urogentital infections

Question 1

___ common cause of chlamydia
which is a ____

Answer 1

Chlamydia trachomatis
an obligate intracellular bacterium that relies on the host cells to live and reproduce.

Question 2

two genotypes of chlamydia

Answer 2

non LGV
LGV (more invasive)

Question 3

what’s the 1st line of treatment for chlamydia

Answer 3

doxycycline 100mgPO BID x 7days OR
Azithromycin 1g PO single dose

Question 4

what’s the 2nd line of treatment for chlamydia

Answer 4

Erythromycin 2g/day PO divided QID x 7 days OR
Moxifloxacin 400mg OD x 7-14 days

Question 5

What’s the 1st line of treatment for pregnant patient with chlamydia

Answer 5

Azithromycin 1g PO single dose
OR
Erythromycin 2g/day PO divided QID x 7 days

Question 6

what’s the treatment for LGV chlamydia

Answer 6

Doxycycline 100mg PO BID x 21 days

Question 7

What’s the 1st line treatment for gonorrhoea? (duol therapy)

Answer 7

Cefixime 400-800 mg PO single dose
OR
Ceftriaxone 250 mg IM single dose

ANY ONE of the above PLUS ONE of the following:
Azithromycin 1gram PO single dose
OR
Doxycycline 100mg PO BID for 7 days

Question 8

What’s the second line of treatment for gonorrhoea?

Answer 8

Ciprofloxacin 500mg PO single dose
PLUS one of the following:
Azithromycin 1gram PO single dose
OR
Doxycycline 100mg PO BID for 7 days

Question 9

trichomoniasis caused by ___

Answer 9

caused by small one cell parasite

Question 10

what’s the treatment for trichomoniasis

Answer 10

Metronidazole 2 G PO single dose
OR
Metronidazole 500mg PO BID x 7 days

Question 11

pathophysiology of bacterial vaginosis

Answer 11

Shift in vaginal flora- overgrowth of anaerobic bacteria and a reduction in lactobacillary flora.
This reduces the levels of hydrogen peroxide and acids in the vagina

Question 12

1st line of treatment for bacterial vaginosis

Answer 12

Metronidazole 500 mg BID orally x 7 days

OR cream One applicatorful (5g) intravaginally once nightly for 5 days
Metronidazole 0.75% gel
OR
Clindamycin 2% cream

Question 13

2nd line of treatment for bacterial vaginosis

Answer 13

Metronidazole 2g single dose Or
Clindamycin 300 mg BID X 7days

Question 14

1st line of treatment for inflammatory pelvic disease

Answer 14

Cefixime 800 mg single dose
OR
Ceftriaxone IM 250-500mg IM single dose
ONE of the above PLUS: Doxycycline 100mg BID x 14 d
+/-
Metronidazole 500mg BID x 14 d

Question 15

the incubation days for syphilis is ___

Answer 15

10-90 days

Question 16

5 stages of syphilis are

Answer 16

3 early infectious stages:
1. primary: chancre
2. secondary: rash, lesions
3. early latent: asymptomatic infection acquired within the past 12 months

2 late non-infectious stages:
4. late latent: asymptomatic, > 1 year up to 30 or more years
5. tertiary: untreated lesions can lead to death

Question 17

1st line of treatment for syphilis

Answer 17

Primary, secondary, and early latent syphilis:
Benzathine penicillin G (Bicillin-LA) 2.4 million international units IM x single dose

Latent, late latent Syphilis:
Benzathine penicillin G (Bicillin-LA) 2.4 million international units IM weekly x 3 doses

Question 18

Alternative treatment for syphilis

Answer 18

Primary, secondary, and early latent syphilis:
Doxycycline 100mg PO BID x 14 days
Latent, late latent Syphilis: Doxycycline 100mg PO BID x 28 days

Question 19

neurosyphilis symptoms

Answer 19

Headaches
Vision changes
Hearing changes, tinnitus
Vertigo

Question 20

syphilis serology stays positive for

Answer 20

Stays positive for life

Question 21

HSV-I typically causes

Answer 21

oral lesions

Question 22

HSV-II typically causes

Answer 22

genital lesions

Question 23

primary infection of HSV

Answer 23

HSV travels through the
peripheral nerve to the sacral dorsal root ganglia- it remains dormant here until it is reactivated

Question 24

Recurrent Infection of HSV

Answer 24

Recurrent Infection: HSV viral particles travel back through the nerve root to the skin, the virus multiples and lesions develop

Question 25

Incubation of genital herpes

Answer 25

2-12 days

Question 26

Genital Herpes Testing

Answer 26

1) NAAT/PCR Swab
2) Serology Type Specific Serology

Question 27

1st line of treatment for genital herpes
1st symptom

Answer 27

Acyclovir 400mg TID for 5-10 days
Famciclovir 250 mg TID for 5-10 days
Valacyclovir 1000mg BID for 5-10 days

Question 28

Acute Recurrent <6 Episodes per year

Answer 28

Acyclovir 400mg TID x 5 days OR 800 mg BID x 5 days OR 800 mg TID x 2 days
Famciclovir 125 mg BID x 5 days
Valacyclovir 500mgBIDx3days OR 100mg daily x 3 days

Question 29

Chronic Suppressive therapy > 6 outbreaks/year

Answer 29

Acyclovir 400mg BID
Famciclovir 250mg BID
Valacyclovir 250mg BID OR 500mg daily