STIs

Question 1

what is the most common bacterial Sti in the US

Answer 1

C. trachomatis

(chlamydia)

Question 2

When is most herpes transmitted?

Answer 2

70% during asymptomatic oerios

many are unaware infected

Question 3

how do you diagnose herpes?

Answer 3

PCR - most sensitive

Question 4

hwo do you treat herpes?

Answer 4

primary - nucleoside analogue for 7-10d

recurrent - nucleoside analogue for 5 d

suppressive - daily for >6 recurrences/year

council

pregnancy

Question 5

treponema pallidum

Answer 5

syphillis spirochete

man is the only host

Question 6

how do you diagnose treponema pallidum

Answer 6

(syphillis)

serology - RPR (titer) + treponemal test (positive after therapy - specfic

can PCR

Question 7

who has highest number of syphillis infection

Answer 7

men who have sex with men

Question 8

syphillis time line

Answer 8

in latent phase - RYR and treponema positive

Question 9

chancres

Answer 9

seen in primary syphillis

a painless ulcer, particularly one developing on the genitals as a result of venereal disease.

depends on where sporochette is

Question 10

presenting signs of syphillis

Answer 10

chancres

Question 11

signs of secondary syphillis

Answer 11

rash

condyloma lata

meningitis

alopecia

Question 12

signs of tertiary syphillis

Answer 12

aortic aneurysm

gumma

Question 13

treatment of syphillis

Answer 13

primary/secondary

benzathine for one day (PCN)

OR

tetracyclin for 14 days if alergic to PCN

tertiary

benzathine PCN for 3 weekly doses

Question 14

what is the jarisch herxheimer reaction?

Answer 14

seen ins yphillis treatment in first 24 hours

spirochettes lyse - cytokine reaction with fever and chills

Question 15

chancroid

Answer 15

a venereal infection causing ulceration of the lymph nodes in the groin.

difficult to culture and highly infectious

Question 16

treatment of chancroid

Answer 16

asiprate ulcers

HIV test

azyithromycin for 1 day

Rx sexual partners

Question 17

gonorrhea

Answer 17

2nd most common communicable disase in US - highest in adolescents, MSM, southeast

now we screen high risk populations

Question 18

how do you diagnose gonorrhea?

Answer 18

culture and nucleic acid amplification tests (NAAT)

Question 19

presentation of gonorrhea

Answer 19

women - vaginal discharge, pain dysuria

men - dysuria, discharge, testicular pain

Question 20

sequelae of gonorrhea

Answer 20

women - chronic pelvic pain, infertility, ectopic pregnanc

men - epididytis, pharyngitis

Question 21

treatment of gonococcal

Answer 21

(floroquinolose no longer indicated)

cephalosporin (now some resistance!)

ceftriaxone IM PULS azithromycin x1

evaluate sexual partners

Question 22

chlamydia sequlae in women

Answer 22

ectopic pregnancy

infertility

PID

asymptomatic infection common

screen all sexually active women <25

Question 23

how do you diagnose chlaydia

Answer 23

nucleic acid amplification tecnniques

Question 24

how do you treat chlamydia

Answer 24

azithromycin 1 gm

repeat screening in 6 mo

HIV test

to decrease incidence of PID!

Question 25

what is the most common STD?

Answer 25

HPV

immune system clears 90% in 2 years

assoc w cervical cancer, anogenital malignancies , head/neck cancer

Question 26

how do you diagnose bv?

Answer 26

increased pH

DNA probes

POC tests (rapid smear)

Question 27

How do you treat BV?

Answer 27

metronidazole 500 mg BID for 7 days

treat recurrences with metonidazole gel

Question 28

trichomonas vaginalis

Answer 28

flagellated protozoa

sexually transmitted

facilitates HIV transmission, assoc with PID

Question 29

trichomonas vaginalis treatment

Answer 29

metronidazole

test 3 months after treatment

Question 30

treatment for pubic lice

Answer 30

permethrin

pyrethrins