urogentital infections Flashcards
___ common cause of chlamydia
which is a ____
Chlamydia trachomatis
an obligate intracellular bacterium that relies on the host cells to live and reproduce.
two genotypes of chlamydia
non LGV
LGV (more invasive)
what’s the 1st line of treatment for chlamydia
doxycycline 100mgPO BID x 7days OR
Azithromycin 1g PO single dose
what’s the 2nd line of treatment for chlamydia
Erythromycin 2g/day PO divided QID x 7 days OR
Moxifloxacin 400mg OD x 7-14 days
What’s the 1st line of treatment for pregnant patient with chlamydia
Azithromycin 1g PO single dose
OR
Erythromycin 2g/day PO divided QID x 7 days
what’s the treatment for LGV chlamydia
Doxycycline 100mg PO BID x 21 days
What’s the 1st line treatment for gonorrhoea? (duol therapy)
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
What’s the second line of treatment for gonorrhoea?
Ciprofloxacin 500mg PO single dose
PLUS one of the following:
Azithromycin 1gram PO single dose
OR
Doxycycline 100mg PO BID for 7 days
trichomoniasis caused by ___
caused by small one cell parasite
what’s the treatment for trichomoniasis
Metronidazole 2 G PO single dose
OR
Metronidazole 500mg PO BID x 7 days
pathophysiology of bacterial vaginosis
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
1st line of treatment for bacterial vaginosis
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
2nd line of treatment for bacterial vaginosis
Metronidazole 2g single dose Or
Clindamycin 300 mg BID X 7days
1st line of treatment for inflammatory pelvic disease
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
the incubation days for syphilis is ___
10-90 days
5 stages of syphilis are
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
1st line of treatment for syphilis
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
Alternative treatment for syphilis
Primary, secondary, and early latent syphilis:
Doxycycline 100mg PO BID x 14 days
Latent, late latent Syphilis: Doxycycline 100mg PO BID x 28 days
neurosyphilis symptoms
Headaches
Vision changes
Hearing changes, tinnitus
Vertigo
syphilis serology stays positive for
Stays positive for life
HSV-I typically causes
oral lesions
HSV-II typically causes
genital lesions
primary infection of HSV
HSV travels through the
peripheral nerve to the sacral dorsal root ganglia- it remains dormant here until it is reactivated
Recurrent Infection of HSV
Recurrent Infection: HSV viral particles travel back through the nerve root to the skin, the virus multiples and lesions develop
Incubation of genital herpes
2-12 days
Genital Herpes Testing
1) NAAT/PCR Swab
2) Serology Type Specific Serology
1st line of treatment for genital herpes
1st symptom
Acyclovir 400mg TID for 5-10 days
Famciclovir 250 mg TID for 5-10 days
Valacyclovir 1000mg BID for 5-10 days
Acute Recurrent <6 Episodes per year
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
Chronic Suppressive therapy > 6 outbreaks/year
Acyclovir 400mg BID
Famciclovir 250mg BID
Valacyclovir 250mg BID OR 500mg daily
