Term
| What is the usual onset of symptoms of Gonorrhea in males? |
|
Definition
|
|
Term
| Where can N Gonorrhea infect males? |
|
Definition
| Urethra, rectum, oropharynx, and eyes |
|
|
Term
| True or false: Gonorrhea is usually symptomatic in females but not in males. |
|
Definition
| False: it is usually associated with minimal to no symptoms in both genders. |
|
|
Term
| What are the symptoms of urethral infection of gonorrhea in males? (3) |
|
Definition
| Dysuria, urinary frequency, and purulent discharge |
|
|
Term
| What are the symtoms of rectal infection of gonorrhea in males? (3) |
|
Definition
| Pruritus, mucopurulent discharge, and bleeding |
|
|
Term
| What is the usual onset of symptoms of gonorrhea in females? |
|
Definition
|
|
Term
| Where can N gonorrhea infect females? |
|
Definition
| Endocervical canal, urethra, rectum, orophraynx, and eye |
|
|
Term
| What are the symptoms of urethral gonorrhea in females? (4) |
|
Definition
| Dysuria, urinary frequency, abnormal vaginal discharge, and bleeding |
|
|
Term
| What are the symptoms of rectal gonorrhea in females? (3) |
|
Definition
| Pruritus, mucopurulent discharge, and bleeding |
|
|
Term
| What are four complications that can arise from gonorrhea in males? |
|
Definition
Epididymitis
Prostatitis
Inguinal lymphdenopathy
Urethral stricture |
|
|
Term
| What are three complications of gonorrhea infection in females? |
|
Definition
PID
Ectopic pregnancy
infertility |
|
|
Term
What is Disseminated Gohorrhea and what are the symptoms? (3)
Also, more common in which gender? |
|
Definition
It's gonorrhea in the blood. It presents with tender necrotic skin lesions
Tenosynovitis
Monarticular artritis
more common in females (3 times) |
|
|
Term
| What is the first line treatment for gonorrhea in adults? |
|
Definition
Ceftriaxone 125 mg IM once
OR
Cefixime 400mg PO once (tab or suspension
PLUS
Treatment for presumed chlamydial infection |
|
|
Term
| What is the alternative treatment for gonorrhea in adults? (4) |
|
Definition
Spectinomycin 2G IM once
OR
Ceftizoxime 500mg IM once
OR
Cefotaxime 500mg IM once
OR
cefoxitin 2g IM once with Probenecid 1g PO once
PLUS
Treatment for presumed chlamydia |
|
|
Term
| How do you treat gonorrhea in pregnancy? (2) |
|
Definition
Ceftriaxone 125 mg once OR cefixime 400mg PO once
PLUS
presumptive treatment for chlamydia. |
|
|
Term
| What are the alternative treatments for gonorrhea in pregnancy? |
|
Definition
Spectinomycin 2G IM once
OR
Ceftizoxime 500mg IM once
OR
Cefotaxime 500mg IM once
OR
cefoxitin 2g IM once with Probenecid 1g PO once
PLUS
Treatment for presumed chlamydia |
|
|
Term
| What is first line for Disseminated Gonorrhea in adults? |
|
Definition
| Ceftriaxone 1g IM or IV every 24 hours |
|
|
Term
| What are the alternative treatments for disseminated gonorrhea in adults? |
|
Definition
Cefotaxime 1g IV every 8 hours
OR
Ceftizoxime 1g IV every 8 hours
Or
Spectinomycin 2g IM every 12 hours |
|
|
Term
| What is first line for uncomplicated gonorrhea in children? |
|
Definition
| Ceftriaxone 125mg IM once |
|
|
Term
| What is the alternative treatment for uncomplicated gonorrhea in children? |
|
Definition
| Spectinomycin 40mg/kg IM once (not to exceed 2g) |
|
|
Term
| What is the threatment for opthalmic gonorrhea in neonates? |
|
Definition
| Ceftriaxone 25-50 mg/kg IV or IM once (not to exceed 125mg) |
|
|
Term
| What are the two prophylaxis treatments for opthalmic gonorrhea in neonates? |
|
Definition
Erythromycin 0.5% ointment (single application)
OR
Tetracycline 1% opthalmic ointment (single application) |
|
|
Term
| What are the symptoms of primary syphilis? (3) |
|
Definition
Chancre
lasts 1-8 weeks
Often heals spontaneously |
|
|
Term
What is the clinical presentation of secondary syphilis?
