UTI's and STD's

Question 1

Physical exam findings consistent with urinary tract infections

Answer 1

flank pain/CVA tenderness or abdominal tenderness in suprapubic area

Question 2

Highly specific UA result for a UTI

Answer 2

presence of nitrites

Question 3

Why should you consider imaging when working up patient with polycystic kidneys?

Answer 3

prone to abscess formation

Question 4

What urinary tract complication are patients with tuberculosis prone to developing?

Answer 4

ureteral strictures

Question 5

Inpatient abx classes for UTI

Answer 5

3rd gen cephalosporin or fluoroquinolones

Question 6

Risk factors for urethritis

Answer 6

high risk sexual behavior and multiple partners

Question 7

What testing should be done if patient has genital ulcers?

Answer 7

cultures for HSV and syphilis

Question 8

How do you diagnose genital herpes besides physical exam?

Answer 8

viral culture by swab for one minute

Question 9

Antiviral prescriptions for intitial outbreaks

Answer 9

Acyclovir (Zovirax) 400mg tid, Famciclovir (Famvir) 250mg po tid, or Valacyclovir (Valtrex) 1gm po bid all for 7-10 days

Question 10

How do prescriptions for antivirals change for recurrent outbreaks?

Answer 10

only need to take for 5 days and doses decreased by half

Question 11

How many herpes outbreaks are needed for consideration of suppression therapy?

Answer 11

6 in one yr

Question 12

Topical treatments for HPV

Answer 12

Imiquimod (Aldara) or Conylox

Question 13

Type of syphilis where pt develops one or more sores resembling large bug bites usually 10-90 days post exposure

Answer 13

primary

Question 14

Presentation of secondary syphilis 1-3 months post-exposure

Answer 14

Rosy copper penny rash on hands and feet

Question 15

Treatment for early primary, secondary, or latent <1yr syphilis

Answer 15

Benzathine Penicillin G 2.4 million U, IM single dose

Question 16

Treatment for syphilis if PCN allergy

Answer 16

doxy or tetracycline for 14 days

Question 17

Tropical disease that rarely occurs in US. Presentation is painless genital nodule

Answer 17

Granuloma Inguinale (Donovanosis)

Question 18

Chlamydial dz that invades lymphatics. Presents with unilateral inguinal lymphadenopathy or painless red erosion on the genitals or rectum

Answer 18

Lymphogranuloma Venereum

Question 19

Treatment for Lymphogranuloma Venereum

Answer 19

Doxycycline 100 mg bid for 21 days

Question 20

Caused by gram-negative, anaerobic bacillus Haemophilus ducreyi. Begins as a small inflammatory papule that erodes to form an extremely painful deep ulceration plus inguinal adenopathy

Answer 20

chancroid

Question 21

Recommended abx for chancroid

Answer 21

Azithromycin 1 g PO or

Ceftriaxone 250 mg intramuscularly (IM)

Question 22

Recommended abx for uncomplicated gonococcal infections

Answer 22

Ceftriaxone 250mg IM single dose or Cefixime 400 mg single oral dose

Question 23

What is the treatment regimen if you suspect chlamydia or are unable to rule it out?

Answer 23

Azithromycin 1 g po single dose or doxy 100 mg bid 7 days