Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Infectious Disease > STI's > Flashcards

STI's Flashcards

1
Q

STI Bacterial Infections

A 
Gonorrhea – Neisseria gonorrhoeae
Chlamydia – Chlamydia trachomatis
Bacterial Vaginosis
Syphilis – Treponema pallidum
Chancroid - Haemophilus ducreyi
Pelvic Inflammatory Disease***
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Urethritis and Cervicitis

A

Frequent co-infection so use drug regimens effective against both gonorrhea and chlamydia unless diagnostic point-of-care testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Organism(s): Neisseria gonorrhoeae

A

Gram negative diplococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Organism(s): Neisseria gonorrhoeae

Clinical Presentation:

A 
Often asymptomatic (especially in females)
Dysuria
Green or white discharge from urethra or cervix
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Gonorrhea

A

Ceftriaxone 250 mg IM x 1 plus
azithromycin 1 g PO x 1
Administer on the same day & together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Disseminated Gonococcal Infection

A

Skin lesions (red or purple spot)
Asymmetric arthralgia or septic arthritis
Endocarditis (rare)
Meningitis (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Disseminated Gonococcal Infection

Diagnosis

A

Nucleic Acid Amplification Tests (NAAT)

and/or cultures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Disseminated Gonococcal Infection

Treatment

A

Ceftriaxone 1 g IM/IV Q24H for at least 7 days

plus azithromycin 1 g PO x 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Organism(s): Chlamydia trachomatis

A

Gram negative obligate intracellular parasite

Highest prevalence: age <24 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Organism(s): Chlamydia trachomatis: Diagnosis

A

Nucleic Acid Amplification Tests (NAAT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Organism(s): Chlamydia trachomatis: Treatment

A

Azithromycin 1 g PO x 1

Doxycycline 100 mg PO BID x 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Bacterial Vaginosis: Organism(s):

A

Polymicrobial clinical syndrome
Result of normal flora being replaced by an overgrowth of anaerobes

Clinical Presentation:
Asymptomatic or malodorous discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Bacterial Vaginosis: Diagnosis

A

Amsel’s Criteria require 3 of following 4:

  1. ) Homogeneous, thin, white discharge
  2. ) Clue cells (vaginal skin cells with bacteria “stuck” to edges) on microscopy
  3. ) pH >4.5
  4. ) Whiff test positive (fishy odor to discharge before or after addition of 10% KOH)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bacterial Vaginosis Treatment:

A
  1. ) Metronidazole 500 mg PO BID x 7 days
  2. ) Metronidazole gel 0.75%, 5 g intravaginally once daily x 5 days
  3. ) Clindamycin cream 2%, 5 g intravaginally at bedtime x 7 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Syphilis Organism(s):

A

Treponema pallidum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Syphilis Diagnosis:

A

Darkfield microscopy

Visualization of spirochete is definitive diagnostic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Syphilis Diagnosis: Treponemal Tests

A

Used for confirmation
Less sensitive, but highly specific
Most patients remain reactive for rest of life
NOT used to assess treatment response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Syphilis Diagnosis: Nontreponemal Tests

A

Used for screening
Highly sensitive, but less specific
Venereal Disease Research Laboratory (VDRL)
Rapid Plasma Reagin (RPR)
Reported quantitatively as antibody titer
4-fold change in titer (e.g. 1:16 to 1:4) is considered clinically significant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Types of Syphilis

A 
Primary
Secondary
Latent
Early latent
Late latent
Tertiary
Neurosyphilis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Primary Syphilis

Timing:

A

10-90 days after infection
Average = 21 days

Clinical Presentation: 
Single, painless ulcer or chancre 
Localized to where bacteria entered body
External genitalia
Vagina
Anus
Rectum
Mouth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Secondary Syphilis

Timing:

A

2-8 weeks after initial infection
Occurs primarily in untreated individuals

Clinical Presentation: Systemic symptoms
Skin rash (painless)
Mucocutaneous lesions
Lymphadenopathy
Genital warts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Latent Syphilis Timing:

A

If occurred within 1 year, then early latent

If occurred >1 year ago or unknown, then late latent

Clinical Presentation:
Serologic activity without signs/symptoms of disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Tertiary Syphilis Timing:

A

10-30 years after initial infection
May damage the brain, nerves, eyes, heart, blood vessels, liver, bones, or joints and lead to death

Clinical Presentation:
Difficulty coordinating muscles or paralysis
Numbness
Gradual blindness
Dementia 
Gumma = soft, inflammatory masses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Neurosyphilis Timing:

