STIs + PID Flashcards
Chlamydia
caused by which gram neg bacteria?
chlamydia trachomatis
Chlamydia
mode of transmission
sex (anal or oral)
Chlamydia
risk factors
- young age
- new partner/multiple partners
- inconsistent use of barrier methods
Chlamydia
presentation of most patients male & female which allows for rapid spread?
asx
Chlamydia
sx in women
8 things
- white, yellow, gray vaginal discharge (no odor)
- ithcing, burning, metrorrhagia
- postcoital bleeding, painful intercourse
- PID: pelvic pain, fever chills
- UTI sx
Chlamydia
sx in men
3
- mucus or clear watery penile discharge (no odor)
- testicular pain/swelling
- burning with urination (dysuria)
Chlamydia
rectal sx
5
- mucus like anal discharge
- anal bleeding, pain, pruritis
- painful bowel movements
Chlamydia
Physical Exam Findings
Women
- can be unremarkable
- Cervicitis: mucupurulent discharge, cervical edema, cervical contact bleeding
- PID: cervical motion tenderness
Chlamydia
Physical Exam Findings
Men
- can be unremarkable
- Urethral discharge
- scrotal swelling/pain
Chlamydia
Dx
- NAAT (vaginal/cervical swab or urine)
Chlamydia
Tx
firstline, second, and then 3 other options.
- Doxycycline (100mg PO, Q12 hrs, 7 days)
- Azithromycin (1gm PO x1 dose)
- Erythromycin, Ofloxacin, Levofloxacin
Chlamydia
woh shuld be treated with Azithromycin?
pregnant women
Chlamydia
which previous sexual partners should receive treatment?
anyone from three months
Chlamydia
What follow up is done?
2 things
- test of cure within 3 wks
- test for reinfection after 3 mo (everyone)
Chlamydia
which pts get test of cure withing 3 wks?
3 groups
- pregnant pts
- those with persistent sx
- Rx with erythromycin or amoxicillin because they are sub-optimal
Chlamydia
Who is recommended for regular screening?
- under 25 years old
- pregnant
- new or multiple partners
- hx of chlamydia
Chlamydia
Complications
2 overall, regardless of gender
- reactive arthritis
- conjunctivitis
Chlamydia
Complications
non-pregnant females- 3 things
- increased risk for chronic pelvic pain
- infertility
- ectopic pregnancy
Chlamydia
Complications
to fetus in preg females- 3 things
- preterm delivery
- neonatal blindness (conjunctivitis)
- neonatal pneumonia
Chlamydia
Complications
Men
- reduced fertility
- epididymitis
Gonorrhea
caused by which gram negative diplococci?
Neisseria gonorrhoeae
Gonorrhea
Epi- relative rates, who infected most?
not a specific rate, just a generalized statement
- second most common communicable disease in US
- highest rates among sexually active teens & adults
Gonorrhea
Sx
Women- 7 sx, 1 general statement on commonality of sx
- often asx
- white/yellow discharge from vagine
- metrorrhagia, postcoital bleeding
- PID: pelvic pain, chills, fever
- UTI sx
Gonorrhea
Sx
Men- 1 statement on commonality of sx, 4 sx
- sx more common with gonorrhea than with chlamydia
- white/yellow penile discharge
- burning with urination
- testicular/scrotal pain/swelling
Gonorrhea
Sx
Rectal- 6ish
- anal discharge, pain, pruritis
- anal bleeding
- painful bowel movements
- possible: throat infection/pain
Gonorrhea
Physical Exam Findings
Women- 3
mucoprurulent discharge
friable cervix
cervical motion tenderness
Gonorrhea
Physical Exam Findings
Men- 1
mucopurulent urethral discharge
Gonorrhea
Dx
NAAT
Gonorrhea
Tx
one med
- Ceftriaxone (500-1000mg IM; wt dosed)
Gonorrhea
why do we use high dose ceftriaxone?
- high dose because of increased MIC
- drug resistance is challenging rx
Gonorrhea
which condition do we treat for simultaneously? which med?
- chlamydia
- Doxy or azithro
Gonorrhea
who do we do test of cure on?
inf. location
those with oropharyngeal infection
Gonorrhea
Complications
All populations- 1 category w/ 6 things in it
Disseminated Infection
* septic arthritis
* skin lesions
* pericarditis
* endocarditis
* meningitis
Gonorrhea
Complications
Females- 3
- chronic pelvic pain
- infertility
- ectopic pregnancy
Gonorrhea
Complications
Men- 4
- scars in urethra
- inflammation of testicles
- infertility
- chronic prostate pain
Gonorrhea
Complications
Infants- 4
- ophthalmia neonatorum
- sepsis
- meningitis
- scalp abscesses
Syphilis
caused by which spirochete?
Treponema pallidum
Syphilis
who is disproportionately infected?
African American/Black individuals
Syphilis
associated with ____ infection among ____ population.
- HIV
- MSM