Week 8 - STIs

Question 1

Symptoms of HPV and Genital warts

Answer 1

• HPV often asymptomatic
• Bumps to vaginal introitus, vulva, labia or anus

Question 2

Treatment for genital warts

Answer 2

• Podofilox, imiquimod, sinecatechins- applied topically by the patient
• Cryotherapy in the office
• Surgical removal
• Trichloroacetic acid
• Bath in oatmeal solution, dry area with hair dryer
• Wear cotton underwear and loose fitting clothing

Question 3

S/S genital herpes

Answer 3

• May be asymptomatic
• Assess for general viral symptoms – malaise, fever, headache, myalgias,
• vulvar pain, dysuria, itching, or burning at the site of infection, and painful genital lesions that heal spontaneously are very suggestive of HSV infection

Question 4

How is genital herpes diagnosed?

Answer 4

PCR test

Question 5

Treatment for genital herpes

Answer 5

• PO - acyclovir, valacyclovir, or famciclovir
• Oral analgesics for pain
• Warm sitz baths
• Drying lesions with hair dryer on cool setting
• Cotton underwear/loose clothing
• Apply cold milk or witch hazel to lesions followed by aloe vera gel or burrows solution
• Minimize foods containing arginine - coffee, grains, chicken, chocolate, corn, dairy products, meat, peanut butter, nuts, and seed
• Suppressive therapy to prevent spread to partners

Question 6

Chancroid

Answer 6

bacterial STI uncommon in the US

Question 7

Symptoms of chancroid

Answer 7

• painful macule on the external genitalia that rapidly changes to a pustule and then to an ulcerated lesion. May develop enlarged unilateral or bilateral inguinal nodes.

Question 8

Treatment for chancroid

Answer 8

Azithromycin 1 gm orally in a single dose

Question 9

Pubic lice treatment

Answer 9

1% permethrin cream rinse, apply daily and rinse off after 10 minutes – failure after 1 week then drug resistance  malathion cream or PO ivermectin.

Question 10

Trichomoniasis

Answer 10

A common sexually transmitted infection caused by a parasite.

Question 11

S/S Trichomoniasis

Answer 11

• Asymptomatic
• yellow to greenish, frothy, mucopurulent, copious, malodorous discharge
• Inflammation of the vulva, vagina, or both may be present
• irritation, pruritus, dysuria, or dyspareunia

Question 12

Treatment for trichomoniasis

Answer 12

Metronidazole 2 gm orally in a single dose or tinidazole 2 gm orally in a single dose

Question 13

Chlamydia

Answer 13

Bacterial STI

Question 14

S/S of chlamydia

Answer 14

• Usually asymptomatic
• vaginal spotting or postcoital bleeding
• mucoid or purulent cervical discharge
• urinary frequency
• dysuria
• lower abdominal pain
• Dyspareunia

Question 15

Treatment for chlamydia

Answer 15

• Azithromycin 1 gm orally in a single dose

Question 16

Gonorrhea

Answer 16

Bacterial STI

Question 17

S/S Gonorrhea

Answer 17

• May be asymptomatic
• Dyspareunia
• a change in vaginal discharge
• unilateral labial pain and swelling
• lower abdominal discomfort.
• Later in the course of infection, women may describe a history of purulent, irritating vaginal discharge or rectal pain and discharge. Menstrual irregularities

Question 18

Treatment for Gonorrhea

Answer 18

• Ceftriaxone 250 mg IM in a single dose

Question 19

Pelvic inflammatory disease

Answer 19

Infection of the female reproductive organs. It most often occurs when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes or ovaries.

o includes endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis
o Caused by a variety of bacterial pathogens common in the vagina

Question 20

S/S of Pelvic Inflammatory Disease

Answer 20

 abrupt onset of acute lower abdominal pain following menses
 may have mild, nonspecific symptoms
 abdominal, pelvic, and low back pain
 abnormal vaginal discharge
 intermenstrual or postcoital bleeding
 fever; nausea and vomiting
 urinary frequency
 Pelvic pain exacerbated by the Valsalva maneuver, intercourse, or movement

Question 21

Diagnosis of PID

Answer 21

 often made based on findings of pelvic organ tenderness and signs of lower genital tract infection, including mucopurulent cervicitis and cervical friability

Question 22

Treatment for PID

Answer 22

• Ceftriaxone 250 mg IM in a single dose PLUS Doxycycline 100 or Metronidazole 500 mg orally two times/day for 14 days
• Analgesia for pain
• Many need hospitalization for severe symptoms

Question 23

Syphilis

Answer 23

Bacterial STI

Question 24

S/S of Syphilis

Answer 24

o periods of active symptoms and periods of asymptomatic latency.
o primary lesion, or a chancre, which often begins as a painless papule at the site of inoculation and then erodes to form a nontender, shallow, indurated, clean ulcer that is several millimeters to a few centimeters in size.
o Secondary – fever, pruritic rash

Question 25

Treatment for Syphilis

Answer 25

• Benzathine penicillin G 2.4 million units IM in a single dose

Question 26

Hepatitis B

Answer 26

a vaccine-preventable liver infection caused by the hepatitis B virus (HBV).

Question 27

S/S Hepatitis B

Answer 27

 arthralgias, fatigue, anorexia, nausea, vomiting, fever, abdominal pain, clay-colored stools, dark urine, and jaundice
 may be asymptomatic

Question 28

Treatment for Hep B

Answer 28

• Women with a definite exposure to hepatitis B should be given hepatitis B immunoglobulin IM in a single dose as soon as possible, and preferably within 24 hours after exposure.
• There is no specific treatment for acute hepatitis B; recovery is usually spontaneous

Question 29

Hep C

Answer 29

an inflammation of the liver caused by the hepatitis C virus. The virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness to a serious, lifelong illness including liver cirrhosis and cancer.

Question 30

Symptoms of Hep C

Answer 30

 fatigue, fever, abdominal pain, nausea, vomiting, anorexia, jaundice, dark urine, or clay-colored stool.

Question 31

Treatment for Hep C

Answer 31

• combination of interferon and ribavirin with or without protease inhibitors

Question 32

HIV

Answer 32

HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system.

Question 33

Symptoms of HIV

Answer 33

• fever, malaise, rash, myalgias, lymphadenopathy, sore throat, and headache

Question 34

Diagnosing HIV

Answer 34

ELISA tests

Question 35

Treatment for HIV

Answer 35

Antiretroviral therapy