STD Flashcards
STIs ______ (facilitate/impede) HIV transmission
Facilitate
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
C) Their primary health care provider
What are two differentials for a patient presenting with genital ‘sores’?
Syphilis Gential Herpes (HSV 1 & 2)
What are two differentials for a patient presenting with discharge?
Gonorrhea Chlamydia Trichomonas Bacterial Vaginosis Candidiasis
Are each of the following painful or painless…..
Syphilis
Gential Herpes
Syphilis: Painless
Genital Herpes: Painful
What is the incubation period of syphilis?
10-90 days
How is a syphilis lesion described?
Chancre…….
Painless, indurated ulcer with a clean base and smooth, firm borders
How often does a chancre go unnoticed in syphilis patients?
15-30% of the time
How quickly does a chancre resolve in a syphilis paitent?
1-5 weeks
T/F: Syphilis is not contagious
False
It is HIGHLY contagious
How does secondary syphilis manifest?
Whole body rash including soles, palms, and mucous membranes
Condylomata lata (highly infectious)
Constitutional Sx
***resolves in 2-10 weeks
Genital Herpes is contracted through direct contact most commonly during _________ (asymptomatic/symptomatic) shedding
Asymptomatic
How is a genital herpes lesion often described?
Vesicle that turns to a painful ulceration and ultimately crusts
T/F: Genital herpes simplex is most often asymptomatic
True
How is genital herpes simplex diagnosed?
PCR
Cx
Serology (Type-specific;Western blot)
What are THREE medications that can be used to treat genital herpes?
Acyclovir
Valacyclovir
Famiciclovir
How should acyclovir be dosed for initial treatment?
400 mg PO q8hr for 7-10 days
When should pharmacological therpay for genital herpes simplex be initiated for recurrence?
At the earliest sign/symptom
How is azithromycin dosed when treating a gonorrhea or chlamydial infection?
1 gram PO in one dose
Is urethritis more common in men or women?
Men
What are the symptoms of urethritis?
Dysuria, discharge
5% are asymptomatic
Urogenital infections are more common in ____ (men/women) and the majority are ________ (asymptomatic/symptomatic)
Women
Asymptomatic
What would be seen on a gram-stain that is consistent with gonorrhea?
Gram-positive diplococci
A urine microscopy with ____ PMNs would be consistent with a nongonococcal urethritis
> 10 PMNs
What is the most common pathogen in nongonococcal urethritis?
C. Trachomatis
Mycoplasmas would be the second most common in nongonococcal urethritis
Are patients with chlamydia more common symptomatic or asymptomatic?
Asymptomatic (especially women - 75%)
Why is chlamydia screened for in pregnancy?
Risk of transmission during child birth
ex: Conjunctivits, Pneumonia
Why would you obtain a gram stain in working up chlamydia?
Rule Out Gonorrhea
Other than a gram stain….
What test should 9or could) be obtained when working up gonorrhea?
Culture
NAAT
Specimen Samples (Urine, Cervical, etc…)
Serology
What Abx should be used in treating chlamydia?
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)
What are the alternatives to azithromycin and doxycycline in chlamydia treatment?
Erythromycin
Levofloxacin
Ofloxacin
What STD is a parasite?
Trichomonas Vaginalis
What percent of women undergoing STD testing for GC/CT are found to have trichomonas?
8.7%
Most trichomonal vaginalis infections are ________ (symptomatic/asymptomatic)
Asymptomatic
How is trichomonas treated?
2 grams Metroniadazole PO (one dose)
OR
2 grams of Tinidazole PO (one dose)
