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1
Q

Gonorrhea is caused by what organism?

A

neisseria gonorrhoeae

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2
Q

If a gram stain shows gram negative diplococci, the most likely STD is?

A

gonorrhea

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3
Q

A female presenting with mucopurulent vaginal discharge is concerning for which STD?

A

=green discharge–> gonorrhea

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4
Q

A male presenting with white/yellow/green penile discharge is concerning for which STD?

A

gonorrhea

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5
Q

Diagnosis of gonorrhea

A

gram stain=GN diplococci cervical cx + N. gonorrhoeae using Thayer-Martin media

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6
Q

Treatment for gonorrhea

A

Ceftriaxone 250mg IM + Azithromycin 1gm PO x 1 report to health department

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7
Q

Which STD is most likely to involve multiple organ systems?

A

syphilis

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8
Q

What organism causes syphilis?

A

treponema pallidum

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9
Q

3rd most commonly reported infectious disease in US?

A

syphilis

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10
Q

Clinical manifestations of primary syphilis

A

PAINLESS chancre indurated ulcer erythema at site

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11
Q

Clinical manifestations of secondary syphilis

A

*flu-like sxs

*lymphadenopathy

*generalized macro-papular rash

-malaise -anorexia -alopecia -arthralgias

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12
Q

Which stage of syphilis is seropositive but asymptomatic?

A

latent syphilis

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13
Q

Serologic Tests for Syphilis

A

initial test: VDRL/RPR

confirmatory test: flourescent treponemal antibody absorption

Nontreponemal: VDRL/RPR Treponemal: FTA-ABS (flourescent treponemal antibody absorption); MHA-TP (microhemagglutination assay for antibody to T.pallidum)

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14
Q

Which serologic tests are used to confirm syphilis?

A

treponemal: flourescent treponemal antibody absorption

FTA-ABS , MHA-TP

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15
Q

Which serologic test confirms 100% of secondary syphilis cases?

A

FTA-ABS

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16
Q

What is the antibiotic of choice for syphilis?

A

PCN G

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17
Q

What is the treatment for primary, secondary or early syphilis (<1yr) syphilis?

A

PCN G 2.4 million unit IM

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18
Q

What is the treatment for late, latent/indeterminate stage & tertiary syphilis?

A

PCN G 2.4 million units IM weekly x 3 wks

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19
Q

If patient has PCN allergy, what is the treatment for syphilis?

A

Doxycycline 100mg BID or Erythromycin 500mg PO QID

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20
Q

Which is the most common STD in the US?

A

chlamydia (C in common= C in chlamydia)

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21
Q

Chlamydia is caused by what organism?

A

chlamydia trachomatis

22
Q

Which STDs causes dyspareunia?

A

chlamydia & trichomonas

23
Q

What are the 4 most common causes of dyspareunia?

A

-chlamydia -PID: trichomonas -menopause

24
Q

If a male presents with thicky, cloudy penile discharge, which STD is of concern?

25
Q

What is the most definitive test to confirm chlamydia?

A

culture (*but takes 3-9d for results)

26
Q

What is the preferred method to test for chlamydia?

A

EIA (enzyme immunoassay) - 30-120min for result

27
Q

Treatment for chlamydia

A

Azithromycin 1gm PO x 1` OR Doxycycline 100mg BID x 7 d

28
Q

What are the most common causes of vulvovaginitis?

A
  1. trichomoniasis 2. bacterial vaginosis 3. candidiasis
29
Q

Clinical presentation of trichomonas

A

-malodorous, frothy yellow-greenish discharge -pruritus -vaginal erythema -“strawberry patches” on cervix & vagina -dyspareunia -dysuria

30
Q

“Strawberry patches” on the cervix are noted on pelvic exam. The most likely diagnosis is?

A

trichomonas

31
Q

Malodorous, frothy, yellowish-green discharge is concerning for which STD?

A

trichomonas

32
Q

Clinical presentation of bacterial vaginitis?

A

*“fishy” smelling discharge which is watery & gray -vaginal spotting

33
Q

“Fishy” smelling discharge is concerning for which STD?

A

bacterial vaginosis

34
Q

Diagnostic test for trichomonas?

A

microscopic wet prep: NS mixture shows motile trichomonads

35
Q

Diagnostic test for bacterial vaginosis?

A

microscopic wet prep: NS mixture shows clue cells

36
Q

Diagnostic test for candidiasis?

A

microscopic wet prep: KOH mixture shows pseudo hyphae

37
Q

Treatment for trichomonas?

A

Flagyl 2g PO x 1

38
Q

Treatment for bacterial vaginosis?

A

Flagyl 2g PO x 1 -Clindamycin vaginal cream 2% (5g) vag qHS x 7d or 300mg PO BID x 7d

39
Q

Treatment for Candidiasis?

A

Miconazole (mono-stat) Clotrimazole Terconazole Butaconazole

40
Q

Cause of chancroid?

A

hemophilis ducreyi

41
Q

If gram stain shows GN bacillus, what is the most likely STD?

42
Q

Which STD(s) cause painful ulcers?

A

chancroid herpes

43
Q

Treatment for chancroid

A

Azithro 1gm PO x 1 OR Ceftriaxone 250mg IM x 1

44
Q

Which STD has no cure?

45
Q

Which STD is associated with painful genital lesions?

A

herpes *lesions that Hurt= Herpes

46
Q

Initial clinical presentation of herpes?

A

fever malaise dysuria **painful/pruritic ulcers usu x 12d

47
Q

Clinical presentation of recurrent herpes

A

less painful/pruritic ulcers, usu x 5d

48
Q

Most definitive test for herpes?

A

viral culture

49
Q

Treatment of herpes?

A

-symptomatic tx w/drying & antipruritic agents -Acyclovir -Famciclovir -Valacyclovir

50
Q

Which drug is especially helpful for asymptomatic viral shedding of HSV2?

A

Valacyclovir (valtrex) *10% of ppl shed all the time

STD's (1 decks)

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