STIs Flashcards
Chlamydia - Causes/Incidence
> C. -1-
> Most -2- in the U.S.
> Remains the -3- of -4-
- trachomatis
- common bacterial STI
- most common cause
- cervicitis and urethritis
Chlamydia - S/S > Females: -1- >> -2- bleeding >> -3- >> Vaginal -4-
- often asymptomatic
- postcoital
- Dyspareunia
- discharge
Chlamydia - S/S > Males: -1- >> -2- >> -3- discharge >> -4- pain >> Rectal -5-
- often asymptomatic
- dysuria
- Thick, cloudy, penile
- testicular
- tenesmus
Chlamydia
Lab/Dx
> -1- to detect -2-
Mgmt
> Infants and Children
» < forty-five kg: little data; erythromycin base or ethyl succinate fifty mg/kg/day PO QID x fourteen days
» Weighing forty-five+ kg: -4- PO, -5-
» less than eight years of age: may use -5- as an alternate to -3-
» -5- becomes the standard from adolescence forward
- Nucleic acid amplification test (NAAT)/culture
- bacterial DNA/RNA
- Azithromycin 1 gram
- single dose
- doxycycline (100 mg PO BID x 7 days)
Chlamydia - Mgmt
> During -1-
» -2- PO x 1 dose
» Alternative: -3- PO TID x 7 days
- pregnancy
- Azithromycin 1 g
- amoxicillin 500 mg
Gonorrhea
Causes/Incidence
> Causes -1- and -2- in women
> -3- among females
S/S
> Females are -4-
» -5- discharge
- urethritis in men
- cervicitis
- leading infertility cause
- often asymptomatic
- copious mucopurulent discharge
Gonorrhea - S/S > Males are -1- >> -2- >> Urinary -3- >> -4- discharge >> -5- pain
- often asymptomatic
- dysuria
- frequency
- white/yellow-green penile
- testicular
Gonorrhea - Lab/Dx
> -1- using modified -2-: endocervical or urethral (male)
- Culture
2. Thayer-Martin media (“G-plate”)
Gonorrhea - Mgmt > -1- >> Neonate: 20-50 mg/kg IV or IM x1; cap @ 250mg >> 45- kg: minimum 25 mg/kg >> 45-150 kg: 500 mg IM (including -2-) >> 150+ kg: 1g > If -3- ruled out >> in adolescents/adults pt: -4- BID x 7 days >> in -2-: -5- PO x 1 dose
- Ceftriaxone
- Pregnant women
- chlamydia not
- Doxycycline 100 mg PO
- Azithromycin 1 g
Syphilis
Def: STD involving multiple organ systems and cause dby t. pallidum, a -1-; the caustive orgaism may be transmitted across the placenta
S/S Clinical Stages > -2- >> -3- present at site of infection common at 3 wks after exposure >> -3- is -4-
- spirochete
- Primary
- Chancre
- indurated and painless
Syphilis - Clinical Stages
> -1-
» -2- [-3-], esp. on the palms and soles
- secondary
- generalized maculopapular rash
- pityriasis rosea (copper-red, scaly, nonpruritic)
Syphilis - Clinical Stages
> -1-
» -2-
» About -3- of untreated cases devleop -4-
- Latent
- seropositive, but asymptomatic
- 15-30%
- tertiary syphilis
Syphilis - Clinical Stages
> Tertiary
» -1- insufficiency: -2- inflammation & regurgitation
» Infiltrative tumors of the -3-, -4-, and -5-
- Cardiovascular
- aneurysms and aortic
- skin
- bones
- liver
Syphilis - Serologic Tests
> -1- with non–5-: -2- and/or the -3-
> -4- with one of the -5-
- screening
- VDRL (venereal disease research laboratory)
- rapid plasma reagin (RPR)
- confirmed
- treponemal antibody tests (there are many)
Syphilis - Management
> -1-
» Primary through early latent acquired syphilis, and unconfirmed congenital (neonatal): 50k u/kg IM, cap 2.4 mil u
» Late latent/indeterminant acquired syphilis: IM weekly x 3
> -2-: -3- 100 PO BID OR -4- 500 mg QID
» Early latent: 2-week regimen
» Late latent or unknown: 4-week regimen
» Not acceptable for patients during pregnancy
> -5-
- Benzathine PCN G
- PCN sensitive
- Doxycycline
- Tetracycline
- Report to HHS (along with gonorrhea, and chlamyidia)
Herpes - Causes
> HSV
» -1-: Found on the lips, face, and mucosa
» -2-: found on the genitalia
> Transmission by -3- with -4- or by virus containing fluid (e.g., saliva or cervial secretions)
- Type 1
- Type 2
- direct contact
- active lesions
Herpes - S/S
> -1-: -2-, malaise, dysuria, -3- lasting -4-
- Initial
- fever
- painful/pruritic lesions
- 2-4 weeks
Herpes - S/S
> -1-: -2- ulcers for a -3-
- Recurrent
- less painful/pruritic
- shorter duration
Herpes
Lab/Dx
> -1- from a lesion
> -2- from a lesion
Mgmt
> -3- recommended for topical, oral, and IV use
> -4-
> -5-: esp. useful for reducing asymptomatic shedding of HSV-2
- NAAT (Nucleic Acid Ampilfication Test)
- Culture
- Acyclovir
- famciclovir
- valacyclovir (valtrex)
HIV/AIDS
Def: a disorder characterized by immunodeficiency as the result of infections -1-
Epidemiology > -2- >> Perinatal >>> typically -3- >> Postnatal >>> -4- is -5- route
- caused by HIV
- modes of transmission
- maternal infant
- breastfeeding
- primary postnatal vertical
HIV/AIDS - S/S > -1- and falling ratio of HC to ht/wt > -2- > -3- delay > -4-, generalized -5-
- LBW
- recurrent infections
- developmental
- hepatosplenomegaly
- lymphadenopathy
HIV/AIDS - Lab/Dx
> Screening
» Inital testing: HIV-1/2 -1-
» confrimatory testing: HIV-1/2 -2-
- antigen/-body immunoassay
2. antibody differentiation immunoassay
HIV/AIDS - mgmt
> Prevention of -1-
» bactrim for -2- and toxoplasmosis prevention
> Antiretroviral Therapy (ART)
» -3- is standard
» When to start ART is contraversial
»> DHHS & Int’l AIDS Society-USA both recommend starting medications at the time of -4-, regardless of -5-
- opportunistic infection
- pneumocystis pneumonia (P. jiroveci)
- Combination therapy
- HIV-positive diagnosis
- CD4 count
While non-specific scaly rashes are common in -1-, it is important to -2- so that management is appropriate. Scaly patches that are -3- and involve the torso, palms of the hands, and -4- should prompt consideration of secondary syphilis for which the -5- test is appropriate.
- children and adolescents
- differentiate possible causes
- copper in color
- soles of feet
- nontreponemal (RPR)
