STIs and UTIs

Question 1

How is initial infection with herpes simplex virus characterized?

Answer 1

viral-like symptoms preceding appearance of vesicular genital lesions; prodrome of burning or irritation can cause significant urinary retention requiring catheter drainage

Question 2

How is herpes outbreak treated?

Answer 2

care of local lesions and symptoms with sitz baths, perineal care and topical xylocaine jellies or creams may be helpful; antiviral meds such as acyclovir can decrease viral shedding and shorten course of the outbreak

Question 3

If left untreated, how many patients will develop systemic symptoms of secondary syphilis, which include low grade fever, malaise, headache, generalized lymphadenopathy, rash, anorexia, weight loss and myalgias

Answer 3

25%

Question 4

It is estimated that __% of hep B are acquired from sexual transmission.

Answer 4

38

Question 5

When should HBV post-exposure prophylaxis be initiated?

Answer 5

no later than 7 days after blood contact and 14 days after sexual.

Question 6

If an individual is unvaccinated but exposed to persons who are HBsAG positive, what are treatment recommendations?

Answer 6

one dose of HBIG and HBV vaccine series

Question 7

If unvaccinated person is exposed to HBsAG negative or unknown status, how is it treated?

Answer 7

HBV vaccine series

Question 8

If exposed to HBV and is nonresponder to vaccine, how do you treat?

Answer 8

then HBIG plus HBV or HBIG times 2 is used

Question 9

What is the incubation period for HBV?

Answer 9

6 weeks to 6 months

Question 10

What are some indications for inpatient treatment with IV abx for PID?

Answer 10

nausea/vomiting
pregnancy
high fever

Question 11

What are some common causes of ascending infection from GU or GI tract causing salpingitis besides gonorrhea and chlamydia?

Answer 11

E. coli, Klebsiella, G. vaginalis, Prevotella, GBS and/or enterococcus

Question 12

What are diagnostic criteria for acute salpingitis?

Answer 12

lower abdominal tenderness, uterine/adnexal tenderness and mucopurulent cervicitis

Question 13

What is the rate of tubal infertility after PID?

Answer 13

12% after one episode, 25% after two episodes and 50% after three episodes

Question 14

what are some possible sequelae of inadequately treated gonococcal or chlamydial infections?

Answer 14

chronic pelvic pain, hydrosalpinx, tubal scarring, ectopic pregnancy, infertility

Question 15

What causes 80-85% of cases of acute cystitis?

Answer 15

E. coli; other major pathogens are staph saprophyticus, Klebsiella, enterococcus faecalis and Proteus mirabilis

Question 16

What are some symptoms of UTI?

Answer 16

low pelvic pain, urinary frequency, urinary urgency, hematuria or new issues with incontinence

Question 17

What is inpatient treatment for pyelo?

Answer 17

IV aminoglycoside pluse either ampicillin, piperacillin or first gen cephalosporins, aztreonam, third gen cephalosporins, Zosyn, or flouroquinolones; after resolution of fevers and systemic symptoms pt should be discharged home to complete 14 day course

Question 18

In stable patients with mild uncomplicated pyelonephritis, what is first line therapy?

Answer 18

fluroquinolone such as ciprofloxacin; bactrim is also acceptable