Module 2 - STI's

Question 1

Gonorrhea

Answer 1

Symptoms: vaginal discharge, dysuria, pelvic pain
PE:
Diagnostic: Gram Negative Neisseria, NAAT?
Treatment: DUAL
- ceftriaxone IM x 1
- doxycycline x 7 days

Question 2

Chlamydia

Answer 2

Primarily asymptomatic
PE: mucopurulent cervicitis
Treatment: Azithromycin single dose
Diagnostics: NAAT

Complications:
Fitz-Hugh-Curtis: associated with chlamydia/gonorrhea resulting in inflammation of hepatic glisson capsule
- RUQ pain
- Friction rub
- Referred shoulder pain

Question 3

Syphilis

Answer 3

Primary stage: painless lesion first like kanker sore usually resolves on it’s own (genital rash) and inflammed lymph nodes
Secondary stage: flu like symptoms
- rash on hands/palms and soles of feet
- the great imitator
Tertiary: CV and neuro expression

Treatment: Penicillin
PCN ALLERGY?: Doxycycline

Question 4

Candidiasis

Answer 4

C. Albicans
Symptoms: burning, itching irritation
PE: excoriation, thick/white adherent discharge - curd-like, erythema
Diagnostics: budding yeast on microscope
Treatment: Fluconazole (NO ETOH), 2nd metronidazole

Question 5

BV

Answer 5

Not an STI
Gardnerella Vaginalis

Symptoms: malodorous vaginal discharge, dysuria, dysparenuria, pruritis
Risks: douching, multiple partners, cig smoking, recent abx, IUD
Diagnostics: CLUE CELLS
Amsel Criteria 3/4:
- thin, white homogenous vaginal discharge
- clue cells on wet mount
- pH more than 4.5
- fishy odor on adding KOH (Positive WHIFF Test)
Treatment: vaginal Clindamycin or PO metronidazole

Question 6

Trich

Answer 6

Motile Organism (motile protozoa)

Symptoms: burning, foul smelling, postcoital bleeding
PE: frothy, greenish discharge, patchy macular erythema cervix,
Diagnostics: movement
Treatment: metronidazole

Question 7

PID

Answer 7

Symptoms: abdominal pain, vaginal discharge, CMT, FRIABLE CERVIX
Risk Factors: multiple sex, unprotected sex

Question 8

UTI

Answer 8

Most common organisms:
- E Coli and Klebsiella