Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PDAT6 ID > 27/28 - STDs > Flashcards

27/28 - STDs Flashcards

(42 cards)

Start Studying
1
Q

Chlamydia Trachomatis

Transmission & Long Term Complications

A

Typical - Anal/Vaginal/Oral Sex

  • *Vertical Transmission**
  • -> Baby = conjunctivitis & pneumonia

Long Term Complications:
Damage to FEMALE Reproductive system
10% of untreated women:
PID / Chronic pelvic pain / infertility / felopian tube dmg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Syphilis

DIAGNOSIS / TESTS

A

Serologic Tests:
RPR** + **EIA
need BOTH to confirm disease

RPR = non-treponemal & non-specific
measured titer –> used to monitor TX response or Re-Infection
correlates w/ disease activity
4-Fold Titer change = CLINICALLY SIGNIFICANT
1:2 = lowest

EIA = treponemal & specific
CONFIRMS DISEASE
but is positive for ENTIRE life –> can’t tract treatment progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

LATENT SYPHILIS

Presentation

A
  • Untreated Primary or Secondary Stage*
  • LACKS CLINICAL MANIFESTATIONS*

Detected by:
Serologic Testing = RPR + EIA

EARLY LATENT SYPHILIS
acquired within 12 months & patient remains INFECTIOUS

LATE LATENT SYPHILIS
acquired >1 year or unknown duration
thought to be NON-infectious
Treated like TERTIARY syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Chlamydia Trachomatis

Testing & Follow-Up

A

NAAT
Nucleic Acid Amplification Test
Urine Sample –> 24 hour return
also for RECTAL & OROpharyngeal SWABS

RTC in 3 MONTHS
for ALL, to check for RE-INFECTION (common)
or RTC if sx persist after treatment

PARTNER NOTIFICATION
refer all sex partners in past 60 DAYS
EPT = expidited partner therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Neurosyphilis

TREATMENT

PCN ALLERGY

A

CSF Evaluation (Lumbar Puncture) –> confirm diagnosis

LIMITED DATA - NO GOOD ALTERNATES

  • *Ceftriaxone 2gm QD IM/IV**
  • *IM/IV for 10-14 days**

PREGNANT PATIENTS:
Can’t take Doxy –> PCN DESENSITIZATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

HERPES

Primary Infection

Signs & Symptoms

A

Incubation period b4 onset of lesions = 5 days
w/o tx –> 20-30 day infection

One or MORE blisters
on or around genital area, can break and leave a
PAINFUL SORE
that takes weeks to heal
(Syphilis is only 1 blister and no pain)

1/3 show systemic sxs:
fever / malaise myalgia

1-10% develop:
aseptic meningitis - neck rigidity / HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

HERPES

S/Sx

A
  • *PRODROMAL**
  • *burning / itching / tingling** @ site of infection
  • -> lesion within 12-24hr

TREAT ASAP

  • *Almost ALL persons** w/ symptomatic 1st HSV episode get recurrence of genital lesions
  • *3-4 episodes a year**
  • *Reactivates periodically** caused by factors:
  • *stress / UV light / menses / trauma / illness**
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Late Latent** & **Tertiary Syphilis

TREATMENT

A
  • *Benzathine Penicillin G 2.4mil units IM**
  • *WEEKLY** for 3 WEEKS

if patients MISS >14 days –> START OVER

Late latent
no sxs+confirmed by RPR + EIA
> 1 year or Unknown

Tertiary Syphilis
CV Complications + Gummatous Lesions
1/3 of patients untreated –> 10-30 years later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Neisseria Gonorrhea
Gonococcal Cervicitis

1st Line Treatment

A

CEFTRIAXONE 250mg IM
oral doesnt have high bactericidal levels at anatomic sites
+
Azithromycin 1g
OR
Doxycycline 100mg BID x7days
for Chlamydia coverage

quinolones are RESISTANT now
& resistance to cephalosporins are rising –> surveillance is crucial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chlamydia Trachomatis

Male & Female
SYMPTOMS

A

MOST COMMONLY: ASX DISEASE
reason for ROUTINE screening = women <25y/o q1year

Symptoms occur 1-3 weeks AFTER & are similar to UTI
Burning urination / Dysuria
Discharge
Swollen lymph nodesingroin

symptoms are SIMILAR to GONORRHEA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What STD has this condition and what is it?

