STI

Question 1

treatment for uncomplicated urogenital gonorrhea

Answer 1

1st line:
ceftriaxone IM 500mg single dose
Alternative:
gentamicin 240mg +azithro 2g single dose

+ chlamydia (7days)
doxycycline
alternative: levo

Question 2

treatment for syphillis for naive pts

Answer 2

pri/sec: IM benzathine pen G 2.4mil units single dose
alternative: doxycycline x14d

tertiary: IM benxathine pen g 2.4 mil units once a week 3 doses
alternative: doxycycline x28 days

neurosyphillis (10-14 days): IV crystalline 3.2 mil units q4h
OR IM procaine 2.4 mil units OD + probanecid 500mg QDS
alternative: ceftriaxone 2g OD

Question 3

treatment for 1st occurence genital herpes

Answer 3

acyclovir 200mg TDS
valacyclovir 1g BD

x7-10days

Question 4

chronic suppressive therapy for recurrent genital herpes

Answer 4

acyclovir 400mg BD
Valacyclovir 1g OD

Question 5

episodic therapy for recurrent genital herpes

Answer 5

acyclovir 800mg BD x5d
famicyclovir 1g BD x1d
valacyclovir 500mg BD x3g

Question 6

ART combis in naive HIV pts

Answer 6

tenofovir+ emtricitabine+ bictegravir

tenofovir + emtricitabine + dolutegravir

abacavir + lamivudine + dolutegravir

alternative is no Hep B and viral<500k, emtricitabine + dolutegravir

Question 7

describe the toxicity with abacavir and screening as a result

Answer 7

hypersensitivity esp in ppl with HLA-B*5701 gene. indians and malays with AIDS

Question 8

major toxicity for each of the 5 classes of ART

Answer 8

NRTI: mitochondrial loss, fat loss

NNRTI: neuropsychiatric

INTI: elevated CK, rhabdo

protease I: dyslipidemia, insulin resistance, lipohypertrophy

fusion inhibitors: Injection site reaction

Question 9

egs of ART from each class

Answer 9

NRTI: abacavir, emtricitabine, tenofovir, lamivudine, zidovudine

NNRTI: efavirenz, ripivirine

INSTI: (-gravir) bictegravir, dolutegravir

Protease inhibitors: (-navir)

fusion inhibitor: enfuvirtide

CCR5 inhibitor: maraviroc

Question 10

3 things to do to manage sex partners in STIs

Answer 10

1. eval and treat sex partners past 60days
2. abstain from sex for 7 days aft initiating tx
3. abstain from sex with partners not treated