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Therapy: year 3 > STI - part 1 > Flashcards

STI - part 1 Flashcards

1
Q

what are reportable STIs

A

chlamydia
gonorrhea
Chancroid
syphilis
Viral Hep
HIV

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2
Q

it is not important to notify the partners of thos who have a reportable STI

A

false

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3
Q

what is the first most common vs second most comon STI

A

chlamydia and gonorhea ( these are closily linked)

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4
Q

chlamydia and gonorhea patient demogrphaic

A

youth (under 30)

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5
Q

chlamydia and gonorhea whihc is more prominaint in females and whihc in males

A

chlamydia - females

gonorrhea- males

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6
Q

syhpilis trend in canda

A

rising

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7
Q

syphilis patient demogrpahic

A

males

above 30

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8
Q

is HPV reportable?

A

no

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9
Q

HpV how common

A

70% have it in lifetime

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10
Q

is HSV reportable

A

no

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11
Q

for HSV and HPV patient demogrpahic

A

adolescents

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12
Q

STI screening - shoudl we use a syndromal apporch why or why not?

A

not, because many STIs are asymptomatic

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13
Q

what should we do routine screening for?

A

chlamydia, gonorrehea, syphilis, HIV, hep B

for women add trichonomas

should also screen for HSV and HPV (however a pap is needed for HPV)

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14
Q

is POC testing enough to confirm a diagnosis by?

A

no need lab values, serology

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15
Q

is co-infection with STIs a concern

A

yes - example chlamydia and gonorhea

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16
Q

HIv and STI conerns

A
  • having an STI increase HIV transmission
  • HIV patients may be less responisve to STi med especially if immune surppresed (not all HIV patients are immune suppressed)
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17
Q

what are the screening approaches

A

prenatal screening

risk factor screening (25 plus)

annual screening ( for Ct and NG for those under 30 that are LGBTQ)

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18
Q

for Ct and NG how do we screen?

A

we can use urien of swabs (swabs all areas involved in sex, urtheral, vaginal, cervical, recatl, pahryngeal)

for urine we do a NAAT

for swabs we do a NAAT and culture

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19
Q

for syphilis how do we screen?

A

blood work - lab does seroly

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20
Q

when we suspect NG how does it affect screening

A

we should also culture

also chcek for both due to co-infection

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21
Q

when collecting urine samples what is of importance

A

firt pee

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22
Q

what do condoms not protect against?

A

HSV, HPV, and syphilis (due to lesions?)

23
Q

what do condoms protect against

A

CT, NG, HIV, HBV

24
Q

what kind of condoms should we avoid and why?

A

nonoxynol-9 (spericide

  • increase risk of HIV and STI by disruption and lesions
25
Q

CT serovars and what they cause

A

D-V

serovars L1, L2, and L3 cause LGV (whihc has more systemic sym)

26
Q

CT tissue it affects

A

lymphatic tissue

27
Q

CT presentation and complication

A

can cause small painless ulcers or painful hemorrhagic proctitis with complications such as anal fissure and strictures

28
Q

CT incubation period

A

2-6 weeks

29
Q

NG invubation period, and timelines of syms

A

incubates for 2-7 days

sym within week of exposure

30
Q

NG asymptomatic groups

A

Asymptomatic in females

rectal and pharyngeal infections asymptomatic

31
Q

Ch and NG clinical presentation what symptomatic should we be aware of and treat?

A

PID

32
Q

CH tx

A

Doxy BID for 7 days or Azithromycin one singel dose

33
Q

CH tx with LSV

A

Doxy BID for 21 days

34
Q

Ch whihc drug is favored why?

A

doxy - cheaper

35
Q

CH if we vomit an hour after dose what do we do?

A

nothing - dose is good

36
Q

what is EPT

A

delivering of drugs to infected partner to ensure adequate treatment

37
Q

due to resistance emerging what drug class should be avoided for routine therpay?

A

tetrcycline, macrolide, quinolones

38
Q

NG tx - anogenital

A

Cetriaxone IM single dose plus azithromycin po single dose

or

Cefixime Po single dose PLS azithromycin po single dose

39
Q

NG tx - angiogenital MSM

pharyngeal infection

A

Cetfriaxone IM single dose plus azithromycin po single dose

or

Cefixime Po single dose PLS azithromycin po single dose

40
Q

NG - when is cefriatoxone favored over cefixime

A

when MSM, when deeper penetration such as with pharyngeal infections

41
Q

NG- cepholosporialin allergy

A

use high dose azithrom

42
Q

NG tretaed should not be given at same time at CT tx, true or false

A

NG and co-infections occur so best to treat for both conditiosn

43
Q

what type of NG - requires hospitalization

A

disseminated gonococcal infections

44
Q

CT moniotring and follow up

A

test for cure not indicated unless prego or pre-pubertal children or adherence conernces

can chcek NAAT after 4 week

45
Q

GN moniotring and follow up

A

test to cure culture 3-7 days post therpay

46
Q

CT and GN follow up

A

chcek for reingfection at 306 months due tp high rate of reinfection

47
Q

Ct and GN abstain from sex for how long?

A

until done theroay or 7 days after single dose

48
Q

PID what is it

A

infecteion of female upper genital tract

  • usualy due to untreated Ct and NG
49
Q

PID long term sequela

A

inferitilty
ectopic pregenancy
chronic pelvic pain

50
Q

PId organims and what does that mean tretament wise

A

polymicrobial and thus broad spetrum abx

51
Q

PID tx paternal options

A

-cefoxitin(IV) and doxy (IV or oral) - duration of IV 24 hours after improvement otherwise for 14 days

or

clindamycin IV with gentamicin (IV or IM) - duration of IV 24 hours after improvement otherwise for 14 days
- gentamcin needs a loading dose

52
Q

PID tx outpatient options

A

ceftriaxone IM plus doxy po BID for 14 days

or

cefoxitin IM plus probenecid po and doxy po BID for 14 days

or

other third gen cephalosporines and doxy for 14 days

53
Q

what do we do for anaerobe coverge

A

add metronidazole (avoid alcohol fro 24 hr)

Therapy: year 3 (14 decks)

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