STDs Flashcards

1
Q

what are the 5 Ps of sexual health (helpful for gathering a sexual history)

A

Partners, practices, prevention of pregnancy, protection from STIs, past history of STIs

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2
Q

what is the organism for gonnorrhea, where are cultures taken from?

A

Neisseria gonorrhoeae: gram negative bacteria

cultures: GU- urine sample, oropharynx, conjunctiva, rectum

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3
Q

complications if gonorrhea untreated

A

women: pelvic inflammatory disease, fallopian tube damage, infertility or risk of ectopic pregnancy
men: epididymitis- infertility (rare)

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4
Q

what are s/s of gonorrhea- female vs male

A

female: dysuria, mucopurulent vaginal discharge, lower abd pain, fever, dysmenorrhea, n/v
male: dysuria, frequency, white/ yellow penile discharge, testicular pain

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5
Q

what is the lab test for gonorrhea?

A

Urine sample: NAAT nucleic acid amplification test
POC Cepheid test
culture- Thayer-Martin media- rectal, oropharyngeal, conjunctival infection, and endocervical or urethral

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6
Q

what is gonorrhea treatment?

A

ceftriaxone 500 mg IM x 1 dose < 150kg, 1gm if >150kg
if chlamydial infection not rule out: doxycycline 100mg PO BID x 7 days
alternatives: gentamycin, azithromycin or cefixime

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7
Q

what is organism of syphillis

A

treponema pallidum

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8
Q

what are the 4 stages of syphilis

A
  1. painless chancre- within 3 weeks of exposure, regional lymphadenopathy
  2. flu like symptoms, generalized lymphadenopathy, generalized maculopapular rash- palms and soles
  3. latent phase: seropositive but asymptomatic
  4. tertiary: leukoplakia, cardiac insufficiency: aortic regurg. aortitis, aneurysms, infiltrative tumors of skin, bones, liver, CNS involvement: meningitis, hemiparesis, hemiplegia
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9
Q

syphilis screening test

A

Screening: VDRL: Venereal Disease Research Laboratory or rapid plasma reagin: non-treponemal antibody tests
Diagnosis: Treponemal test (confirmation) TP- particle agglutination assay (TP-PA)
FTA-ABS- fluorescent treponemal antibody absorption
ICA: chemiluminescence imunoassays

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10
Q

syphilis treatment

A

benzathine penicillin IM single dose (early syphilis)

IM weekly x3 doses for latent infection, indeterminate length or tertiary stage

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11
Q

severe conditions of syphilis: CNS, eye or ear involvement: treatment

A

neurosyphilis, ocular or otosyphilis: aqueous crystalline penicillin IV q 4hours, continuous infusion 10-14 days, or procaine PCN IM once daily plus probenecid 500 mg PO QID for 10-14 days

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12
Q

if PCN allergy, what is syphilis tx?

A

Early: doxycycline 100 mg PO BID x 14 days or tetracycline
Latent: doxy or tetracycline x 28 days

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13
Q

what is organism for chlamydia?

A

parasitic infection- intracellular obligate- looks like gram neg bacteria
chlamydia trachomatis

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14
Q

what are s/s of chlamydia by sex, and what are complications?

A

female: vaginal discharge, pelvic pain, postcoital bleeding, spotting, dysuria, PID, infertility, ectopic pregnancy
male: penile discharge- thick and cloudy, dysuria, testicular pain, rectal tenesmus, epididymitis, prostatitis

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15
Q

chlamydia testing

A

NAAT: bacterial DNA or RNA
women- vaginal or cervical swabs optimal
men: first void urine or urethra swab

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16
Q

chlamydia treatment

A

doxycycline: 100 BID x 7 days
alternative: azithromycin 1gm PO x 1 dose or levofloxacin 500 mg PO daily x 1 week

17
Q

vulvovaginitis

A

inflammation of vulva and vagina: bacteria, protozoa or fungi infection
common: trichomoniasis (chlamydia)- malodorous, yellow/green discharge, pruritus, petichiae (strawberry patches) on cervix, candidiasis (non-sexual transmission) thick white curd like discharge, erythema, pruritus
bacterial vaginosis: watery, gray, fish smelling discharge

18
Q

how to diagnosis vulvovaginitis

A

microscopic wet prep; NAAT or vaginal culture

19
Q

treatment for trichomoniasis and bacterial vaginosis

A

metronidazole 500 PO BID x 7 days
alternative: tinidazole orally for 2 days
clindamycin

20
Q

candidiasis regimen

A

clotrimazole cream intravaginally 7-14 days or miconazole cream intravaginally
oral: fluconazole 150 mg PO x1 (not recommended in 1st trimester of pregnancy- this has been retracted recently, now considered safe)

21
Q

genital chancroid organism, coinfections

A

hemophilus ducreyi (gram neg bacillus)
cofactor for HIV transmission, 10% also infected with syphilis and HSV
Men; superficial painful ulcer- may be necrotic or erosive
women: asymptomatic
diagnose based on morphology of chancroid (sensitivity < 80%)

22
Q

treatment of chancroid

A

azithromycin, ceftriaxone (rocephin), ciprofloxacin

gram negative coverage

23
Q

Herpes organism, treatment

A

herpes simplex virus, recurrent infection, no cure
type 1: lips, face, mucosa
type 2: genitalia

24
Q

triggers for HSV flare

A

stress, lack of sleep, sunlight exposure, cold weather exposure, female hormone changes

25
Q

HSV- 2 s/s

A

headache, fever, aches, malaise, joint pain

26
Q

what is a herpetic whitlow

A

can be both type 1 and type 2 HSV
small blisters form on fingertip- painful- develop after contact with contagious sore
diagnosis: NAAT, culture
Tx: no treatment needed- usually clears in 2-3 weeks, or antiviral meds can be given: acyclovir, famiciclovir, valacyclovir: can shorten duration of ulcer