1
Q

Chlamydia is transmitted

A

Sexually, prenatally at birth from cervix to neonate

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2
Q

Chlamyida is most frequently seen in

A

F <25yo, screen this population annually

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3
Q

Other populations to consider screening for chlamydia

A

males in high prevalent areas
MSM
F >25yo who are high risk

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4
Q

Screening for males

A

first catch urine, urethral swab- pharynx and rectum

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5
Q

Screening for females

A

first catch urine, cervical swab- pharynx and rectum

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6
Q

Symptoms of Chlamydia in females

A
vaginal discharge, mucopurulent
cervicitis with edema and friability
urethritis
PID
ectopic pregnancy
infertility
endometriosis
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7
Q

Symptoms of Chamydia in males

A

Thin, clear discharge

dysuria

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8
Q

Pearls of Chlamydia

A

1/2 have no SS

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9
Q

Symtoms of Chlamydia in infants and neonates

A

1-3mos old: Presents in mucous membranes of eyes, oropharynx, CU tract and rectum as subacute, afebrile PNA.
neonates: asymptomatic infections of oropharynx, GU, rectum

Most commonly presents as conjunctivitis 5-12d after birth

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10
Q

Chlamydia treatment

A

Azithromycin ( macrolide) works in the bacterial cell.

1g PO x 1 dose OR Doxycycline 100mg PO BID x 7d

abstain from sexual relations for 7 days post finishing abx treatment

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11
Q

When should repeat testing be done for chlamydia

A

Not recommended unless:
doubt in adherence
if SS return
if the alternate medication is used

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12
Q

Chlamydia in pregnancy

A

Do not use Doxycycline
Azythromicin 1g PO x one dose OR Amoxicillin 500mg TID x 7 days
repeat testing in 3-4 weeks, then at 3 months
abstain from sexual relations for 7 days post finishing abx treatment

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13
Q

High risk populations for chlamydia

A
adolescents
women 15-24yo
multiple partners
those who utilize family planning clinics or abortion facilities
juvenile detention centers
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14
Q

Gonorrhea

A

usually co infects with Chalmydia, routinely both are treated

increased resistance to FQ
Some TCA resistance

abstain from sexual relations for 7 days post finishing abx treatment

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15
Q

Gonorrhea Treatment

A

Ceftiraxone 250mg IM once AND azythromycin 1g PO once

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16
Q

Alternative Cephalosporins for Gonorrhea

A

not as effective on pharyngeal infection

ceftoximine 500mg IM once
cefoxitin 2g IM c Probenecid 1g PO
cefotaxime 500mg IM

cefixime 400 mg PO, not as effective - hard to maintain bactericidal levels

17
Q

When should a pt follow up for Gonorrhea

A

Follow up in 14d only if :
given an alternative treatment
if repeat test is positive, CS is needed

18
Q

Syphilis - three clinical stages are

A

Primary
Secondary
Tertiary

19
Q

Primary syphilis

A

painless ulcerations/chanchers in genital area

20
Q

Secondary syphilis

A

rash on palms and soles, possible lymphopathy

21
Q

tertiary syphilis

A

internal- cardiac issues, brain lesions

22
Q

Other stages of Syphilis

A

latent - early, late, or unknown

23
Q

Screening for Syphilis

A

Screening is primary risk and symptom based
Annual screening in active MSM and persons who are HIV+
Testing is paired

24
Q

Syphilis Treatment for Primary or Secondary or Early Latent

A

2.4 million U B Pen G IM single dose

25
Q

Syphilis treatment Tertiary or Late latent or Unknown

A

2.4 million U B Pen G IM x3 dose- one dose a week

26
Q

Neurosyphilis Treatment

A

14 days of 18-24 million U Pen G IV per day

27
Q

Alternative Syphilis Treatment in non pregnant primary or secondary

A

doxycycline 100mg PO BID x 14 d

tetracycline 500mg PO QID x 14 d

28
Q

Alternative Syphilis Treatment in latent

A

doxycycline 100mg PO BID x 28 d

tetracycline 500mg PO QID x 28 d

29
Q

PCN allergic patients with uncertain compliance and pregnant patients get what treatment for syphilis

A

desensitize to PCN for treatment

30
Q

Herpes, HSV-1, HSV-2

A

chronic viral infection
HSV-2 is most common in genital herpes, increase in prevalence of HSV-1
PCR testing is most sensitive

31
Q

Treatment for first episodes of HSV 1 and 2:

A

acyclovir 400mg PO TID x7d-10d
acyclovir 200mg PO 5xd for 7-10d
valacyclovir 1g PO BID x7-10days
famiciclovir 250mg PO TID x 7-10 d

32
Q

Treatment for first episodes of HSV 1 and 2:

A

acyclovir 400mg PO TID 7-10d
acyclovir 200mg PO 5 times a day 7-10d
valacyclovir 1g PO BID 7-10d
famiciclovir 250mg PO TID 7-10d

33
Q

Treatment for established Herpes Supressive therapy

A

Suppressive helps reduce outbreaks and transmission

acyclovir 400mg PO TBID
valacyclovir 500mg PO daily
valacyclovir 1g PO daily
famiciclovir 250mg PO BID

34
Q

Treatment for established Herpes Episodic therapy

A

Episodic should be initiated during prodromal period or within one day of lesion onset

acyclovir 800mg PO BIDx5d
valacyclovir 500mg PO BID x 3d
valacyclovir 1g PO daily x 5d

35
Q

Treatment for established Herpes Suppressive therapy

A

Suppressive helps reduce outbreaks and transmission

acyclovir 400mg PO TBID
valacyclovir 500mg PO daily
valacyclovir 1g PO daily
famiciclovir 250mg PO BID

36
Q

What is -cycline

A

ex doxycycline or tetracycline

a tetracycline antibiotic