STDs

Question 1

AIDS

Answer 1

AIDS is defined by an absolute CD4 cell count of fewer than 200 cells/mm3

Question 2

Normal CD4 levels in healthy people

Answer 2

range from 500 to 1,400 cells/mm3

Question 3

STD symptoms with new onset of swollen red knee

Answer 3

May be caused by Disseminated Gonococcal Infection

Question 4

Chlamydia

Answer 4

Usually asymptomatic

NAAT test - swab or urine

Question 5

Treatment for chlamydia

Answer 5

Doxycycline 100 mg BID × 7 days

Azithromycin used for pregnant patients who have chlamydia. Test-of-cure needed 3 to 4 weeks after treatment.

Question 6

HSV-1

Answer 6

Oral ulcers are aggravated by eating/drinking/swallowing acidic foods (e.g., lemons, orange juice, tomato sauce). Primary infection is when the greatest viral shedding occurs (vesicular fluid and crusts are contagious). It is more severe than subsequent recurrences and can last from 2 to 4 weeks.

Question 7

Treatment for initial genital HSV infection

Answer 7

Valacyclovir (Valtrex) 1,000 mg PO BID × 7 to 10 days (preferred due to less frequent dosing)

Acyclovir TID

Question 8

Treatment for genital HSV flares

Answer 8

acyclovir or valacyclovir × 2–5 days

Question 9

Prophylaxis for pneumonia in HIV/AIDS patients

Answer 9

Bactrim PO

Question 10

Treatment for genital warts

Answer 10

Podophyllotoxin (Condylox) 0.5% gel or cream

Apply to external anogenital warts BID x 3 consecutive days, then hold for 4 days and repeat up to 4 times.

Cryotherapy and TCA are best for small warts; surgical excision is beneficial for large warts (>1 cm).

Question 11

Gonnorhea

Answer 11

A gram-negative bacteria that infects the urinary and genital tracts, anorectum, pharynx, and conjunctiva

Question 12

Test for gonorrhea

Answer 12

NAAT

Question 13

Treatment for gonorrhea

Answer 13

Ceftriaxone one dose

Question 14

Pelvic Inflammatory Disease

Answer 14

An acute, ascending polymicrobial infection of the upper genital tract structures in females. PID can be caused by cervical microorganisms (including C. trachomatis, N. gonorrhoeae, and Mycoplasma genitalium), as well as the vaginal microflora including other types of anaerobic organisms and bacteria.

Question 15

Testing for PID

Answer 15

Rule out gonorrhea, chlamydia,

Question 16

Treatment for PID

Answer 16

Ceftriaxone (Rocephin) 500 mg IM
plus
doxycycline 100 mg PO BID for 14 days
plus
metronidazole 500 mg PO BID for 14 days.

Question 17

Syphilis s/s - primary

Answer 17

Painless chancre (heals in 6–9 weeks if not treated)

Chancre has clean base, well demarcated with indurated margins

Question 18

Syphilis s/s - secondary

Answer 18

Systemic illness that develops within weeks to a few months after the chancre develops.

Generalized symptoms (e.g., fever, headache, lymph node enlargement), dermatologic findings (e.g., rash, alopecia),

GI symptoms, musculoskeletal abnormalities, renal complications, neurologic findings, and visual/auditory symptoms.

Dermatologic findings
- Condyloma lata: Infectious white papules [that look like white warts] in warm, moist areas (such as the mouth and perineum)
- Maculopapular rash (most characteristic finding of secondary syphilis) involving the entire trunk and extremities including the palms and soles that is not pruritic (may be generalized

Question 19

Syphilis treatment

Answer 19

Benzathine penicillin G 2.4 mU IM × one dose