Exam 4 - STIs Jenkins (not done)

Question 1

PrEP 3 drug options (brand names)

Answer 1

Truvada (F/TDF)
Descovy (F/TAF)
Apretude

Question 2

Truvada components (2)

Answer 2

emtricitabine + tenofovir disoproxil fumarate

(F/TDF)

Question 3

Descovy components (2)

Answer 3

emtricitabine + tenofovir alafenamide

(F/TAF)

Question 4

Apretude active ingredient

Answer 4

cabotegravir

Question 5

HPV vaccine is recommended for routine vaccination at age ___ or ___ (can be started at age ___). It is recommended for everyone through age ___ years if not completed when younger

Answer 5

11 or 12
9
26

Question 6

Gonorrhea etiologic agent

Answer 6

Neisseria gonorrhoeae

Question 7

epidemiology of neisseria gonorrhoeae: major cause of _____ _____ _____

Answer 7

pelvic inflammatory disease (PID)

Question 8

standard of care for diagnosis of gonorrhoeae in urine, rectum, throat

a. gram stain
b. NAAT
c. culture

Answer 8

b. NAAT

Question 9

preferred drug for uncomplicated gonococcal infections of the cervix, urethra, and rectum (not including doses)

Answer 9

ceftriaxone

Question 10

drug that is tx of choice for all stages of syphilis

Answer 10

Pen G (parenteral)

Question 11

T or F: people who are already using PrEP typically need PEP as well

Answer 11

F

Question 12

nPEP preferred regimen (3 drug regimen)

Answer 12

tenofovir disoproxil fumarate +
emtricitabine +
raltegravir OR dolutegravir
x 28 days

(F/TDF + RAL or DTG)

Question 13

nPEP alternative regimen

Answer 13

tenofovir disoproxil fumarate +
emtricitabine +
darunavir +
ritonavir
x 28 days

(F/TDF + DRV + RTV)

Question 14

pharmacokinetic enhancer to inc trough conc and prolong half life of protease inhibitors

a. darunavir (DRV)
b. ritonavir (RTV)
c. raltegavir (RAL)
d. dolutegravir (DTG)

Answer 14

b. ritonavir (RTV)

Question 15

second most common notifiable disease in the US

a. syphilis
b. gonorrhoeae
c. chlamydia
d. trichomoniasis

Answer 15

b. gonorrhoeae

Question 16

tx of uncomplicated gonococcal infections of the cervix, urethra, and rectum:
< 150 kg

a. ceftriaxone 500 mg IM x 1
b. ceftriaxone 1 gm IM x 1
c. doxy 100 mg PO BID x 7 days
d. azithro 1 gm PO x 1

Answer 16

a. ceftriaxone 500 mg IM x 1

Question 17

tx of uncomplicated gonococcal infections of the cervix, urethra, and rectum:
< 150 kg
chlamydia not excluded
not pregnant

a. ceftriaxone 500 mg IM x 1
b. ceftriaxone 1 gm IM x 1
c. doxy 100 mg PO BID x 7 days
d. azithro 1 gm PO x 1

Answer 17

c. doxy 100 mg PO BID x 7 days

Question 18

tx of uncomplicated gonococcal infections of the cervix, urethra, and rectum:
150+ kg

a. ceftriaxone 500 mg IM x 1
b. ceftriaxone 1 gm IM x 1
c. doxy 100 mg PO BID x 7 days
d. azithro 1 gm PO x 1

Answer 18

b. ceftriaxone 1 gm IM x 1

Question 19

tx of uncomplicated gonococcal infections of the cervix, urethra, and rectum:
150+ kg
chlamydia not excluded
not pregnant

a. ceftriaxone 500 mg IM x 1
b. ceftriaxone 1 gm IM x 1
c. doxy 100 mg PO BID x 7 days
d. azithro 1 gm PO x 1

Answer 19

c. doxy 100 mg PO BID x 7 days

Question 20

tx option for PREGNANT uncomplicated gonococcal infection of the cervix, urethra, and rectum

a. ceftriaxone 500 mg IM x 1
b. ceftriaxone 1 gm IM x 1
c. doxy 100 mg PO BID x 7 days
d. azithro 1 gm PO x 1