SeroFast

A

SYPHILIS

Pts continue to have low RPR titers d
espite adequate treatment
Ex.
1:2 or 1:4 for many years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Syphilis

Epidemiology & Transmission

A
  • *MEN** > Women
  • *MSM epidemic**

Caused by:
Treponema Pallidum = Spirochete

Sexual contact w/ infectious lesions during:
PRIMARY** or **SECONDARY
stages

less common in utero / non-genital body contact w/ infectious lesions / blood borne

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

SYPHILIS

COUNSELING

A

Important for PARTNERS & INFECTED

Initiate treatment for recurrent disesae
@time of PRODROMAL SXs or 1st Blister

Transmission can occur during ASx periods

NO SEX
when lesions/prodromal Sxs present = highest risk of infection

CONDOMS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Neisseria Gonorrhea

Testing & Follow-Up

A

NAAT
Nucleic Acid Amplification Test
Bacterial culture –> ANTIMICROBIAL RESISTANCE TEST

Alternate Regimen** –> **RTC for TEST OF CURE in 14-21 DAYS

PARTNER NOTIFICATION
refer all sex partners in past 60 DAYS

RTC in 3 MONTHS?? - was for Chlamydia
for ALL, to check for RE-INFECTION (common)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Neisseria Gonorrhea

PREGNANCY

Treatment & Special Considerations

A
  • *SAME AS NORMAL TREATMENT**
  • except DOXY is C/I in pregnancy*

CEFTRIAXONE 250mg IM
+
Azithromycin 1g

Repeat NAAT (3 weeks) to confirm eradication
– FOR PREGNANT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

HERPES

Supressive Treatment for Recurrent disease

A

Supressive Therapy –> ↓outbreaks by 70-80%

↓Frequency & ↓Risk of HSV transmission

  • BUT*
  • *Can result in DRUG RESISTANCE**

Recommended doses:

  • *Acyclovir 400mg BID**
  • *Valacyclovir 1g QD**
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Neisseria Gonorrhea

Testing Recommendations?

Study These Flashcards
A

CDC Recommendations:

ANNUAL GONORRHEA TESTING FOR:

All Sexually active WOMEN <25yo
(Same as Chlamydia)
commonly co-infected with CHLAMYDIA

18
Q

Late Latent** & **Tertiary Syphilis

TREATMENT

PCN ALLERGY

Study These Flashcards
A

Doxycyline 100mg BID
for 28 DAYS
+ close clinical & serologic follow-up

Late latent
no sxs+confirmed by RPR + EIA
> 1 year or Unknown

Tertiary Syphilis
CV Complications + Gummatous Lesions
1/3 of patients untreated –> 10-30 years later

19
Q

HERPES

DIAGNOSIS

Study These Flashcards
A

Clinical Diagnosis
most common, just can tell

PCR
is the preferred assay to CONFIRM
but is not often done –> need to scrape base of lesion

Serologic Testing
also available, but seldom used, just tells you if you had it

20
Q

Syphilis

Secondary Stage Presentation

Study These Flashcards
A

Untreated infxn –> hematogenous dissemination
in 4-8 weeks after Chancre appreance

“Great Imitator”
Variety of Sxs –> affect many organs

RASH on PALMS & SOLES
is most common, but can occur in other areas

Tongue Lesions** + **ALOPECIA

Lymphadenopathy / low grade fever / weight loss
pain in bone + joints

21
Q

Chlamydia Trachomatis

PREGNANCY

Treatment & Special Considerations

Study These Flashcards
A

Azithromycin 1g Single dose
STILL THE SAME

For Pregnant w/ allergy:

  • *Amoxicillin 500mg TID x7days**
  • Doxycycline & Quinolone (levo) are C/I in pregnancy*