Onset?
Symptoms? (8)
Duration? |
|
Definition
starts 2-8 weeks.
Nonpruritic skin lesions
Lymphadenopathy
Malaise
Fever
HA
Anorexia
Arthralgia
Lasts 4-10 weeks |
|
|
Term
| What is the main distinguishing factor of late syphilis? |
|
Definition
| The presence of gumma on organs. Can be on any of them |
|
|
Term
| What are the symptoms of neurosyphilis? (6) |
|
Definition
Meningitis
Paralysis
Dementia
Tabes orsalis
Deafness
Blindness |
|
|
Term
| Can syphilis pass through the placenta? |
|
Definition
|
|
Term
What is the first line treatment for primary syphilis?
And when do you follow up? |
|
Definition
Benzathine Pen G 2.4 million units IM
Followup at 6 and 12 months to make sure it's gone |
|
|
Term
What is the first line treatment for secondary syphilis?
When do you follow up? |
|
Definition
Benzathine pen G 2.4 million units IM single dose.
Follow up at 6 and 12 months. |
|
|
Term
What is first line treatment for early latent syphilis?
When do you follow up? |
|
Definition
Benzathine pen G 2.4 million units IM single dose.
Follow up at 6, 12, and 24 months |
|
|
Term
| What is the treatment for late latent syphilis and when do you follow up? |
|
Definition
Benzathine Pen G 2.4 million units IV once a week for 3 weeks
Follow up at 6, 12 and 24 months |
|
|
Term
| What is the treatment for neurosyphilis and when do you follow up? (2) |
|
Definition
Aqueus crystalline Pen G 18-24 million units IV every four hours or by continuous infusion for 10-14 days
OR
Aqueuous procaine Pen G 2.4 million units IM daily PLUS probenecid 500 mg PO four times daily, both for 10-14 days
Follow up every six months. If not normal, consider retreatment |
|
|
Term
| How do you treat congenital syphilis? (2) |
|
Definition
Aqueuous crystalline Pen G 50,000 units/kg IV every 12 hours for the first 7 days of life, then every 8 hours for days 8-10
OR
Procaine Pen G 50,000 units/kg IM daily for 10 days |
|
|
Term
| What do you do if a person has an allergic reaction to penicillin and has syphilis? |
|
Definition
| If it's not anaphylaxis, give it anyway. If it's anaphylactic, you can desensitize them. Then give it. Either way, they get it. |
|
|
Term
| What are three factors that make chlamydia somewhat unique? |
|
Definition
It's an obligate intracellular organism
Has features that resemble both virus and bacteria
Often occurs in conjunction with gonorrhea |
|
|
Term
| What is the clinical presentation of chlamydia (2) |
|
Definition
Often asymptomatic
May have disuria and discharge |
|
|
Term
| What are complications seen with chlamydia? (4) |
|
Definition
Infertility
PID
Epididimytis
Reiter's Syndrome |
|
|
Term
| What is first-line treamtne for uncomplicated chlamydia? (2) |
|
Definition
Azithromycin 1g PO once
OR
Doxycline 100mg PO BID x 7 days |
|
|
Term
What are the alternative treatments for chlamydia in adults?