A

May occur during any stage

Clinical Presentation:
Early signs = cranial nerve dysfunction, meningitis, stroke, acutely altered mental status, auditory or visual abnormalities
Late signs = tabes dorsalis, muscle weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Syphilis Treatment | Primary, secondary, and early latent syphilis
Benzathine penicillin G 2.4 million units IM x 1
26
Syphilis Treatment | Tertiary, late latent syphilis, syphilis of unknown duration
Benzathine penicillin G 2.4 million units IM weekly x 3 doses
27
Syphilis Treatment | Neurosyphilis or Ocular Syphilis
Aqueous crystalline penicillin G 3-4 million units IV Q4H x 10-14 days Aqueous crystalline penicillin G 18-24 million units IV continuous infusion x 10-14 days
28
Penicillin notes
T. pallidum can reside in sequestered sites (e.g., the CNS) that are poorly accessed by some forms of penicillin. Oral penicillins are NOT appropriate for syphilis. Combinations such as Bicillin C-R are NOT appropriate for syphilis.
29
Penicillin dosage forms
``` IV Formulation Penicillin G (Aqueous) IM Formulations Penicillin G Benzathine (Bicillin L-A) Penicillin G Procaine Penicillin G Benzathine and Penicillin G Procaine (Bicillin C-R) PO Formulation Penicillin V Potassium ```
30
Jarisch-Herxhelmer Reaction
As bacterial cells die, endotoxins are released more quickly than the body can process Fever, headache, myalgia, tachycardia May occur in first few hours after administration of penicillin for syphilis treatment ****Manage with antipyretics, but do not change syphilis treatment regimen****
31
Penicillin Allergy in pregnancy
Pregnant with any stage of syphilis: Penicillin desensitization Neurosyphilis: Penicillin desensitization
32
Penicillin Allergy in Primary & secondary syphilis:
Doxycycline 100 mg PO BID x 14 days Tetracycline 500 mg PO four times daily x 14 days Ceftriaxone 1-2 g IM/IV daily x 10-14 days
33
Penicillin Allergy in Latent syphilis alternatives:
Doxycycline 100 mg PO BID x 28 days | Tetracycline 500 mg PO four times daily x 28 days
34
Syphilis follow-up:
Primary or secondary syphilis: 6 and 12 months Early or late latent syphilis: 6, 12, and 24 months Neurosyphilis: CSF exam every 6 months until CSF WBC count is normalized
35
Pregnancy and Syphilis
Only penicillin is currently recommended Desensitization required for β-lactam allergic pregnant patients Some experts recommend a second dose of benzathine PCN G 2.4 million units IM 1 week after the initial dose for primary, secondary, early latent syphilis in pregnancy
36
Chancroid Organism(s):
Haemophilus ducreyi | Gram negative coccobacillus
37
Chancroid Treatment:
Azithromycin 1 g PO x 1 Ceftriaxone 250 mg IM x 1 Ciprofloxacin 500 mg PO BID x 3 days Follow Up: 3-7 days
38
HPV Genital warts Prevention:
``` Bivalent vaccine (Cervarix): -Types 16 & 18 Quadrivalent vaccine (Gardasil): -Types 6, 11, 16, & 18 9-Valent vaccine (Gardasil-9): -Types 6, 11, 16, 18, 31, 33, 45, 52, & 58 ``` All are 3-dose series given over 6 months Use same product for entire 3-dose series
39
Genital Herpes treatment: | 1st episode
First Episode Acyclovir 400 mg PO TID x 7-10 days Valacyclovir 1 g PO BID x 7-10 days
40
Genital Herpes treatment: | suppresive therapy
Acyclovir 400 mg PO BID Valacyclovir 1,000 mg PO daily Famciclovir 250 mg PO BID
41
Genital Herpes treatment: Episodic Therapy Initiate within 1 day of onset or during prodrome Regimens:
``` Acyclovir 400 mg PO TID x 5 days Acyclovir 800 mg PO BID x 5 days Acyclovir 800 mg PO TID x 2 days Valacyclovir 500 mg PO BID x 3 days Valacyclovir 1 g PO daily x 5 days Famciclovir 125 mg PO BID x 5 days Famciclovir 1 g PO BID x 1 day Famciclovir 500 mg x 1, 250 mg BID x 2 days ```
42
Organism(s): Trichomonas vaginalis
Clinical Presentation: Males: urethritis, epididymitis, prostatitis Females: diffuse, malodorous discharge Complications: increased risk for HIV acquisition, preterm birth, PID
43
Organism(s): Trichomonas vaginalis | Diagnosis
Diagnosis: NAAT Culture Wet mount microscopy
44
Organism(s): Trichomonas vaginalis | Treatment:
Treatment: Metronidazole 2 g PO x 1 Tinidazole 2 g PO x 1 Follow Up: 3 months in women Re-infection rate of 17% at 3 months
45
Vulvovaginal Candidiasis | Organism(s):
Candida spp. Usually Candida albicans but may be other yeast Clinical Presentation: Pruritus, vaginal soreness, painful intercourse, dysuria, abnormal discharge
46
Classification of VVC | Uncomplicated VVC:
``` Sporadic or infrequent AND Mild to moderate AND Likely to be Candida albicans AND Non-immunocompromised women ```
47
Classification of VVC | Complicated VVC
``` Recurrent OR Severe OR Non-albicans Candida OR Women with DM, immunocompromised or debilitation ```
48
Uncomplicated VVC Diagnosis:
Signs/symptoms of vaginitis with: 1. Wet prep or Gram stain with yeast or hyphae 2. Culture positive for yeast species Normal vaginal pH (<4.5)
49
Uncomplicated VVC Treatment:
OTC agents - Clotrimazole cream - Miconazole cream or vaginal suppository - Tioconazole ointment Rx agents - Fluconazole 150 mg PO x 1 - Butoconazole cream - Terconazole cream or vaginal suppository Follow Up: Not required
50
Complicated VVC Diagnosis: Treatment: Follow Up:
Diagnosis: Vaginal culture to confirm diagnosis and check for non-albicans species Treatment: Topical therapy x 7-14 days Fluconazole 150 mg PO Q72H x 2 doses Follow-up: Not required
51
Risk assessment | Five P’s:
``` Partners, Practices, Pregnancy prevention, Protection, Past history ```
52
Prevention via Male Condoms
May reduce the risk of developing pelvic inflammatory disease (PID) in women
53
Pelvic Inflammatory Disease (PID)
Definition: Ascending infection of the female genital tract involving the fallopian tubes
54
Salpingitis:
type of PID, inflammation of the fallopian tube
55
Tubo-ovarian abscess:
Late complications of PID that can be life-threatening if the abscess ruptures and results in sepsis Consists of an encapsulated or confined “pocket of pus” with defined boundaries during an infection of a fallopian tube and ovary Should be managed inpatient initially
56
PID is:
spontaneous ascension of microbes from the cervix or vagina to the endometrium, fallopian tubes or adjacent structures
57
PID: Common Pathogens
``` N. gonorrhoeae C. trachomatis Anaerobes Gram-negative bacteria Streptococcus species ```
58
PID: Clinical Presentation
Tenderness in the lower abdomen, cervical motion, and adnexal area Abnormal discharge and menorrhagia Fever Dysuria Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)
59
PID Complications:
Complications: Abscess formation, occlusion, fibrosis, ectopic pregnancy, infertility
60
Who can be treated outpatient?
``` Temp < 38oC WBC < 11,000/mm3 Minimal evidence of peritonitis Active bowel sounds Able to tolerate oral nourishment ```
61
PID Outpatient Treatment Options
Ceftriaxone 250 mg IM x 1, plus doxycycline 100 mg PO BID x 14 days Cefoxitin 2 g IM x 1, plus probenecid 1 gram PO x 1, plus doxycycline 100 mg PO BID x 14 days Metronidazole 500 mg PO BID x 14 days can be added for further anaerobic coverage
62
PID Inpatient Treatment Options
Beta-lactam regimens - Cefotetan 2 g IV q12h + Doxycycline 100 mg IV/PO q12h - Cefoxitin 2 g IV q6h + Doxycycline 100 mg IV/PO q12h Beta-lactam free regimens - Clindamycin 900 mg IV q8h + gentamicin IV/IM 2-mg/kg loading dose followed by 1.5 mg/kg q8h (or 3-5 mg/kg once-daily dosing)
63
PID Treatment Recommendations | IV to PO Switch
Patients can be switched from IV to PO therapy after the patient has been clinically stable for 24-48 hours
64
PID Treatment Recommendations | Treatment failure:
Check for Mycoplasma genitalium | Start Moxifloxacin 400 mg PO daily x 14 days
65
PID Treatment Recommendations | General considerations
Fluoroquinolones no longer recommended because of increasing resistance DOT CDC recommends 14 days of therapy regardless of administration route of therapy

Infectious Disease (56 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions