STD

Question 1

Urethritis in Men

N.gonorrhea
C. trachomatis
M. genitalium
U. urealyticum
T. vaginalis

Answer 1

urethral discharge, dysuria, w/o frequency

Question 2

Treatment for urethritis

Answer 2

for gonorrhea

Ceftriaxone 250 mg IM OR
Cefpodoxime 400 mg PO OR
Cefixime 400 mg PO

PLUS

chlamydia

Azithromycin 1 g PO single dose OR
Doxycycline 100 mg BID PO for 7 days

Question 3

Epididymitis

C. trachomatis
N. gonorrhea (less common)

Answer 3

unilateral pain

swelling and tenderness of the epididymis

Question 4

Treatment for epididymitis

Answer 4

Ceftriaxone 250 mg IM PLUS Doxycycline 100 mg BID for 10 days

Levofloxacin 500 mg BID OD for 10 days (for enterobacteriaceae)

Question 5

Mucopurulent cervicitis

N. gonorrhea
C. trachomatis
M. genitalium

Answer 5

presence of yellow mucopurulent discharge from the cervical os

Question 6

Pelvic Inflammatory Disease (PID)

N. gonorrhea
C. trachomatis

Answer 6

ACUTE PID

lower abdominal pain < 3 weeks duration
pelvic tenderness on bimanual examination
evidence of lower genital tract infection

Question 7

Treatment for PID

Answer 7

OUTPATIENT

1. Ceftriaxone 250 mg IM PLUS
2. Doxycycline 100 mg PO BID for 14 days PLUS
3. Metronidazole 500 mg PO BID for 7 days

INPATIENT

Regimen A

1. Cefotetan 2 g IV q 12 OR Cefoxitin 2 g IV q6 PLUS
2. Doxcycline 100 mg IV or PO q12

Regimen B

1. Clindamycin 900 mg IV q8 PLUS
2. Gentamicin 1.5 mg/kg q8

continue parenteral therapy until 48 hrs after clinical improvement then change to outpatient regimen

Question 8

Vulvovaginal candidiasis

C. albicans

Answer 8

vulvar itching and/or irritation

scanty white, clumped discharge

Question 9

Treatment for candidiasis

Answer 9

Fluconazole 150 mg PO single dose

Azole cream, tab or suppository - miconazole, clotrimazole

Question 10

Trichomonal vaginitis

T. vaginalis

Answer 10

vulvar itching

profuse white or yellow discharge

Question 11

Treatment for vaginitis

Answer 11

Metronidazole 500 mg PO BID for 7 days

Question 12

Bacterial vaginitis

Gardnerella vaginalis

Answer 12

malodorous
slightly inc discharge
CLUE CELLS - vaginal epithelial cells coated w/ cocobaciliary organisms giving them a granular appearance

Question 13

Treatment for vaginosis

Answer 13

Metronidazole 50 mg PO BID for 7 days

Question 14

Herpes

HSV

Answer 14

erythematous ulcers

firm, TENDER and bilateral lymph nodes

Question 15

Treatment for herpes

Answer 15

Acyclovir 400 mg PO TID for 7 days OR
200 mg PO 5x a day for 7-10 days
OR

Valacyclovir 1 g PO BID for 7-10 days OR

Famcivlovir 250 mg TID for 7-10 days

Question 16

Chancroid

H. ducreyi

Answer 16

undermined, ragged and irregular ulcers

TENDER , suppurate, loculated, unilateral lymph nodes

Question 17

Lymphogranuloma venereum

C. trachomatis

Answer 17

elevated, round or oval ulcers

TENDER , suppurate, loculated, unilateral lymph nodes

Question 18

Donovanosis

K. granulomatosis

Answer 18

elevated, irregular ulcers

pseudobuboes

Question 19

Treatment for chancroid

Answer 19

Ciprofloxacin 500 mg PO single dose

OR

Ceftriaxone 250 mg IM single dose

OR

Azithromycin 1 g PO single dose

Question 20

Treatment for lymphogranuloma venereum

Answer 20

Doxycycline 100 mg PO BID for 21 days

Question 21

Treatment for donovanosis

Answer 21

Doxycycline 100 mg BID for at least 3 weeks and until all lesions have completely healed

Question 22

Primary Syphilis

Answer 22

sharply demarcated, elevated and round ulcers

bilateral, firm and NONTENDER lymph nodes

Question 23

Secondary Syphilis

Answer 23

generalized, symmetric, NON-PRURITIC mucocutaneous lesions

affects PALMS and SOLES

CONDYLOMA LATA

Question 24

Tertiary Syphilis

Answer 24

cardiosyphilis

gumma

Question 25

Treatment for Primary and Secondary Syphilis

Answer 25

Benzathine penicillin 2.4 million units IM single dose

OR

Doxycycline 100 mg BID for 14 days

Question 26

Treatment for Tertiary Syphilis

Answer 26

Benzathine penicillin 2.4 million units IM once weekly