STIs Flashcards
Who is considered high risk?
Who is considered high risk?
What do you screen pregnant women for?
Syphillus, G/C, heptatitis BsAg
And again at 36 weeks if high risk (
Medication for crabs?
Permethrin 1% cream
Malathion
Ivermectin
When do most HSV transmission occur?
during asymptomatic period
Incubation for HSV?
2-12 days, average 4 days
Recurrence rate of HSV?
78%, 5% recurrence in 5 days. 20% are asymptomatic
Average duration of HSV for primary? Where? How long does it last?
12 days. Cervix. 2-4 weeks
Gold standard for HSV?
Viral Culture
Best test for healing lesions?
Antigen detection test
First episode treatment for HSV?
- Acyclovir 400 mg TID x 7-10 days
- Or Acyclovir 200 mg 5 times per day
- or Famciclovir 250 mg TID
- or Valacyclovir 1000 mg BID x 7-10 days
- May extend treatment if healing is incomplete after 10 days
Daily Suppression for HSV?
Acyclovir 400 mg BID
Famciclovir 25 mg BID
Valacyclovir 500-1000 mg daily
Daily Suppression for HSV?
Acyclovir 400 mg BID
Famciclovir 25 mg BID
Valacyclovir 500-1000 mg daily
What do you screen pregnant women for?
Syphillus, G/C, heptatitis BsAg
And again at 36 weeks if high risk (
Medication for crabs?
Permethrin 1% cream
Malathion
Ivermectin
When do most HSV transmission occur?
during asymptomatic period
Incubation for HSV?
2-12 days, average 4 days
Recurrence rate of HSV?
78%, 5% recurrence in 5 days. 20% are asymptomatic
Average duration of HSV for primary? Where? How long does it last?
12 days. Cervix. 2-4 weeks
Gold standard for HSV?
Viral Culture
Best test for healing lesions?
Antigen detection test
First episode treatment for HSV?
- Acyclovir 400 mg TID x 7-10 days
- Or Acyclovir 200 mg 5 times per day
- or Famciclovir 250 mg TID
- or Valacyclovir 1000 mg BID x 7-10 days
- May extend treatment if healing is incomplete after 10 days
Episodic therapy for HSV?
Acyclovir 800 TID x 2 days
Famiciclovir 1000 mg BID x 1 day
Valcyclovir 2 g BID x 1 day
Daily Suppression for HSV?
Acyclovir 400 mg BID
Famciclovir 25 mg BID
Valacyclovir 500-1000 mg daily
Most common cause of HPV strains?
6 and 11
What perscentage of HPV strains resolve without treatment?
80%
Provider applied treatment for HPV?
Cryotherapy, laser, surgery
Trichloroacetic Acid
Bichloroacetic acid
Patient applied therapy for HPV?
Podofilox
Dimiquimod and IMiquimod
Sinecatechins
What is no longer recommended for HPV?
Podopyllin Resin
Who should receive HPV vaccine and when should you stop?
Boys and girls starting at age 9
Stop at 21 for males
Stop at 26 for females
HIV of MSM- all do 26
two major signs of cervicitis?
- Purlenet or mucopurulent endocervical exudate
2. Sustained bleeding easily induced by mental passage of cotton swab
Other symptoms of Cervicitis?
May be asymptomatic, inter menstrual spotting/post coital bleeding, increased vaginal discharge
Treatment for cervicitis?
Azithromycin 1 g or doxycycline 100 mg BID x 7 days
If persistent, refer to GYN for mycoplasma gentalium work up.
Most common STD?
Chlamydia
Symptoms of chlamydia?
Most are asymptomatic. Cervicitis. Urethritis, PID, perihepaittis, reactive arthritis.
Incubatino period for chlamydia
7-21 days.
When do you retest for chlamydia?
3-4 months and at next visit.
Tests for chlamydia?
Nucleic acid amplification test- good
Non NAAT- titers- difficult to interparate
Culture is gold standard
Treatment of chlamydia?
Azithromycin 1 g or doxycycline
Erythromycin base or ethylsuccinate 7 days
Ofloxacin 300 mg BID x 7 days
Levofloxacin 500 mg PO QD x 7 days
Complications of gonorrhea?
Bartholin’s and Skene gland infections, PID, and Fiz- Hugh- Curtis Syndrome- perihepatitis
Symptoms for gonorrhea for men and women?
Men- burning with urination
Women- PID
Diagnosis of gonorrhea?
Culture, non culture
Amplified tests NAAT
Treatment of gonorrhea?
No fluoquinolones
Rocephin 250 mg IM x1
Oral cefixime 400 mg
What to do if if patient is resistance?
Send to ID doctor
Primary infection of syphilis? How long does it last? Associated symptoms?
Ulcer, 1-6 weeks, rubbery, painless, bilateral lymphadenopathy
Signs of Secondary infection?
Mucous patches, condylomata lata, alopecia, serologic testing highest at this phase
Describe latent phase?
Patient is seroreactive, but no evidence of infection. Can occur between 1, 2, and 3rd fase
Describe the two step process?
- VDRL or RPR
2. Treptomonal test FTA-ABS, or TP-PA
How do you follow treatment?
Titers should decrease
Treatment of syphilis?
Benzathine penicillin G 2.4 million units
What to do if patient has pencillin allergy for syphilis?
Consult ID
What is a Jarisch-Hexheimer Reaction?
Self limited reaction to anti-treptomonal therapy. Fever, malaise, N&V, usually within 24 hours after therapy
When do you follow up for Syphilis?
6 and 12 months
