STDs - McCandless

Question 1

Chlamydia - treatment
What else to do?

Side effect? Why?

Answer 1

Azithromycin
Treat sexual partner

GI distress - but MUST give the whole dose at 1 time

Question 2

Gonorrhea - treatment

What else to do?

Answer 2

Ceftriaxone

Treat sexual partner

Question 3

Non-gonococcal urethritis - bug potentials

Treatment

Answer 3

Chlamydia, Ureaplasma, Mycoplasma

Azithromycin

Question 4

Syphilis - treatment
NOT?
What else to do?

Answer 4

Benzathine penicillin G (IM)
NOT other penicillins
Treat sexual partner

Question 5

Benzathine penicillin G – levels in body over time

Answer 5

Low, but constant for 2 weeks

Question 6

A pregnant woman is allergic to penicillin. She develops a syphilis infection. Treatment?

Is this permanent?

Answer 6

Penicillin - desensitization process (low dose –> high dose)

NO - must repeat next time

Question 7

Vulvovaginal candidiasis - treatment (office)

Treatment (home)

Benefit to the second one?

Answer 7

Fluconazole - oral

Miconazole - topical

VERY fast symptoms relief (maybe while fluconazole is doing its job)

Question 8

Trichomonas - treatment

What else to do?

Answer 8

Metronidazole

Treat sexual partner

Question 9

Vaginosis (Gardnerella, Mycoplasma… - treatment

What to know? So?

Answer 9

Metronidazole

Recurs frequently – can give prescription to use between office visits

Question 10

HPV - primary prevention

Answer 10

Gardasil (6, 11, 16, 18)

Question 11

Pubic lice, crabs, scabies - treatment options

Important to do what else?

Child w/ one of these?

Answer 11

Permethrin (topical)
Ivermectin (oral)

Make sure they wash all clothes and bedding

Permethrin ONLY

Question 12

Male condoms are better at preventing which type of infection?

So NOT which ones?

Answer 12

Those transmitted by body fluids (gonorrhea, chlamydia, HIV)

HSV, HPV, syphilis, chancroid

Question 13

HSV will usually present how?

Where are the vesicles?

Answer 13

Coalesced ulcer w/ heaped-up borders

Usually pop w/in 48 hrs

Question 14

When is HSV MOST virulent?

Answer 14

In the pro-drome when there is lots of itching, etc.

Question 15

HSV - treatment

Cheapest one? What’s bad about it?

Must do what? Why?

Answer 15

Acyclovir, Famciclovir, Valacyclovir

Acyclovir - must take 5 times per day

Take w/ water (crystallizes in kidney tubules)

Question 16

Punched-out, sharply-demarcated, heaped-up borders, clean base, painless

Location?

Virulent?

Answer 16

Syphilis chancre (1º)

Inoculation site (anywhere)

YES - do NOT touch it

Question 17

Multifocal rash on palms/soles that cross skin fold lines

Answer 17

2º syphilis

Question 18

Soft, fleshy, raised lesions that look like globs of skin in the perianal or vulvovaginal area

Often confused for?

Answer 18

2º syphilis (C. lata)

Hemorrhoids or genital warts

Question 19

Recurrent UTIs, WBCs on urinalysis, no growth on culture, cobble-stoning and redness on cervix

Answer 19

Chlamydia

Question 20

Man, cloudy white drip from penis after peeing, burns to urinate, yellow stain on underwear

Answer 20

Chlamydia

Question 21

Dysuria, yellow discharge, vaginal bleeding, vaginal pain, cervical tenderness

Answer 21

Gonorrhea

Question 22

20s, purpura/blister on one knee, other joints

Other presentations of this?

Answer 22

Gonorrhea - septic arthritis

Pharyngitis, endocarditis, F-H-C syndrome (PID)

Question 23

Malodorous, frothy yellow discharge

Treatment?

Answer 23

Trichomonas

Metronidazole

Question 24

HPV - treatment

Curative?

Answer 24

Removal of warts

NO

Question 25

Small, round, umbilicated lesions on the body

Answer 25

Molluscum contagiosum

Question 26

Molluscum-looking lesions on the face?

Answer 26

Cryptococcus (HIV) until proven otherwise