Answer 20

d. azithro 1 gm PO x 1

Question 21

tx of uncomplicated gonococcal infections of the cervix, urethra, and rectum: two options if ceftriaxone is NOT available

Answer 21

-genta + azithro
-cefixime

Question 22

AC is a 32yof with a past medical history of asthma, non-insulin dependent type 2 diabetes, and obesity who presents to hospital with anal pruritis, bleeding, discharge, and pain. She has recently been newly sexually active with one new partner. Her partner does not always use a condom when they have sex. She is diagnosed with uncomplicated gonococcal infection of the rectum and ruled out chlamydia infection. She has no known drug allergies and is not pregnant. Weight 162kg

Which would be the best treatment option?
A.) Ceftriaxone 500 mg IM x1 dose
B.) Ceftriaxone 1000 mg IM x1 dose
C.) Gentamicin 240 mg IM x1 dose PLUS doxycycline 100mg PO BID x 7 days
D.) Ceftriaxone 1000 mg IM x1 dose PLUS azithromycin 1000 mg PO x 1 dose

Answer 22

B.) Ceftriaxone 1000 mg IM x1 dose

(a. is wrong dose; c is genta plus azithro; d. would be if they have chlamydia and pregnant)

Question 23

syphilis etiologic agent

Answer 23

treponema pallidum

Question 24

first line for primary and secondary syphilis

a. benzathine pen G
b. doxy
c. tetracyline
d. azithro

Answer 24

a. benzathine pen G

(the other 3 are if there is a PCN allergy)

Question 25

KC is a 52yom with PMH of IV drug use who presents to hospital with altered mental status. He was diagnosed with syphilis about 8 years ago but had left the hospital against medical advice. Lab results show elevated C-reactive protein (measure of inflammation or infection) and was diagnosed with tertiary (late) syphilis. He has no known drug allergies. Weight 87kg - BP 141/74 - HR 102 – RR 17 – Afebrile Which would the best treatment option? A.) Benzathine penicillin G 2.4 million units IM once weekly x 3 weeks B.) Aqueous crystalline penicillin G 4 million units IV Q4h x 10-14 days C.) Benzathine penicillin G 2.4 million units IM x 1 dose D.) Doxycycline 100mg PO BID x 14 days

Answer 25

A.) Benzathine penicillin G 2.4 million units IM once weekly x 3 weeks (b. is for neurosyphilis; c. is for primary, secondary, and early latent; d. tx duration should be 28 days and there is no PCN allergy)

Question 26

which of the following is NOT used in early latent syphilis? a. benzathine pen G 2.4 mil units IM x 1 b. doxy 100 PO BID x 14 days c. tetracycline 500 PO QID x 14 days d. azithromycin 2 g PO x 1

Answer 26

d. azithromycin 2 g PO x 1

Question 27

What is the first-line treatment for uncomplicated gonorrhea if pt < 150 kg? a) Azithromycin 1g PO once b) Doxycycline 100mg BID for 7 days c) Ceftriaxone 500mg IM once d) Metronidazole 2g PO once

Answer 27

c) Ceftriaxone 500mg IM once

Question 28

Which of the following is the recommended treatment for syphilis in a non-pregnant adult? a) Penicillin G benzathine 2.4 million units IM once b) Doxycycline 100mg BID for 7 days c) Ceftriaxone 250mg IM once d) Acyclovir 400mg TID for 7 days

Answer 28

a) Penicillin G benzathine 2.4 million units IM once

Question 29

What is the preferred regimen for chlamydia infection? a) Azithromycin 1g PO once b) Ceftriaxone 250mg IM once c) Metronidazole 2g PO once d) Doxycycline 100mg BID for 7 days

Answer 29

d) Doxycycline 100mg BID for 7 days

Question 30

What is an alternative treatment for chlamydia if doxycycline cannot be used? a) Azithromycin 1g PO once b) Ceftriaxone 500mg IM once c) Metronidazole 500mg BID for 7 days d) Acyclovir 800mg TID for 7 days

Answer 30

a) Azithromycin 1g PO once (or levofloxacin 500 mg PO q24h x 7 days)

Question 31

Which of the following is the recommended treatment for trichomoniasis in females? a) Doxycycline 100mg BID for 7 days b) Metronidazole 500 mg PO BID for 7 days c) Acyclovir 400mg TID for 7 days d) Fluconazole 150mg PO once

