STI

Question 1

• neutrophils & mixed flora
• asymptomatic; Odorless mucopurulent vaginal discharge
• cervical discharge or friable

Answer 1

chlamydia in female

Question 2

• mild to moderate clear/sticky urethral discharge
• nongonococcal urethritis
• epididymitis

Answer 2

chlamydia in males

Question 3

unilateral testicular pain and tenderness

Answer 3

epididymitis

Question 4

how is chlamydia diagnosed

Answer 4

NAAT

Question 5

Prior infection w/in ____ is important risk factor for future chlamydia infection

Answer 5

6 months

Question 6

when do you rescreen everyone who has been treated for chlamydia? when do you test for cure?

Answer 6

rescreen 3 months after
test for cure no earlier than 3 wks

Question 7

tx option for chlamydia in general? if pregnant?

Answer 7

• doxycycline 100 mg PO BID x 7 days
• azithromycin 1 g PO x 1 dose (if pregnant)

Question 8

unless a test proves otherwise, which two infections are typically co treated if a patient has one of them?

Answer 8

chlamydia & gonorrhea

Question 9

what is it? how is it treated? (2 options)

• Polymorphonuclear leukocytes w/ intracellular gram neg diplococci
• purulent discharge in males
• asymp or odorless (maybe greenish) discharge in females, post coital bleed, lymphadenopathy

Answer 9

gonorrhea
- ceftriaxone 500 mg IM x 1 dose
- gentamicin + azithromycin as single dose

Question 10

when can you do test of cure in gonorrhea

Answer 10

ONLY for those w/ pharyngeal version 7-14 days after tx

Question 11

how is gonorrhea diagnosed

Answer 11

NAAT
culture if worried about abx resistance
gram stain

Question 12

standard dx test for HSV

Answer 12

viral culture

Question 13

which HSV test can detect asymptomatic shedding?

Answer 13

PCR

Question 14

what is this?

soft noncancerous growth that is a form of granuloma

Answer 14

gumma– a possible manifestation of tertiary syphilis

Question 15

how is primary vs secondary syphilis diagnosed?

Answer 15

primary: darkfield microscopy– visualize spirochete
secondary: serology

Question 16

how is syphilis tx? when do you f/u?

Answer 16

Benzathine PCN G 2.4 million units IM x 1 dose
f/u at 6 and 12 months

Question 17

what 3 conditions can you do EPT for?

Answer 17

chlamydia
GC
trich

Question 18

what is this? tx?

• Gonorrhea & chlamydia are most common infections that cause it
• UA will have pyrura but negative culture; can mimic acute cystitis
• Dx is clinical

Answer 18

urethritis
tx: doxycycline 100 mg PO BID x 7 days (same as chlamydia)

Question 19

Uveitis, urethritis, arthritis– “cant see, pee or climb a tree”
Chlamydia is most common genital pathogen that causes it

Answer 19

reactive arthritis

Question 20

tx of PID

Answer 20

Ceftriaxone 1g IV q 24 hrs x 1 dose + Doxycycline 100mg PO or IV BID x 14 days + Metronidazole 500mg PO or IV BID x 14 days

cef, dox, metro– 1g, 100mg, 500mg– 1 day, 14 days, 14 days

Question 21

what is this? tx?

• Acute febrile reaction after syphilis or lymes dz tx
• HA, myalgia, fever w/in 24 hrs of giving IM PCH
• can cause fetal distress & early labor

Answer 21

Jarisch- Herxheimer reaction
tx: antipyretics