(4) |
|
Definition
Ofloxacin 300mg PO BID x 7 days
Levofloxacin 500mg PO x 7 days
Erythromycin base 500 mg PO QID x 7 days
Erythromycin ethyl succinate 900mg PO QID x 7 days |
|
|
Term
| What are first-line treatments for chlamydia during pregnancy? (2) |
|
Definition
Azithromyci 1g PO once
OR
amoxicillin 500mg PO TID x 7 days |
|
|
Term
| What are secondary treatments for chlamydia during pregnancy? (4) |
|
Definition
Erythromycin base 500mg PO QID x 7 days
Erythromycin base 250mg PO QID x 14 days
Erythromycin ethyl succinate 800 mg PO QID x 7 days
Erythromycin ethyl succinate 400mg PO QID x 14 days |
|
|
Term
| How do you treat chlamydia in newborns? |
|
Definition
| Erythromycin base 50mg/kg/day PO QID x 14 days |
|
|
Term
| What is a prodrome of herpes? |
|
Definition
| It's a time period before the outbreak where the patient may be able to tell an outbreak is imminent. |
|
|
Term
| How long do the symptoms last for the first episode of herpes? |
|
Definition
|
|
Term
| How long do symptoms last in non-primary herpes? |
|
Definition
|
|
Term
| How long do you shed virus during herpes outbreaks? |
|
Definition
|
|
Term
| What are 5 complications of herpes infection? |
|
Definition
Meningitis
Enchephalitis
Transverse myelitis
Sacral radiculopathy syndrome
Neonatal transmission has 50% fatality rate |
|
|
Term
| What is the treatment for first clinical episode of genital herpes? (4) |
|
Definition
Acyclovir 400mg PO TID x 7-10 days
Acyclovir 200mg PO 5 times a day for 7-10 days
Famcyclovir 250mg TID x 7-10 days
Valacyclovir 1g PO BID x 7-10 days |
|
|
Term
| What is the alternative treatment plan for the first clinical episode of genital herpes? |
|
Definition
| Acyclovire 5-10 mg/kg IV TID x 2-7 days followed by PO to complete 10 days. |
|
|
Term
| What are the treatments for acute episodes of genital herpes? (7) |
|
Definition
Acyclovir 400 mg PO TID x 5 days
Acyclovir 800 mg PO BID x 5 days
Acyclovir 800 mg PO TID x 2 days
Famciclovir 125 mg PO BID x 5 days
Famciclovier 1000mg PO BID x 1 day
Valacylovir 500 mg BID x 3 days
Valacyclovir 1g PO daily x 5 days |
|
|
Term
| What are the three suppressive treatment options for herpes? |
|
Definition
Acyclovir 400mg PO BID
Famciclovr 250 mg PO BID
Valaclyclovir 500 OR 1000 mg daily |
|
|
Term
What is the most common STD in young women?
What type of organism is the causative agent? |
|
Definition
| Trichomaons vaginalis (protozoan) |
|
|
Term
| True or false: Men can get Tricomonas Vaginalis |
|
Definition
| True. usually spontaneously cures |
|
|
Term
| What are symptoms of tricomonas vaginalis (4) |
|
Definition
Malodorous discharge
Pruritis
Dysuria
Dyspareunia |
|
|
Term
| What are 3 complications of Tricomonas Vaginallis in men? |
|
Definition
Epididymitis
Chronic prostatitis
Infertility |
|
|
Term
| What are 3 complications of Tricomonas Vaginallis in women? |
|
Definition
PID
Premature labor
Low risk of neonatal infection |
|
|
Term
| What is first-line treatment of trichomonas vaginalis? (2) |
|
Definition
Metronidazole 2g PO x 1 dose
OR
Tinidazole 2g PO x 1 dose |
|
|
Term
| What is alternate treatment of tricomonas vaginallis? |
|
Definition
Metronidazole 500 mg PO BID x 7 days
Or
Tinidazole 2g PO x 1 dose |
|
|
Term
| How do you treat Trichamonas Vaginalis in pregnancy? |
|
Definition
| Metronidazole 2g PO x 1 dose |
|
|
Term
| You failed treatment for trichamonas vaginallis. What do you do? (3) |
|
Definition
Treat both partners.
Can use higher doses
Can use concomitant vaginal metronidazole |
|
|
Term
| You've got trichanomas vaginalis and you just got pregnant. What do you do? |
|
Definition
Oral therapy is contraindicated
Topical metronidazole is indicated. |
|
|
Term
What are the pathogenic strains of HPV?
Which cause cervical cancer? |
|
Definition
Pathogenic: 6 and 11
Cancer: 16 and 18 |
|
|
Term
| What is the gold standard for detecting HPV? |
|
Definition
|
|
Term
| What are provider administered therapies for HPV? (5) |
|
Definition
Cryotherapy
Podophyllin resin 10-25% in a compound tincture of benzoin
Trichloracetic acid 80-90%
Bichloracetic acid 80-90 percent
Surgical removal |
|
|
Term
| What are patient applied therapies for HPV? (2) |
|
Definition
Podofilox 0.5% solution or gel BID x 3 days. 4 days no therapy. May repeat up to 4 cycles
OR
Imiquimod 5% QHS 3 times weekly up to 16 weeks |
|
|
Term
| Which warts can be removed by surgery? |
|
Definition
| Anal warts. Cannot remove vaginal or urethral meatus warts) |
|
|
Term
| What strains of HPV does gardasil cover? |
|
Definition
6,11,16,18
Given in 3 doses |
|
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