REPEAT NAAT** in **3 WEEKS
to confirm eradication for PREGNANCY:
Still RTC 3 months later & possibly for 3rd trimester
to avoid vertical transmission / neonatal infxn

22
Q

​Syphilis

Primary Stage Presentation

Study These Flashcards
A

CHANCRE
Single - PAINLESS ulcer
stage where spirochetes enter body

Sxs occur ~3 weeks after exposure

Ulcer will heal with scarring 2-8 weeks REGARDLESS of Treatment

23
Q

Chlamydia

Epidemiology

Study These Flashcards
A

WOMEN 66% > men
BOTH are ASx (asymptomatic)

Most Common in:
Adolescents** & **Young Adults

MOST COMMON STD
Intracellular Bacterium

24
Q

Neurosyphilis

Presentation

Study These Flashcards
A

Can occur at:
ANY STAGE of Disease
typically 2mo-2years after initial infxn

Treponemal Invasion of CNS

Symptoms:
Meningitis-like = Alterned Mental Status
Cranial Nerve Dysfxn / Stroke / Sensory-motor deficit

25
**Primary / Secondary / Early Latent (\<1 yr)** **_TREATMENT_** **PCN ALLERGY**
**_Doxycycline 100mg BID x 14 days_** requires **close serologic follow up** --\> **more likely to have tx failure** **_Primary_ Chancre** **_Secondary_ sytematic symptoms** **rash on palm/soles** + **alopecia** + **fever + weight loss** **_Early Latent_** ***no sxs*** **- confirmed by RPR + EIA** but \< 1 year
26
**Primary / Secondary / Early Latent (\<1 yr)** **_TREATMENT_**
**_Benzathine PENICILLIN G 2.4mil units IM_** for **one dose**, 1.2mil/syringe into each gluteus **_Primary_ Chancre** **_Secondary_ sytematic symptoms** **rash on palm/soles** + **alopecia** + **fever + weight loss** **_Early Latent_** ***no sxs*** **- confirmed by RPR + EIA** but \< 1 year
27
**Chlamydia Trachomatis** **1st Line Treatment**
**_Azithromycin 1g_** in one dose NO RESISTANCE FOUND + improved adherence OR **_Doxycycline 100mg BID x7days_** NOT FOR WOMEN may be more effective for **Rectal infxn** / **LGV** (caused by **C serovars)** **_RTC in 3 MONTHS_**
28
**HERPES** **Severe Disease Classification**&**TREATMENT**
**Disseminated Infxn** severe morbidity / mortality --\> **hospitilization Pneumonia / Hepatitis / Encephalitis** **_IV ACYCLOVIR 5-10 mg/kg**_ _**q8h_** for **10 days** **_HSV ENCEPHALITIS**_ --\> _**21 DAYS_**
29
**HERPES** **Recurrent / Episodic TREATMENT**
* *_Acyclovir 400mg TID_** * *x5 days** * *_Valacyclovir 1gm QD_** * *x5 days** *topical not effective*
30
**HERPES** **1st Episode TREATMENT**
* *_Acyclovir 400mg TID_** * *7-10 days** * *_Valacyclovir 1gm BID_** * *7-10 days** Start within **24 HOURS of First Episode**
31
**Neisseria Gonorrhea​** Gram (-) Diplococci ## Footnote **Male & Female SYMPTOMS**
**_MALES have Sx_** Burning urination / Dysuria / Discharge - 90% have sxs by day 5 **DGI = Disseminated Gonococcal Infection:** petechial skin rash, septic arthritis, endocarditis, meningitis **_FEMALES**_ = _***often ASx 50%*_** untreated --\> PID / tubal scarring / infertility
32
**_Syphilis_** **MONITORING**
**Test _RPR Titers**_ --\> fall by at least _**4-fold_** @ **6 / 12 / 24 months** takes a MONTHS for RPR to decline For **SEX PARTNERS:** Persons exposed for **_90**_ _**DAYS_** should be **referred for treatment** *if serologic test not available* *was 60 days for other*
33
