STI - part 1 Flashcards
what are reportable STIs
chlamydia
gonorrhea
Chancroid
syphilis
Viral Hep
HIV
it is not important to notify the partners of thos who have a reportable STI
false
what is the first most common vs second most comon STI
chlamydia and gonorhea ( these are closily linked)
chlamydia and gonorhea patient demogrphaic
youth (under 30)
chlamydia and gonorhea whihc is more prominaint in females and whihc in males
chlamydia - females
gonorrhea- males
syhpilis trend in canda
rising
syphilis patient demogrpahic
males
above 30
is HPV reportable?
no
HpV how common
70% have it in lifetime
is HSV reportable
no
for HSV and HPV patient demogrpahic
adolescents
STI screening - shoudl we use a syndromal apporch why or why not?
not, because many STIs are asymptomatic
what should we do routine screening for?
chlamydia, gonorrehea, syphilis, HIV, hep B
for women add trichonomas
should also screen for HSV and HPV (however a pap is needed for HPV)
is POC testing enough to confirm a diagnosis by?
no need lab values, serology
is co-infection with STIs a concern
yes - example chlamydia and gonorhea
HIv and STI conerns
- 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)
what are the screening approaches
prenatal screening
risk factor screening (25 plus)
annual screening ( for Ct and NG for those under 30 that are LGBTQ)
for Ct and NG how do we screen?
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
for syphilis how do we screen?
blood work - lab does seroly
when we suspect NG how does it affect screening
we should also culture
also chcek for both due to co-infection
when collecting urine samples what is of importance
firt pee
what do condoms not protect against?
HSV, HPV, and syphilis (due to lesions?)
what do condoms protect against
CT, NG, HIV, HBV
what kind of condoms should we avoid and why?
nonoxynol-9 (spericide
- increase risk of HIV and STI by disruption and lesions
CT serovars and what they cause
D-V
serovars L1, L2, and L3 cause LGV (whihc has more systemic sym)
CT tissue it affects
lymphatic tissue
CT presentation and complication
can cause small painless ulcers or painful hemorrhagic proctitis with complications such as anal fissure and strictures
CT incubation period
2-6 weeks
NG invubation period, and timelines of syms
incubates for 2-7 days
sym within week of exposure
NG asymptomatic groups
Asymptomatic in females
rectal and pharyngeal infections asymptomatic
Ch and NG clinical presentation what symptomatic should we be aware of and treat?
PID
CH tx
Doxy BID for 7 days or Azithromycin one singel dose
CH tx with LSV
Doxy BID for 21 days
Ch whihc drug is favored why?
doxy - cheaper
CH if we vomit an hour after dose what do we do?
nothing - dose is good
what is EPT
delivering of drugs to infected partner to ensure adequate treatment
due to resistance emerging what drug class should be avoided for routine therpay?
tetrcycline, macrolide, quinolones
NG tx - anogenital
Cetriaxone IM single dose plus azithromycin po single dose
or
Cefixime Po single dose PLS azithromycin po single dose
NG tx - angiogenital MSM
pharyngeal infection
Cetfriaxone IM single dose plus azithromycin po single dose
or
Cefixime Po single dose PLS azithromycin po single dose
NG - when is cefriatoxone favored over cefixime
when MSM, when deeper penetration such as with pharyngeal infections
NG- cepholosporialin allergy
use high dose azithrom
NG tretaed should not be given at same time at CT tx, true or false
NG and co-infections occur so best to treat for both conditiosn
what type of NG - requires hospitalization
disseminated gonococcal infections
CT moniotring and follow up
test for cure not indicated unless prego or pre-pubertal children or adherence conernces
can chcek NAAT after 4 week
GN moniotring and follow up
test to cure culture 3-7 days post therpay
CT and GN follow up
chcek for reingfection at 306 months due tp high rate of reinfection
Ct and GN abstain from sex for how long?
until done theroay or 7 days after single dose
PID what is it
infecteion of female upper genital tract
- usualy due to untreated Ct and NG
PID long term sequela
inferitilty
ectopic pregenancy
chronic pelvic pain
PId organims and what does that mean tretament wise
polymicrobial and thus broad spetrum abx
PID tx paternal options
-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
PID tx outpatient options
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
what do we do for anaerobe coverge
add metronidazole (avoid alcohol fro 24 hr)
