Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Pharmacy 2 > STIs > Flashcards

STIs Flashcards

1
Q

What is pelvic inflammatory disease?

A
  • ascending spread of pathogens from the vagina/cervix to upper female genital tract (endometrium, fallopian tubes, other structures). May present as a combination of endometriosis, salpingitis, turbo-ovarian abscess and pelvic peritonitis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the common symptoms of mild-severe symptoms of PID?

A
  • abdominal tenderness (abdominal/pelvic pain)
  • cervical motion tenderness
  • vaginal/urethral discharge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the most common STIs?

A
  • gonorrhea
  • chlamydia
  • syphilis
  • trichomoniasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the reportable STIs?

A
  • gonorrhea
  • chlamydia
  • syphilis
  • hep B
  • hep C
  • HIV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

People with gonorrhoea is often co-infected with _____

A

chlamydia

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

Patients with syphilis may be co-infected with _____

A

HIV

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

What are the contributing risk factors to STI infection?

A
  • unaware, lack of knowledge
  • gender (female > male)
  • unprotected sex
  • sexual contact with infected person
  • number of sexual partners
  • anonymous sex
  • MSM
  • host susceptibility ( e.g.. HIV)
  • age
  • socioeconomic
  • sex worker and contacts
  • societal stigma
  • co-infection
  • unreported infections
  • asymptomatic patients
  • missed sx
  • geographic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What STIs are attributed to PID?

A
  • gonorrhea and chlamydia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the other impacts of STIs?

A
  • complications in reproduction
  • PID
  • risk of cervical cancer
  • damage to reproductive tract
  • transmission to others
  • congenital/perinatal infections
  • social stigma
  • economic
  • antibiotic resistance
  • spread of other infectious diseases (HIV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chlamydia- highest rates are found in _____ cases

A

female

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

What age groups have the highest prevalence of STIs?

A

Females: 15-19 or 20-24
Males: 20-24 and 25-29 age groups

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

What STI have the majority of STIs in men?

A
  • syphilis (highest rates in men 20-24 and in 30-39)
  • female rates of syphilis lower than that for males
  • however the female rate increased nearly four fold between 2013 and 2014
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Sex must be abstained from for at least ______ after treatment completed

A

3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the test used to diagnose gonorrhoea?

A
  • called the NAP - nucleic acid plasma test- to determine and test for gonorrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Humans are the only host for _____

A

gonorrhea

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

What are the risk factors of gonorrhea in females?

A
  • can lead to scarring of the reproductive tract in females
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the main risk factor for gonorrhoea in people?

A
  • anonymous sex is risk factor here
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the signs and symptoms of gonorrhea?

A
  • milky discharge from the penis and scarring of the uterus are the main effects of gonorrhoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How are patients that have both chlamydia and gonorrhea treated?

A
  • they are both treated with zithromax and cefixime combinations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What other kinds of infections can be caused by N. gonorrhoea?

A
  • oropharyanx
  • ocular
  • disseminated gonoccal infection
  • neonatal conjunctivitis (ophthalmia neonatorum)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does n. gonorrhoea attach to the mucosal membrane?

A
  • attach to the mucosal surfaces (columnar, cuboidal or non-cornified squamous epithelial cells)
  • N. gonorrheae cell proteins (virulence factors) contribute to the acquisition, spread and response to infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the male complications of gonorrhoea?

A
  • rare complications of gonorrhoea in men (prostatitis, inguinal lymphadenopathy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the complications of gonorrhea in females?

A
  • PID, ectopic pregnancy, infertility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the signs of gonorrhea in females?

A
  • asymptomatic originally
  • dysuria, frequency of urination increases
  • abnormal vaginal discharge or uterine bleeding, purulent urethral or rectal discharge can be scant to profuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the signs of gonorrhea in males?

A
  • symptomatic more common- dysuria and frequency increased of urination, purulent urethral or rectal discharge can be scant to profuse, pruritus of anus, bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the signs of disseminated gonorrhoea infections?

A

(when gonorrhoea seeds outside of the reproductive tract)

  • fever, chills, joint pain, joint swelling, skin rash red spots
  • can disseminate to other organ sites (meningitis, endocarditis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How can neonates get gonorrhea?

A
  • newborns can acquire gonorrhea during delivery - infection can lead to blindness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is done in MB to prevent newborns from getting gonorrhea?

A
  • erythromycin 0.5% eye ointment applied to newborns as GC prophylaxis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What gives a positive diagnosis of gonorrhoea?

A
  • gram stain of gram negative diplococci

- culture of N. gonorrhoea from the urine, cervix or urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the treatment issues associated with gonorrhoea infections?

A
  • emergency of antibiotic resistance form sulphonamides to ceftiaxone
  • increased gonorrhoea treatment failure, concern with superbug
  • increasing antibiotic resistance in Canada
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

39% of gonorrhoea is resistant to_____

A

ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the antibiotics is gonorrhoea staring to become resistant to?

