STI

Question 1

Symptoms of Chlamydia Syndrome

Answer 1

Cervicitis (bleeding after sex), itis-everything (proctitis, urethritis, epidydimitis, conjunctivitis, endometritis, salpingitits, perihepatitis)

Question 2

Describe cervix in Chlamydia

Answer 2

Mucopurlent drainage (yellow or green); friable (just with cotton swab or speculum exam), erythema, edema, all WBC seen on microscope

Question 3

Chlamydia Complications

Answer 3

PID (10 - 15%), increase r/o HIV, chronic pelvic pain, ectopic pregnancy, tubal infertility, epididymitis, reactive arthritis syndrome, eye infection or pneumonia in newborn

Question 4

Lab testing for Chlamydia

Answer 4

NAAT; extrogenital recommended for MSM

Question 5

30% symptomatic gonococcal urethritis attributed to what kind of exposure?

Answer 5

oro-pharyngeal

Question 6

HIV risk for MSM w/ chlamydia infection

Answer 6

1/15 MSM diagnosed with HIV within 1 year of Chlamydia infection

Question 7

Treatment for Chlamydia

Answer 7

Azithromycin 1 g PO

alternative: Doxy 100 mg PO BIX x 7D (may be superior for rectal infections)

Question 8

When to retest for Chlamydia

Answer 8

Pregnancy, non-adherence suspected, persistent symptoms, early reinfection

Question 9

Population most commonly infected with Chlamydia

Answer 9

Young female

Question 10

Population most commonly infected with Gonorrhea

Answer 10

MSM (not nearly as much with MSW)

Question 11

Clinical manifestations of gonorrhea

Answer 11

Male: urethritis, 5% asymptomatic
Female: majorly asymptomatic though may have dysuria, abdominal pain, discharge, labial pan and swelling

Question 12

Gonorrhea testing

Answer 12

NAAT

Question 13

Treatment for Gonorrhea

Answer 13

Ceftriaxone 250 mg IM x1 & Azithromycin 1g PO x1
Alternate (not pharyngeal): Gentamicin 240 mg IM x1 & Azithromycin 2g PO x1 OR Gemifloxacin 320 mg IM x1 & Azithromycin 2g PO x1

Question 14

Issues with PCN allergy in treating for gonorrhea

Answer 14

PCN and cephalosporins are cross-reactive but is negligible with 3rd generation cephalosporins (ceftriaxone)

Question 15

Nongonococcal Urethritis Symptoms

Answer 15

clearish mucoid discharge, mild dysuria

Question 16

Etiology of Nongonococcal Urethritis

Answer 16

chlamydia, trichomonis, mycoplasma or HSV most common

Question 17

Treatment for Nongonococcal Urethritis

Answer 17

Azithromycin 1 g PO x1 (and consider treatment for trich if prevalent in your population)