STD's Flashcards
what is the most common bacterial STD
Chlamydia
what is the preferred test for G/C
NAAT ( nucleic acid amplification test)
When should you collect specimens for G/C
Men: first urine of the morning
W: vaginal swab is = to cervical
MSM should get annual pharyneal and rectal using NAAT
Chlamydia screening, symp, complications
screening: sexual active adlescents and women under 26
d/c : scant clear or cloudy white
complications: cervicitis, urethral syndrome, bartholinitis, endometritis, PID, procitis
Chlamydia tx
uncomplicated ( cervicitis, urethitis, tx partner)
- azithryomcine 1 mg single dose or doxy 7 days
Preg:
- azithryomycin
need to do pre testing and post testing ( 3-4 weeks after therapy)
complicated ( PID, prostatis, epdidiymitis)
- doxy DIB x 14 days
Gonorrhea
Purulent green d/c.
Both genders: procitisis, phargynitis
if dessiminated : miratory arthiritis , synovits, rash, fever, chills
Gonorrhea TX
uncomplicated : cervix, urthra, pharynx
- ceftriazone + azithryromcin (1) / doxy x 7 days
if they have gonorrhea must tx for chylamdia
- complicated (PID epididymitis, prostatistis)
- Ceftriazone + doxy 14 days
Proctitis or proctorcolitis screening
annual for MSM hx of unprotected receptive anal intercourse. New sexual partner in the < 60 days.
acute onset of purulent rectal discharge, anorectal pain, and tenesmuc ( frequent urges of passing stool)
swab anus for GC
TX: complicated
- ceftriazone + doxy 14
PID presentaton/labs/tx/partner/complications
sexually active < 24 year old with new onset one sided pelvic pain w/ mucopurulent vaginal discharge. New sexual partner. pelvic pain while walking, pain with intercourse ( dysapreunia), postive cervical motion tenderness w/ or w/o adnexal pain
Labs: r/o preg, HIV, G/C
Male partners: any partner within the last 60 dyas shoudl be tested and tx for g/c
TX: complicated
- ceftriazone + doxy x 14
complications: infertility, ecptopic preg, pelvic abbcess
What is the organism and test for syphilis
treponema pallidum
RPR
VDRL
Primary stage and secondary stage of Syphilis
P: chancre painless, indurated, clean base , can resolve on own in 3-6 weeks
TX: benzathine peniciilin G IN x 1 dose
S: rash on palms and soles, no itch, condylona lata swollen lymph nodes, mucous patches on mouth, throat
Latent stage of spyhilis
usually no symptoms
> 1 year from time of infection
TX: benzathine pencillin IM one dose X 3 weeks
Tertiary spyhilis
soft tiisue tumors, aortic aneurysms
TX: benzathine pencillin IM one dose X 3 weeks
Jarisch-Herxheimer reaction
common immune reaction after starting syphilis tx (myalgias, fever, headache, tachycardia)
Fitz High Curtus Syndrome
complicated case of PID w/ G/c
what are two most common strains of HPV that cause cancer
16 #18
what is the tx for HPV ( pt applied)
Pt applied methods ( cant use if preg) - Imiquimod 3/75 or 5 cream or Podofilox Sinecatchins
what is the tx for HPV ( provider applied)
cryotherapy ( can use w/ preg
tricholeacetic aced or bichloroactici be applied to warts
W/ preg and HIV for HPV
screen pap every 6 months
Gardasil
HPV vaccine at ages 11-12 (can be as early as 9) 6-12 month apart ( if completed by 15th bday only need two doses)
for ages 15-26 needs 3 doses 0, 1-2 y, 6 months
Herpes simplex 1
usually oral infection
Herpes simplex 2
gential infection
erythemetous papules that devlop into smal grouped vesicles, easily ruptured - small shallow ulcers
primary episode more severe adn can last up to 2 weeks
labs: HSV PCR DNA
Herpes simplex 2 tx
first episode: Acyclovir po TID x 7-10dyas or Valtrex TID
episode therapy: duration 5 days
Acyclovir TID or Valtrex BID
Supressive therapy ( every day) Acylcovir BID or Valtrex BID
when is a herpes simplex 2 non infectious
never, even if skin has healed, still have low levels of viral shedding
high risks for HIV
unsafe sex, msm, IVDU, blood products from 1975 to 1985, breast fed infant w/ HIV mother
R/O signs of HIV
thrush ( candida esophagitis), hairy lekoplakia, weight loss w/ diahrea,
what is acute retroviral syndrome
Acute HIV infection and Primary HIV
first time infection HIV virus. Acute onset of fever, lymphadenopathy, malaise, sore throat, rash
may resemble mono
HIV testing
HIV1/HIV2 antigen/antibody immunoassay test
- test for both strains and P24 antigen ( established infection/acute HIV)
- if both strains are + = HIV
there is a window period of 6 weeks to 6 months
older screening test is ELISA TEST w/ Western blot as comfirmatory testing
what should you do if CD 4 < 200
prophylaxis for PCP pneumonia
which is Bactrim, dapsone and pentamidine
Pneumocystis Jiroveci Pneumonia
happens in AIDS w/ CD4 50–150
check CD4 count eery month if on ART
Cytomegalovirus
common cause of blindness in people with AIDS ( CD 4 < 100)
Toxoplasmosis AIDS
part of aids
adult male present with difficulty walking complains of headache, blurry vision, weakness, change in mental status
AIDS keys
HIV infection w/ CD 4 count < 200
other manifestations
- candidiasis of esophagus/ bronchi/ trachea / lungs
- pneumocyctis pnuemonia
- Kaposi sarcoma - red to purple patches on the skin oral muscosa of the mouth / nose or throat
- “C” infections: coccidiodomycosis, cryptococcosis
what else can cause toxoplasmosis
handling cat litter or raw meat
what can cause histoplasmosis
bird feces
what can cause listeroisis
eating unheated hot dogs or cold cuts
what can cause vibrio bacteria
eating raw oysters
tx for nongonococcal urethritis
azithromycin 1 gm PO in single dose or doxy 100 bid x 7 days