Answer 31

b) Metronidazole 500 mg PO BID for 7 days

Question 32

For primary genital herpes, which of the following is an appropriate treatment regimen? a) Acyclovir 400mg TID for 7–10 days b) Valacyclovir 125mg BID for 5 days c) Penicillin G benzathine 2.4 million units IM once d) Ceftriaxone 500mg IM once

Answer 32

a) Acyclovir 400mg TID for 7–10 days (b. is for recurrent)

Question 33

What is the recommended treatment for late latent syphilis? a) Pen G benzathine 2.4 million units IM weekly for 3 weeks b) Ceftriaxone 1g IV Q24H c) Azithromycin 1g PO once d) Aq crystalline Pen G 3-4 million units IV Q4H x 10-14 days

Answer 33

a) Pen G benzathine 2.4 million units IM weekly for 3 weeks

Question 34

For gonorrhea treatment in individuals weighing ≥150 kg, what is the recommended ceftriaxone dose? a) 500mg IM once b) 1g IM once c) 250mg IM once d) 2g IM once

Answer 34

b) 1g IM once

Question 35

If chlamydia co-infection has not been ruled out in a gonorrhea case, and the patient is not pregnant, what additional treatment should be given? a) Azithromycin 1g PO once b) Doxycycline 100mg BID for 7 days c) Metronidazole 2g PO once d) No additional treatment is needed

Answer 35

b) Doxycycline 100mg BID for 7 days

Question 36

Which alternative antibiotic can be considered for gonorrhea treatment if ceftriaxone is unavailable? a) Azithromycin 2g PO once b) Gentamicin 240mg IM plus azithromycin 2g PO once c) Doxycycline 100mg BID for 7 days d) Metronidazole 500mg BID for 7 days

Answer 36

b) Gentamicin 240mg IM plus azithromycin 2g PO once (or cefixime 800 mg PO x 1)

Question 37

What is the first-line treatment for primary, secondary, or early latent syphilis? a) Penicillin G benzathine 2.4 million units IM once b) Doxycycline 100mg BID for 7 days c) Ceftriaxone 500mg IM once d) Azithromycin 1g PO once

Answer 37

a) Penicillin G benzathine 2.4 million units IM once

Question 38

What is the recommended treatment for late latent syphilis? a) Penicillin G benzathine 2.4 million units IM weekly for 3 weeks b) Doxycycline 100mg BID for 14 days c) Ceftriaxone 1g IV Q24H d) Metronidazole 500mg BID for 7 days

Answer 38

a) Penicillin G benzathine 2.4 million units IM weekly for 3 weeks

Question 39

What is the recommended treatment for neurosyphilis? a) Aqueous crystalline penicillin G 18–24 million units/day IV for 10–14 days b) Penicillin G benzathine 2.4 million units IM once c) Ceftriaxone 1g IV Q24H for 10 days d) Metronidazole 500mg BID for 7 days

Answer 39

a) Aqueous crystalline penicillin G 18–24 million units/day IV for 10–14 days

Question 40

What is the first-line treatment for chlamydia? a) Azithromycin 1g PO once b) Ceftriaxone 500mg IM once c) Metronidazole 2g PO once d) Doxycycline 100mg BID for 7 days

Answer 40

d) Doxycycline 100mg BID for 7 days

Question 41

What is the alternative treatment for chlamydia if doxycycline cannot be used? a) Azithromycin 1g PO once b) Ceftriaxone 500mg IM once c) Metronidazole 500mg BID for 7 days d) Acyclovir 400mg TID for 7 days

Answer 41

a) Azithromycin 1g PO once

Question 42

Which antibiotic should be avoided for chlamydia treatment in pregnancy? a) Doxycycline b) Azithromycin c) Amoxicillin

Answer 42

a) Doxycycline

Question 43

In cases of gonorrhea with chlamydia coinfection, which additional medication should be added to ceftriaxone? A) Doxycycline 100mg PO BID for 7 days B) Azithromycin 2g PO once C) Metronidazole 500mg PO BID for 7 days D) Valacyclovir 1g PO once

