STI Flashcards
Painful, irregularly chapped, deep red ulcerations, with red halo.
Chancroid
How to Dx Chancroid
Culture - definitive dx
What should you test a patient for that has been dx with chancroid
Test for HIV at time of dx
First line Tx for chancroid
First line - Azithromycin X 1
Disease caused by 3 unique strains of chlamydia trachomatis
LGV - Lymphogranuloma venereum
In LGV what s/s would you see during the primary stage
small, painless erosions, that heal quickly
In LGV what s/s would you see during the inguinal stage
lymphadenopathy, may have HA or fever
In LGV what s/s would you see during the late stage
Anorectal swelling, peri-rectal abscess, fistulae, or swelling or ulcerations on labia
How do you confirm dx of LGV
Confirm with serological LCG complement fixation test.
When diagnosing LGV if the titer is 1:16 what does that mean
suspected LGV
When diagnosing LGV if the titer is >1:64 what does that mean
Diagnostic for LGV
First line treatment for LGV
Doxycycline 100 mg BID x 21 days
Herpes simplex virus HSV - what are the two types and where are they located
HSV 1 - oral “cold sores”
HSV 2 - genital herpes
Multiple, painful, vesicular or ulcerated lesions that last 12 days during an initial breakout and 4-5 days during a reoccurring breakout.
S/S HSV
Causes flu-like symptoms, and patient may feel tingling at the site of a lesion before the lesion presents
HSV
how to DX HSV
NAAT - nucleic acid amplification testing (to detect nucleic acid sequence of organisms)
Tx for HSV
Acyclovir
Other name for poxvirus
Molluscum contagiosa
Pearly, raised painless, flesh-colored lesions with dimpled centers
Mulluscum contagiosum
How to dx Mulluscum contagiosum
By visual inspection
How to tx Mulluscum contagiosum
No treatment
How long do Mulluscum contagiosum lesions last
month to years
Can you be reinfected with Mulluscum contagiosum
Once healed; lifetime immunity
If Mulluscum contagiosum lesions become a problem to look at what can be done
Cryotherapy - will scar
What are the three stages of syphilis
Primary (chancre), Secondary (rash), and Late (gumma lesions)
S/S primary Syphilis
Painless ulcer at initial site of contact called a chancre
S/S secondary syphilis
Secondary; maculopapular rash on palms of hands and soles of the feet, flu like s/s
S/S late syphilis
Late stage; cardiac, near, ophthalmic, auditory, and gummatous lesions (gammas)
What is a gumma lesion and when would you expect to see a gumma lesion
Center necrotic tissue and has a rubbery texture - late stage syphilis
If a patient has syphilis what should you also test for
HIV
How to dx syphilis
Dark field microscopy
What will be seen on dark field microscopy if a patient has syphilis
+ for spirochetes
hat are 4 most common STI
Chamydia, gonorrhea, syphilis, and trichomonas
How are Chamydia, gonorrhea, syphilis, and trichomonas cured
abx tx
What are the 3 common viral STI
HSV, HIV, HPV
Tx of primary and secondary syphilis
Benzathine PCN G; IM x1
Tx of late stage syphilis
PCN B IM weekly for 3 doses
What STI gives women these symptoms Frothy, malodorous (yellow-green) discharge, vulvar irritation
Women S/S of Trichomonaisis
What STI increases risk of men getting urethritis, epidymitis, and prostatitis ?
Trichomonaisis
How to dx Trichomonaisis
Cervical wet mount, NAAT, APTIMA T, amplified DNA assay.
Cervical wet mount smear shows motile protozoa and WBC, with a vaginal Ph of >5 - what STI am I ?
Trichomonaisis
If you see a “strawberry cervix” What STI would I most likely have contacted ?
Trichomonaisis
Tx for Trichomonaisis
Metronidazole
If I have Trichomonaisis, and I have been put on the first line abx tx, what fun substance should I avoid if I don’t want to vomit all over myself
Alcohol
GNID
Neisseria gonorrhea
If I have gonorrhea and I am a women what symptoms may I have ?
purulent, yellow, or green vaginal discharge, bleeding, pain in intercourse, or pelvic pain.
Dx gonorrhea
Gonococcal culture & NAAT
If you are trying to dx gonorrhea where do you collect swabs
women: endocervical men: urethral
The tx combo for gonorrhea
Ceftriaxine 250 mg IM X1 PLUS azithromycin 1 gram PO x1
If I am given Ceftriaxine 250 mg IM X1 PLUS azithromycin 1 gram PO x1, what STI do I most likely have ?
Gonorrhea
What two STI can be asymptomatic most a lot of the time
Gonorrhea and Chlamydia
How to Dx chlamydia
NAAT
If you want to dx a patient with chlamydia where do you do the swabs?
Women; vaginal
Men: urethral, rectal, or first catch urine specimen
Tx for chlamydia (2 options)
Azithromycin 1 gram PO x1 or doxycycline 100 mg PO BID x7 days
What are the high risk HPV stereotypes
16 and 18
What are the low risk HPV stereotypes
6 and 11
What does HPV 16 and 18 predispose you too?
cervical carcinoma CA
What does HPV 6 and 11 predispose you too?
Genital warts
External warts that are flat. popular, or pedunculate lesions, single of multiple and of different sizes
HPV
If I have wart-like lesions that are asymptomatic what STI should I be tested for ?
HPV
Dx of HPV
Visually inspect the lesions. cytology (pap smear), colposcopy
Preventative care for cervical CA and HPV
Gardisil vaccine
Tx for HPV
Podofilox BID 3x week for 16 weeks, Imiquimod cream at bedtime 3x week for 16 weeks
DX HIV - initial screening test
HIV1 / HIV2 antigen/antibody combination immunoassay
DX HIV Second screening if HIV1 / HIV2 antigen/antibody combination immunoassay comes back positive
Immunoassay to distinguish between HIV1 and HIV2 antibodies
If Immunoassay to distinguish between HIV1 and HIV2 antibodies was inconclusive what test do you run to dx HIV
NAAT - the HIV viral load testing
Tx for HIV1
Two NRTIs + a third drug from another ARV class (INSTI, NNRTI, PI) + PK
