific;Western blot)

Question 16

What are THREE medications that can be used to treat genital herpes?

Answer 16

Acyclovir
Valacyclovir
Famiciclovir

Question 17

How should acyclovir be dosed for initial treatment?

Answer 17

400 mg PO q8hr for 7-10 days

Question 18

When should pharmacological therpay for genital herpes simplex be initiated for recurrence?

Answer 18

At the earliest sign/symptom

Question 19

How is azithromycin dosed when treating a gonorrhea or chlamydial infection?

Answer 19

1 gram PO in one dose

Question 20

Is urethritis more common in men or women?

Answer 20

Men

Question 21

What are the symptoms of urethritis?

Answer 21

Dysuria, discharge

5% are asymptomatic

Question 22

Urogenital infections are more common in ____ (men/women) and the majority are ________ (asymptomatic/symptomatic)

Answer 22

Women

Asymptomatic

Question 23

What would be seen on a gram-stain that is consistent with gonorrhea?

Answer 23

Gram-positive diplococci

Question 24

A urine microscopy with ____ PMNs would be consistent with a nongonococcal urethritis

Answer 24

> 10 PMNs

Question 25

What is the most common pathogen in nongonococcal urethritis?

Answer 25

C. Trachomatis | Mycoplasmas would be the second most common in nongonococcal urethritis

Question 26

Are patients with chlamydia more common symptomatic or asymptomatic?

Answer 26

Asymptomatic (especially women - 75%)

Question 27

Why is chlamydia screened for in pregnancy?

Answer 27

Risk of transmission during child birth | ex: Conjunctivits, Pneumonia

Question 28

Why would you obtain a gram stain in working up chlamydia?

Answer 28

Rule Out Gonorrhea

Question 29

Other than a gram stain.... What test should 9or could) be obtained when working up gonorrhea?

Answer 29

Culture NAAT Specimen Samples (Urine, Cervical, etc...) Serology

Question 30

What Abx should be used in treating chlamydia?

Answer 30

250 mg of Ceftriaxone IM (one dose) PLUS 1 gram Azithromycin PO (one dose) (can substitute 100 mg of doxy BID x7 days for azithromycin)

Question 31

What are the alternatives to azithromycin and doxycycline in chlamydia treatment?

Answer 31

Erythromycin Levofloxacin Ofloxacin

Question 32

What STD is a parasite?

Answer 32

Trichomonas Vaginalis

Question 33

What percent of women undergoing STD testing for GC/CT are found to have trichomonas?

Answer 33

8.7%

Question 34

Most trichomonal vaginalis infections are ________ (symptomatic/asymptomatic)

Answer 34

Asymptomatic

Question 35

How is trichomonas treated?

Answer 35

2 grams Metroniadazole PO (one dose) OR 2 grams of Tinidazole PO (one dose)