Answer 43

A) Doxycycline 100mg PO BID for 7 days

Question 44

What is the recommended dose of ceftriaxone for treating gonorrhea in patients weighing ≥150kg? A) 500mg IM once B) 1g IM once C) 250mg IM once D) 2g IV daily for 7 days

Answer 44

B) 1g IM once

Question 45

What is the alternative treatment for syphilis in patients allergic to penicillin? A) Doxycycline 100mg PO BID for 14 days B) Benzathine penicillin G 2.4 million units IM once C) Azithromycin 1g PO once D) Moxifloxacin 400mg PO daily for 7 days

Answer 45

A) Doxycycline 100mg PO BID for 14 days

Question 46

What is the recommended treatment for late latent syphilis or tertiary syphilis (without neurosyphilis)? A) Metronidazole 500mg PO BID for 7 days B) Benzathine penicillin G 2.4 million units IM weekly for 3 weeks C) Cefixime 800mg PO once D) Valacyclovir 1g PO daily for 7 days

Answer 46

B) Benzathine penicillin G 2.4 million units IM weekly for 3 weeks

Question 47

What is the preferred first-line treatment for uncomplicated chlamydia? A) Doxycycline 100mg PO BID for 7 days B) Azithromycin 1g PO once C) Ceftriaxone 500mg IM once D) Valacyclovir 1g PO daily for 7 days

Answer 47

A) Doxycycline 100mg PO BID for 7 days

Question 48

What is an alternative treatment for chlamydia in patients who cannot take doxycycline? A) Fluconazole 150mg PO once B) Azithromycin 1g PO once C) Metronidazole 2g PO once D) Penicillin G 2.4 million units IM once

Answer 48

B) Azithromycin 1g PO once

Question 49

What is the preferred first-line treatment for macrolide-resistant Mycoplasma genitalium infection? A) Doxycycline 100mg PO BID for 7 days, then moxifloxacin 400mg PO daily for 7 days B) Ceftriaxone 500mg IM once C) Penicillin G 2.4 million units IM once D) Valacyclovir 1g PO daily for 7 days

Answer 49

A) Doxycycline 100mg PO BID for 7 days, then moxifloxacin 400mg PO daily for 7 days

Question 50

Which of the following is NOT used in the treatment of Mycoplasma genitalium infections? A) Moxifloxacin B) Azithromycin C) Doxycycline D) Ceftriaxone

Answer 50

D) Ceftriaxone

Question 51

What is the first-line treatment for a primary outbreak of genital herpes? A) Valacyclovir 1g PO BID for 7-10 days B) Penicillin G 2.4 million units IM once C) Azithromycin 1g PO once D) Ceftriaxone 500mg IM once

Answer 51

A) Valacyclovir 1g PO BID for 7-10 days

Question 52

What is the typical duration of antiviral therapy for a primary outbreak of genital herpes? A) 3 days B) 7-10 days C) 14 days D) Single dose

Answer 52

B) 7-10 days

Question 53

Which of the following is NOT an antiviral used for genital herpes? A) Valacyclovir B) Acyclovir C) Moxifloxacin D) Famciclovir

Answer 53

C) Moxifloxacin

Question 54

What is the first-line treatment for Trichomoniasis in women? A) Azithromycin 1g PO once B) Valacyclovir 1g PO daily for 7 days C) Ceftriaxone 500mg IM once D) Metronidazole 500mg PO BID for 7 days

Answer 54

D) Metronidazole 500mg PO BID for 7 days

Question 55

What is the recommended treatment for Trichomoniasis in men? A) Metronidazole 2g PO once B) Doxycycline 100mg PO BID for 7 days C) Metronidazole 500mg BID x 7 days D) Benzathine penicillin G 2.4 million units IM once

Answer 55

A) Metronidazole 2g PO once

Question 56

Which medication is an alternative treatment for Trichomoniasis? A) Tinidazole 2g PO once B) Valacyclovir 1g PO BID for 10 days C) Acyclovir 400mg PO TID for 7-10 days D) Cefixime 800mg PO once

Answer 56

A) Tinidazole 2g PO once daily

Question 57

Which of the following medications is NOT part of a standard pelvic inflammatory disease regimen? A) Ceftriaxone B) Doxycycline C) Valacyclovir D) Metronidazole

Answer 57

C) Valacyclovir