A
  • ciprofloxacin
  • azithromycin
  • decreased cefixime and ceftriaxone susceptibilities
  • tetracycline resistance
    (complete loss of penicillin, ampilicillin, and FQ use over the decades)
33
Q

What is the indication of anogenital infections used in adults and youths in 9 years of age (gonorrhoea)

A

ceftriaxone 250 mg IM in a single dose PLUS azithromycin 1 g po in a single dose (also used for MSM)
OR
ceftiaxone 800 mg IM in a single dose PLUS azithromycin 1 g po in a single dose

34
Q

What is the indication for pharyngeal infections used in adults?

A
  • ceftriaxone 250 mg IM in a single dose PLUS azithromycin 1 g po in a single dose
35
Q

What is used for anogenital infections of gonorrhoea in children under the age of 9?

A
  • cefixime 8 mg/kg po bid for 2 doses (max 400 mg per dose) plus azithromycin 20 mg/kg
    OR
    ceftriaxone 50 mg/kg OM plus azithromycin 20 mg/kg in a single dose
36
Q

What is used to treat pharyngeal infections of gonorrhoea in those under 9?

A
  • ceftriaxone 50 mg/kg plus azithromycin 20 mg/kg
37
Q

What is used to treat pharyngeal infections of gonorrhoea in those under 9?

A
  • ceftriaxone 50 mg/kg plus azithromycin 20 mg/kg
38
Q

What is the preferred initial treatment for ALL disseminated infections in adults?

A
  • ceftriaxone and azithromycin
39
Q

What is the duration of ceftiaxone treatment in treating disseminated arthritis?

A

-7 days

40
Q

What is the duration of ceftriaxone treatment in meningitis?

A

14 days

41
Q

What is the duration of ceftriaxone treatment in endocarditis?

A
  • 28 days
42
Q

What is the duration of treatment in gonorreal ophthalmia?

A
  • single dose! as well as azithromycin in a single dose
43
Q

What is the preferred treatment for ophalmia neonatorum?

A
  • ceftriaxone in a single dose
  • irrigate eyes immediately with sterile normal saline and at lease hourly as long as necessary to eliminate discharge wh
44
Q

What is the preferred treatment for neonates with disseminated gonococcal arthritis, meningitis or endocarditis?

A
  • cefotaxime for 10-14 days
  • hospitalization and consultation with an expert in infectious diseases should be initiated as soon as possible
  • prophylactic treatment for possible chlamydial infection is not recommended unless follow-up can be assured
  • testing should be done for chlamydia and if results are positive, treatment should be provided as per chlamydia protocol
45
Q

What is the treatment regimen for those with cephalosporin resistant N. gonorrhoeae or a history of anaphylactic reaction to penicillin or an allergy to cephalosporins?

A
  • azithromycin 2 g (single oral dose) plus gentamicin 240 mg IM (as 2 separate 3 mL injections of 40 mg/mL)
    OR
    can fuse gentamicin 240 mg IV infused over 30 minutes if IV is not feasible
46
Q

What is the treatment regiment for those with macrolide resistant N. gonorrhoeae or a history of anaphylactic reaction to macrolides

A
  • gentamicin IM (as 2 separate injections of 3 mL) OR
    gentamicin240 mg IV infused over 30 minutes when the IM route is not feasible

plus azithromycin 2 g x 1 or doxycycline 100 mg x 7 days recommended

47
Q

What is the quinolone treatment regimen for treating gonorrhoea?

A
  • azithromycin 2 g (single oral dose) plus ciprofloxacin 500 mg (single oral dose)
48
Q

What is PID disease?

A
  • ascending pathogens from the cervix or vagina to the upper genital tract
  • 1/3 PID cases attributed to gonorrhoea/chlamydia
  • other causes included : mycoplasma, gram positives, gram negatives and anaerobes
  • presents as endometriosis, salpingitis, tubo-ovarian abscess and pelvic peritonitis
49
Q

What are the symptoms typically of PID?

A
  • lower abdominal pain/mild pelvic pain
  • increased vaginal discharge
  • irregular menstrual bleeding
  • fever (> 38 degrees)
  • pain with intercourse
  • painfull and frequent urination
  • abdominal tenderness
  • pelvic organ tenderness
  • uterine tenderness
  • adnexal tenderness
  • cervical motion tenderness
  • inflammation
50
Q

What are the complications of PID?

A
  • tubo-ovarian abscess, infertility, ectopic pregnancy, chronic pelvic pain
51
Q

What is the inpatient treatment of PID?

A
  • ## cefoxitin and oral doxycyclin OR clindamycin IV and gentamicin (ceftriaxone and doxycycline and metronidazole)
52
Q

What is the outpatient treatment of PID?

A
  • ceftriaxone 250 mg IM x1 + oral doxycycline (azithromycin alternative) + oral metronidazole
53
Q

What is chlamydia caused by? (what bacteria?)

A
  • chlamydia trachomatis
54
Q

What are the characteristics of chlamydia trachomatis?

A
  • gram negative, obligate intracellular pathogen

- less virulent than gonorrhoea

55
Q

What are the characteristics of chlamydia compared to gonorrhoea?

A
  • infection is less acute than gonorrhea
  • many patients are asymptomatic
  • C. trachomatic serovars D to K responsible for genital/perianal infections
  • asymptomatic in up to 70% of women and 50% men- males are the largest reservoir
  • urethritis may be hard to differentiate from gonorrhoea
  • similar to GC, untreated disease may lead to PID, chronic pelvic pain, ectopic pregnancy
  • increased risk of acquiring HIV
56
Q

What are the main signs and symptoms of gonorrhoea in males?

A
  • symptomatic gonorrhea is common
  • urethral: mild dysuria, discharge
    Pharyngeal: asymptomatic to mild pharyngitis
  • discharge scant to purulent urethral/rectal discharge
  • recta; pain, discharge, bleeding
57
Q

What are the main signs of symptoms of gonorrhoea in females?

A
  • symptomatic gonorrhea is subclinical, dysuria/frequency is uncommon
  • anorectal and pharyndeal symptoms are the same as for men
  • can have abnormal vaginal discharge and uterine bleeding
  • purulent urethral or rectal discharge can be scant to profuse
58
Q

What are the main complications of gonorrhea in females?

A
  • PID, ectopic pregnancy, infertility
59
Q

What are the effects of a pregnant mother birthing a child with chlamydia?

A
  • neonatal conjunctivitis

- pneumonia - generally mild but can be severe

60
Q

What is the bacteria that can cause syphilis?

A

treponema pallidum (spirochete)

61
Q

Can syphilis affect anyone but humans?

A
  • no!
62
Q

how many stages of syphilis are there is left untreated?

A
  • 3
63
Q

co-infection of ____ and syphilis is common

A

HIV

syphilis can enhance the acquisition of HIV

64
Q

What is the site and clinical presentation associated with primary syphilis?

A
  • genitalia, penianal, mouth, throat
  • clinical presentation: chacre, regional lymphadenopathy
    Incubation: 3 weeks
65
Q

What is the site and clinical presentation associated with secondary syphilis?

A
  • multisystem site
  • clinical presentation: rash, fever, malaise, generalized lymphadenopathy, mucosal lesions, condylomata lata, alopecia, meningitis, headaches, uveitis, retinitis
    Incubation: 2-12 weeks
66
Q

What is the site and clinical presentation associated with tertiary syphilis?

A
  • cardiovascular, neurosyphilis (CNS, eyes), gumma
  • clinical presentation: aortic aneurysm, aortic regurgitation, coronary artery ostial stenosis
  • ranges from asymptomatic to symptomatic with headaches, vertigo, personality changes, dementia, ataxia, presence of argyll robertson pupil
  • tissue destruction of any organ, manifestations depend on site involved
67
Q

What is the risk of syphilis to a newborn?

A
  • T. pallidum can cross the placenta, fetal risk is highest when mom primary/secondary syphilis
  • screen newborn early is there are signs and symptoms of early congenital syphilis
  • congenital syphilis early (<2 years) vs late (>2 years)
68
Q

What is the primary treatment for primary and secondary syphilis in adults? (non pregnant)

A
  • benzahtine penicillin G 2.4 million units IM as a single dose
69
Q

What is the alternative treatment for pen allergic patients?

A
  • doxycycline 100 mg po bid for 14 days
  • alternative agents (to be used in exceptional circumstances)
  • ceftriaxone 1 g IV or IM daily for 10 days
70
Q

What is the primary treatment for latent syphilis (>1 year duration)
Latent syphilis of unknown duration. Cardiovascular syphilis and other tertiary syphilis not involving the central nervous system?

A
  • benzathine penicillin G 2.4 million units IM weekly for 3 doses
71
Q

What is the alternative treatment for penicillin allergic patients?

A
  • consider penicillin desensitization
  • doxycycline 100 mg po bid for 28 days
  • alternative agents (to be used in exceptional circumstances)
  • ceftriaxone 1 g IV or IM daily for 10 days
72
Q

What is the treatment for neurosyphilis?

A
  • penicillin G 3-4 million units IV q4h (16-24 million units/day) for 10-14 days
73
Q

What is the cause of trichomonas infection?

A
  • trichomonas vaginalis (flagellated , motile protozoan)

- humans are the only host and it is spread through sexual contact

74
Q

What is the treatment for trichomoniasis?

A
  • metronidazole 2 g as a single dose OR metronidazole 500 mg bid for 7 days
75
Q

What is trich infections associated with in pregnancy?

A
  • premature rupture of the membranes, preterm birth and low birth weight
  • symptomatic women: treat as above- metronidazole is used in pregnancy and breastfeeding
76
Q

What are the characteristics of HPV?

A
  • common viral STI
  • HPV infects the moist mucosa of the anogenital tract, oral cavity and oropharynx
  • non-mucosal HPV causes warts on hands/feet
  • HPV can occur in both males and females, higher in females < 25years old, males across all ages
77
Q

What HPV strains account for most of anogenital warts?

A
  • 6 and 11
78
Q

What HPV strains account for cervical cancers?

A
  • 16 and 18 (high risk)

Clinical Pharmacy 2 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions