STD

Question 1

Chlamydia is transmitted

Answer 1

Sexually, prenatally at birth from cervix to neonate

Question 2

Chlamyida is most frequently seen in

Answer 2

F <25yo, screen this population annually

Question 3

Other populations to consider screening for chlamydia

Answer 3

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

Question 4

Screening for males

Answer 4

first catch urine, urethral swab- pharynx and rectum

Question 5

Screening for females

Answer 5

first catch urine, cervical swab- pharynx and rectum

Question 6

Symptoms of Chlamydia in females

Answer 6

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

Question 7

Symptoms of Chamydia in males

Answer 7

Thin, clear discharge

dysuria

Question 8

Pearls of Chlamydia

Answer 8

1/2 have no SS

Question 9

Symtoms of Chlamydia in infants and neonates

Answer 9

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

Question 10

Chlamydia treatment

Answer 10

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

Question 11

When should repeat testing be done for chlamydia

Answer 11

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

Question 12

Chlamydia in pregnancy

Answer 12

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

Question 13

High risk populations for chlamydia

Answer 13

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

Question 14

Gonorrhea

Answer 14

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

Question 15

Gonorrhea Treatment

Answer 15

Ceftiraxone 250mg IM once AND azythromycin 1g PO once

Question 16

Alternative Cephalosporins for Gonorrhea

Answer 16

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

Question 17

When should a pt follow up for Gonorrhea

Answer 17

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

Question 18

Syphilis - three clinical stages are

Answer 18

Primary
Secondary
Tertiary

Question 19

Primary syphilis

Answer 19

painless ulcerations/chanchers in genital area

Question 20

Secondary syphilis

Answer 20

rash on palms and soles, possible lymphopathy

Question 21

tertiary syphilis

Answer 21

internal- cardiac issues, brain lesions

Question 22

Other stages of Syphilis

Answer 22

latent - early, late, or unknown

Question 23

Screening for Syphilis

Answer 23

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

Question 24

Syphilis Treatment for Primary or Secondary or Early Latent

Answer 24

2.4 million U B Pen G IM single dose

Question 25

Syphilis treatment Tertiary or Late latent or Unknown

Answer 25

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

Question 26

Neurosyphilis Treatment

Answer 26

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

Question 27

Alternative Syphilis Treatment in non pregnant primary or secondary

Answer 27

doxycycline 100mg PO BID x 14 d

tetracycline 500mg PO QID x 14 d

Question 28

Alternative Syphilis Treatment in latent

Answer 28

doxycycline 100mg PO BID x 28 d

tetracycline 500mg PO QID x 28 d

Question 29

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

Answer 29

desensitize to PCN for treatment

Question 30

Herpes, HSV-1, HSV-2

Answer 30

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

Question 31

Treatment for first episodes of HSV 1 and 2:

Answer 31

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

Question 32

Treatment for first episodes of HSV 1 and 2:

Answer 32

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

Question 33

Treatment for established Herpes Supressive therapy

Answer 33

Suppressive helps reduce outbreaks and transmission

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

Question 34

Treatment for established Herpes Episodic therapy

Answer 34

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

Question 35

Treatment for established Herpes Suppressive therapy

Answer 35

Suppressive helps reduce outbreaks and transmission

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

Question 36

What is -cycline

Answer 36

ex doxycycline or tetracycline

a tetracycline antibiotic