**Chlamydia Trachomatis** **Alternate Treatment / Allergic**
**_Levofloxacin 500mg BID x7days_** **RTC in 3 MONTHS** For Pregnant w/ allergy: **_Amoxicillin 500mg TID x7days_** Doxycycline & Quinolone (levo) are C/I in pregnancy
34
**_Neurosyphilis_** **TREATMENT**
**CSF Evaluation (Lumbar Puncture) --\> confirm diagnosis** HOSPITILAZTION REQUIRED: * *_Aqueous Crystalline Penicillin G 18-24mil units_** * *3-4mil units IV q4 hours** for **_10-14 days_** Can occur at: **ANY STAGE of Disease** typically 2mo-2years after initial infxn **_Treponemal Invasion of CNS_** _Symptoms:_ **Meningitis-like** = **Alterned Mental Status Cranial Nerve Dysfxn / Stroke / Sensory-motor deficit**
35
**_Chlamydia Trachomatis**_ & _**Neissria G_****_onorrhea_** **Important Counseling**
**_CONDOM USE_** **_PARTNER NOTIFICATION_** all sex partner in **past 60 days** **EPT = expidited partner therapy** **_RTC in 3 Months_** for all to check for re-infection, **RTC if sxs PERSIST** *pregnant is 3WEEKS* **_Avoid SEX for 7 DAYS after tx**_ & _**after sex partners treated_** **_HIV + Syphilis Testing_**
36
**Neisseria Gonorrhea** **Alternate Treatment / Allergic**
*when CEFTRIAXONE IM is NOT available:* **_CEFIXIME 400mg PO single dose_** + **_Azithromycin 1gm_** OR **Doxycyline 100mg BID x7days** * if severe PCN/Cephalosporin Allergy:* * *_GEMIFLOXACIN 320mg**_ + _**Azithromycin 2GM single dose_** * zithro has gonorrhea activity but needs 2GRAM DOSE* **Alternate Regimen: RTC for TEST OF CURE (NAAT) in _14-21 Days_**
37
**Chlamydia Trachomatis** **Testing Recommendations?**
CDC Recommendations: **ANNUAL CHLAMYDIA TESTING FOR:** **_All Sexually active WOMEN \<25yo_** + **_All MSM (male sex w/ male)_** + **_Sexually active HIV infected persons_**
38
**Neisseria Gonorrhea​** Gram (-) Diplococci ## Footnote **Transmission & Long Term Complications**
Typical - Anal/Vaginal/Oral Sex * *_Vertical Transmission_** --\> Baby * *Co-infection w/ Chlamydia is COMMON** Long Term Complications: * *_Damage to FEMALE Reproductive system_** * *PID** / **Chronic pelvic pain** / **infertility / felopian tube dmg**
39
**Which STD has the ADR of: _Jarisch Herxheimer Reaction_** and **what is it?**
**_SYPHILIS_** **Acute Febrile Rxn** = **HA / Myalgia / Fever** within the first **48 hours of treatment** most common in those with **high RPR primary disease** treat with **Antipyretics**
40
**Neisseria Gonorrhea** **EPIDEMIOLOGY**
* *_MEN_** \> **Women** * but might be because* **MEN have Sx** --\> **reported** **_Gram (--) Dipococci_** **2nd Most Common**
41
**_Herpes_** **Epidemiology**
**_HSV-1**_ or _**HSV-2_** Genital / Oral **chronic/lifelong viral infection = NOT curable** **Recurrence is MALE \> Female**, **3-4 episodes for first few years** _Transmission:_ Typically occurs in **patients UNAWARE they have infxn** **Active lesions --\> MORE INFECTIVE** **VERTICAL TRANSMISSION**
42
**TERTIARY SYPHILIS** **Presentation**
**1/3 of patients** who ***_have not been treated_*** --\> **tertiary** **_10-30 years_** AFTER initial infection **_CARDIOVASCULAR COMPLICATIONS_** + **_GUMMATOUS LESIONS_**

PDAT6 ID (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions