STIs

Question 1

What are the 4Cs of prevention of STIs?

Answer 1

Contact tracing
Compliance with therapy
Counselling on risk reduction: motivational interviewing
Condom promotion, provision

Question 2

What is the recommended tx for gonorrhea?

Answer 2

Ceftriaxone 500mg IM

Question 3

If you’re considering M. Genitalium, what antibiotic should u give bcos u cannot give Doxycycline or Azithromycin?

Answer 3

Moxifloxacin

Question 4

What is the dx and tx for presumed urethritis in heterosexual men (T. Vaginalis)?

Answer 4

NAAT

Metronidazole or tinidazole 3g single dose PO

Question 5

What are the 2 types of urtheral syndrome seen in women?

Answer 5

Internal dysuria = pyuria with or without urinary ugency, absence of E coli (caused by C trachomatis & N gonorrheae)

External dysuria = painful contact of urine w/ inflamed or ulcerated labira or introitus (HSV, Candida spp, T vaginalis)

Question 6

What is the common cause of vulvovaginal candidiasis?

Answer 6

Candida albicans

Question 7

What is the description of VUlvovaginal candidiasis discharge & treatment?>

Answer 7

Scant, white, clumped, adherent plaques discharge

Tx: Azole cream, tablet or suppository, Fluconazole 150mg PO single dsoe

Question 8

What is the description of discharge caused by Trichomonal vaginitis? & treatment?

Answer 8

Often profuse, white/yellow, homogenou

Tx: Metronidazole or Tinidazole 2g PO single dose

Question 9

What is the description of discharge of bacterial vaginosis & tx?

Answer 9

Moderate white-gray, homogenous, low viscosity, uniformly coats vaginal wall

Tx: Metronidazole

Question 10

What are the cardinal signs of Mucopurulet cervicitis diangosis?

Answer 10

Yellow mucopurulent discharge from cervical os
Endocervical bleeding upon gentle swabbing
Edemaotou cervical ectopy

Question 11

What is the description of lymphadenopathy in syphilis?

Answer 11

Firm, nontender, bilteral

Question 12

What is the description of lymphadenopahty in HErpes?

Answer 12

Firm, tender, often bilaterla with initial episode

Question 13

What is the description of lymphadenopathy in chancroid and lymphogranuloma venereum?

Answer 13

Tender, may suppurate, loculated usually unilateral

Question 14

What are the incubation period of genital ulcer diseases caused by STIs?

Answer 14

Chancroid = 1-14 days
Herpes = 2-7 days
Lymphogranuloma venereum = 3 days - 6wks
Syphilis = 9-90days
Donovanosis = 1-4 wks (up to 6 months)

Question 15

What is the characteristic feature of lymphadenopathy in DOnovanosis/

Answer 15

Pseudobuboes

Question 16

What can cause biologic false positive in serolotigc testing for syphilis?

Answer 16

Age and other medical conditions that can cross-react with the infection

Question 17

What are the clinical manifestations of PID?

Answer 17

Endometriosis
Salpingitis
Perihepatitis
Periappendicits

Question 18

What are the primary causes of endocervicitis?

Answer 18

N gonorrheae
C trachomatis
M genitalium

Question 19

What is the treatment for outpx with PID?

Answer 19

Ceftriaxone (500mg IM once) + Doxycycline (100mg BID x 14 days ) + Metronidazole (500mg BID x 14 days)

Question 20

What are the 2 regiments for tx of PID in inpatients?

Answer 20

Regimen A = Cefotetan 2g IV q12h or Cefoxitin 2g IV q6h + Doxycyline 100mg IV/PO q12h

Regimen B
Clindamycin 900mg IV q8h + Gentamicin then maintenance dose of 1.5mg/kg q8h

Question 21

What are the clinical presentations of Epidydymitis?

Answer 21

Unilateral pain, swelling, tenderness of epididymis
With or wihtout signs/symptoms of urethritis

Question 22

What are the tx used for Epididymis?

Answer 22

Ceftraixone 500mg IM single dose + Doxycycline 100mg BID x 10 days

Enterobacteriaceae = Levofloxacin 500mg OD x 10 days