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STDs Flashcards

1
Q

AIDS is defined as an absolute CD4 count of

A

less than 200

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2
Q

s/s of AIDS

A

oral candidiasis, fever, weight loss, diarrhea, SOB

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3
Q

infection that causes the most deaths in patients with HIV

A

Pneumocystis jirovecii

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4
Q

An acute and brief illness that occurs in those within a few weeks after initial exposure to HIV

A

acute retroviral syndrome

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5
Q

s/s of acute retroviral syndrome

A

mimic mono (fatigue, fever, lymphadenopathy)

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6
Q

diagnosis tests for acute retroviral syndrome

A

HIV will be negative; if strongly suspected then order HIV PCR

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7
Q

s/s of disseminated gonococcal disease

A

petchial/pustular lesions on hands and soles; one swollen, red, tender joint; pharyngitis with green purulent exudate

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8
Q

recommended screening for gonorrhea chlamydia

A

screen annually in all sexually active females aged 25 and younger

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9
Q

repeat testing in 3 months is needed for this infection d/t high rate of recurrence

A

gonorrhea

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10
Q

cervical ectropion

A

immature cervix that has red bumps out of the cervical os (columnar cells).

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11
Q

Why young girls are at higher risk of STDs

A

their cervix hasn’t matured yet; columnar cells are easier to infect than squamous (mature cells)

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12
Q

Difference between cervical ectropion and cervicitis

A

ectropion has clear mucus, cervicitis has purulent mucus.

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13
Q

risk factors for chlamydia

A

age younger than 25

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14
Q

complication of chlamydia in males

A

Reiter’s syndrome

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15
Q

most sensitive test for gonorrhea and chlamydia

A

NAAT- can be collected from urine, cervix, urethra, oral, or rectal site.

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16
Q

GenProbe for gonorrhea and chlamydia

A

used to swab only the cervix or urethra

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17
Q

treatment for chlamydia

A

azithromycin 1 g PO x1 or doxycycline 100 mg PO bid x 7 days

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18
Q

side effects of doxycyline

A

GI upset, can cause tooth staining, photosensitivity

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19
Q

treatment for sexual partners of those with chlamydia

A

azithromycin 1 g PO x 1

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20
Q

treatment for pregnant women with chlamydia

A

azithromycin 1 g PO x 1 or amoxicillin 500 mg PO tid x 7 days

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21
Q

trx for PID

A

ceftriaxone 250 mg IM x 1 + doxycycline 100 mg PO bid with or without metronidazole bid x 14 days

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22
Q

difference between chlamydia and gonorrhea

A

gonorrhea can become systemic or disseminated if left untreated

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23
Q

Neisseria gonorrhoeae is a

A

gram negative bacterium

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24
Q

Chlamydia trachomatis is a

A

atypical bacteria

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25
Q

s/s of gonorrhea in female

A

green purulent vaginal discharge; cervix has purulent drainage

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26
Q

s/s of gonorrhea in male

A

purulent penile discharge and dysuria

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27
Q

Bartholin gland abscess

A

can be caused by gonorrhea

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28
Q

trx for gonorrhea

A

ceftriaxone 250 mg IM x1 + azithromycin 1 gm PO x 1 or doxycycline 100 mg BID x 7 days.

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29
Q

test of cure for gonorrhea/chlamydia

A

not needed

30
Q

education about trx for gonorrhea/chlamydia

A

trx partners within 60 days, avoid sex until therapy completed.

31
Q

If gonorrhea/chlamydia infection becomes complicated with PID, epididymitis, prostatitis, then trx

A

for 14 days

32
Q

risk factors for PID

A

age less than 24, hx of PID, multiple partners

33
Q

Fitz-Hugh-Curtis syndrome

A

chlamydia/gonorrhea infection of liver capsule; c/o RUQ pain with normal LFTs

34
Q

Jarisch-Herxheimer reaction

A

acute febrile reaction that occurs during first 24 hours after trx of syphilis; resolves on own.

35
Q

If gonorrhea positive, then

A

always co-treat for chlamydia, even if chlamydia is negative.

36
Q

If chlamydia positive, then

A

you don’t have to co-treat with gonorrhea.

37
Q

HSV1 is more

A

oral herpes

38
Q

HSV2 is more

A

genital herpes

39
Q

who to screen for syphilis

A

HIV infection, gay men, genital ulcer, previous STD, IV drug use

40
Q

syphilis is caused by

A

treponema pallidum (spirochete)

41
Q

s/s of primary syphilis

A

painless chancre

42
Q

s/s of secondary syphilis

A

condyloma lata, maculopapular rash on palms and soles that is not pruritic.

43
Q

s/s of tertiary syphilis

A

neuro, cardiac, and gummatous

44
Q

screening test for syphilis

A

RPR or VDRL (nontreponemal test)

45
Q

diagnostic test for syphilis

A

confirmed with treponemal test (FTA-ABS)

46
Q

trx for primary syphilis

A

benzathine PCN G 2.4 million units IM x1

47
Q

f/u for trx of syphilis

A

recheck RPR and VDRL at 6 and 12 months; look for a 4 fold decrease in titers

48
Q

condyloma lata is seen in ____; condyloma acuminata is seen in ______

A

syphilis (later phyllis!); genital warts

49
Q

risk factors of HIV

A

gay men, received blood from 1975-1985, hx of drug use

50
Q

diagnosis of HIV

A

screening with ELISA, confirmed with Western Blot

51
Q

ability of a test to identify or rule out a person WITH a disease

A

sensitivity (sensitive people have the disease)

52
Q

ability of a test to identify or rule out a person WITHOUT the disease

A

specificity

53
Q

The ELISA and Western blot only detect ____; if both are positive then this needs a ____ ordered

A

IgG antibodies; PCR/RNA

54
Q

window period of HIV

A

6 weeks to 6 months may show false negative Elisa/Western blot

55
Q

prophylaxis for opportunistic infections from HIV

A

Bactrim DS one tab daily

56
Q

live viruses that can be given to HIV people if their CD4 is greater than 200

A

MMR and varicella

57
Q

HIV education

A

avoid handling cat litter or eat uncooked meat; avoid birds; use gloves when gardening

58
Q

antibiotic prophylaxis for pneumocystis jerovecii pneumonia (PCP) is started when

A

CD4 less than 200

59
Q

if HIV patient is allergic to sulfa, then second line trx for PCP is

A

dapsone 100 mg daily

60
Q

the safest HIV drug to use during pregnancy

A

zidovudine (AZT); ideally start during 2nd trimester

61
Q

condylmata acuminata is caused by

A

HPV 6 and 11

62
Q

age a person is eligible for HPV vaccine

A

9-26

63
Q

acetowhitening is

A

white colored skin on cervical surface after acetic acid is applied; used to help detect areas to biopsy during colposcopy

64
Q

cervical cancer is caused by

A

HPV 16 and 18

65
Q

trx for genital warts

A

podofilox 0.5% gel/cream; Imiquimod 5% cream; cryotherapy

66
Q

diagnostic for herpes simplex virus

A

RPR assay HSV 1 and HSV 2

67
Q

s/s of herpes simplex virus

A

may have prodrome phase (itching, burning), sudden onset of small vesicles on erythematous base

68
Q

trx for herpes simplex virus

A

acyclovir 400 mg 5x/day x 7-10 days or Valtrex tid x 7-10 days

69
Q

trx for flare ups of herpes simplex

A

acyclovir or valacyclovir x 5 days; best to start one day of lesion onset.

70
Q

instructions on how to use Imiquimod (Aldara) gel for herpes warts

A

apply 3x/week at bedtime for up to 16 weeks. Do not cover with dressing. Leave on for 6-10 hours

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