STDs Flashcards
Which are fluids?
GC
CT
Trich
HIV
Which are skin-skin?
HSV
HPV
Syphilis
Chancroid
Preexposure vaccines?
- Hep B- ALL sexually active persons
- Hep A- MSM
- HPV- ages 9-26, M & F
What can still get through lambskin condoms due to large pores?
HIV
Hep B
MSM screening
Annual STD screening:
HIV and syphilis serology
- NAAT for GC/CT- urine or discharges (also in W) - pharyngeal and rectal
HPV- pap smear
HBsAg
Hep C ab
Who should always be tested for HIV?
pregnant W
Sores
- Syphilis
- HSV
- Lymphogranuloma venereum
- Chancroid, &
- Granuloma inguinale
Drips
- Gonorrhea
- Chlamydia
- Mycoplasma genitalium
- Mucopurulent cervicitis
- Trichomonas vaginitis/ urethritis
- Candidiasis
Painful vs painless ulcers
Painful
- Chancroid
- Genital herpes simplex
Painless
- Syphilis
- Lymphogranuloma venereum
- Granuloma inguinale “
Herpes virus (HSV1/HSV2)- HSV1 vs HSV2
1-oral- cold sores/blisters
2-genital mucosa
Herpes virus (HSV1/HSV2)- transmission
asymptomatic viral shedding
Herpes virus (HSV1/HSV2)- description and duration
Multiple painful vesicles on erythematous base- painful ulcer surrounded by red halo
- Persists 7-10 days
Herpes virus (HSV1/HSV2)- primary vs recurrent signs and symptoms
Primary lesion:
- Fever and bilateral adenopathy
Recurrent:
- no fever or adenopathy
Herpes virus (HSV1/HSV2)- prodrome
tingling or burning 18-36 hours prior lesion
flu like symptoms
Herpes virus (HSV1/HSV2)- labs and diagnosis
Tzank smear (historic test)- lacks sensitivity- GOLD - (+) if presence of multinucleated giant cells
Serologies- many false + and -
Viral studies
- Cultures
- PCR= BEST
Herpes virus (HSV1/HSV2)- treatment 1st episode
- Acyclovir 400mg TID
- Famciclovir 250mg TID
- Valacyclovir 1000mg BID
7-10days any agent, within 72hrs is best
Herpes virus (HSV1/HSV2)- treatment episodic
same agents
- Acyclovir 400mg TID
- Famciclovir 250mg TID
- Valacyclovir 1000mg BID
For W- happens around menstrual cycle (decreased immunity)- can prescribe episodic if they are regular
Herpes virus (HSV1/HSV2)- treatment suppression
- Acyclovir 400mg BID
- Famciclovir 250mg BID
- Valacyclovir 500-1000mg daily
Herpes virus (HSV1/HSV2) treatment in pregnancy
acyclovir
- no increased risk of major birth defects (1st tri)
- risk of transmission to neonate is 30-50% if acquired HSV near delivery
Hep A vaccine
MSM
Illegal drug users
Chronic liver disease
Hep B and C infection
Hep B vaccine
- sex partners
- MSM
- illegal drug use
- household members
- hemodialysis
- occupational blood exposure
HIV co-infection with?
Hep C= blood borne- no vaccine
Syphilis- incidence increases in…
HIV + men
MSM
IV drug usage
Syphilis caused by
Treponema pallidum