Sexually Transmitted Diseases

Question 1

What is Urethritis?

Answer 1

Inflammation of the Urethra

Question 2

What pathogens are most commonly associated with Urethritis?

Answer 2

N. Gonorrhoeae

Chlamydia

Question 3

What do both Urethritis and Cystitis cause?

Answer 3

Dysuria

Urinary Frequency and burning

Question 4

What separates Urethritis and Cystitis?

Answer 4

there is no urethral discharge with Cystitis

Question 5

How to test for Urethritis?

Answer 5

Urine NAAT for Gonorrhea and Chlamydia

WBC

Gram (-) diplococci (N. Gonorrhea)

Question 6

How is Urethritis Treated?

Answer 6

One drug for Gonorrhea + One drug for Chlamydia

Question 7

What drug is used to treat Gonorrhea?

Answer 7

IM Ceftriaxone

Question 8

What drug is used to treat Chamydia?

Answer 8

PO Doxycycline or Azithromycin

Question 9

How does Cervicitis present?

Answer 9

Cervical discharge and inflamed “Strawberry” cervix

Question 10

How is Cervicitis diagnosed?

Answer 10

Self-administered swab for NAAT

Question 11

What is the most accurate test for Trichomonas?

Answer 11

NAAT

Question 12

What is the treatment for Cervicitis?

Answer 12

Ceftriaxone and Azithromycin as a single dose

Question 13

How does Epididymitis present?

Answer 13

Scrotal pain superior and lateral to the testicle developing over a few days to a very severe point tenderness

Question 14

What relieves the pain in Epididymitis?

Answer 14

Scrotal Elevation

Question 15

How do you treat younger men with suspected Epididymitis?

Answer 15

Treat for Gonorrhea and Chlamydia with Ceftriaxone and Doxycycline

Question 16

How do you treat elderly men for suspected Epididymitis?

Answer 16

Treat for Gram (-) rods that would cause a UTI with TMP-SMX or a quinolone

Question 17

How does a testicular torsion present?

Answer 17

Elevated testicle in transverse (Horizontal) Position

Question 18

How do you diagnose a testicular torsion?

Answer 18

Doppler U/S

Question 19

How do you treat a testicular torsion?

Answer 19

Emergency surgery

Question 20

How does Varicocele present?

Answer 20

Bag of worms feeling on palpation

worse on standing

Question 21

How do you diagnose Varicocele?

Answer 21

Abdominal CT

Question 22

How do you treat Varicocele?

Answer 22

none if asymptomatic

Surgical ligation if bothersome of infertility develops

Question 23

How does Pelvic Inflammatory Disease (PID) Present?

Answer 23

Lower abdominal pain and tenderness

Fever

Cervical motion tenderness

Leukocytosis

Question 24

What is the most appropriate first step in suspected PID?

Answer 24

Pregnancy test to r/o pregnancy

Question 25

What is the most accurate test for PID?

Answer 25

Laparoscopy if the diagnosis is unclear, symptoms persist or there is a recurrence for unclear reasons

Question 26

What test is used to confirm the etiology in suspected PID?

Answer 26

Cervical Swab for Cx, DNA probe or NAAT

Question 27

What pathogens is PID treatment aimed to cover?

Answer 27

Gonorrhea and Chlamydia

Question 28

What is the inpatient treatment regimen for PID?

Answer 28

Cefoxitin or Cefotetan + Doxycycline -if allergic to penicllin use Clindamycin, gentamycin or doxycycline

Question 29

What is the outpatient treatment regimen for PID?

Answer 29

Ceftriaxone + Doxycydline +/- Metronidazole -if allergic to penicillin use Levofloxaxin or Metronidazole

Question 30

What Ulcerative disease is associated with Painless ulcer and painless nodes?

Answer 30

Syphillis

Question 31

What ulcerative disease is associated with a Painful ulcer?

Answer 31

Chancroid (Haemophilius Ducreyi)

Question 32

What ulcerative disease is associated with Tender and Suppurating lymph nodes?

Answer 32

Lymphogranuloma Venereum

Question 33

What ulcerative disease is associated with Vesicles prior to ulcer and painfullness?

Answer 33

Herpes Simplex

Question 34

What are the diagnostic options for Syphilis?

Answer 34

Dark-field microscopy VDRL or RPR test FTA or MHA-TP (confirmatory tests)

Question 35

What is the treatment for Syphillis?

Answer 35

1x dose of IM Benzathine Penicillin If allergic to penicillin Doxycycline is used

Question 36

What is the diagnostic choice for chancroid?

Answer 36

Stain and Cx on special media

Question 37

How is Chancroid treated?

Answer 37

1x dose of Azithromycin

Question 38

How is Lymphogranuloma Venereum diagnosed?

Answer 38

C' fixation titers in blood NAAT on swab

Question 39

How is Lympohgranuloma Venereum treated?

Answer 39

Doxycycline

Question 40

How is Herpes Simplex Virus Diagnosed?

Answer 40

PCR is the most accurate test -if not available then Viral Cx

Question 41

How is Herpes Simplex Virus treated?

Answer 41

Acyclovir, Valacyclovir or Famciclovir -if resistant to acyclovir use Foscarnet