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Oral board studying Prep book > Sexually transmitted infections > Flashcards

Sexually transmitted infections Flashcards

1
Q

How do you test for gonorrhea infection?

A

Molecular testing with NAAT

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2
Q

When would you do a culture for gonorrhea?

A

TOC in cases of persistent symptoms
+NAAT for TOC should be followed up with culture

Performed 7-14 days after treatment

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3
Q

Is a retesting for presence or absence of gonorrhea infection necessary? if so when?

A

Yes within 3 months

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4
Q

What is the treatment for gonorrhea infection and dose?

A

Ceftriaxone 500mg IM x 1 dose for weight <150kg

Ceftriaxone 1g IM x 1 dose for weight >150kg

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5
Q

What is the alternative treatment for gonorrhea infection?

A

Azithromycin + gentamicin

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6
Q

What is the recommended follow up after treatment for gonorrhea?

A

retest within 3 months

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7
Q

Patient counseling after testing positive for STI?

A
  1. Recommend refraining from intercourse until at least 7 days after treatment. Do no engage in intercourse if partner has not be tested and treated
  2. Recommend testing for other STIs such as chlamydia, Syphillis, HIV
  3. Obtain pregnancy test
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8
Q

What is the expedited partner therapy for gonorrhea?

A

Cefexime 800mg PO

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9
Q

What are risk factors that increase risk of STI?

A
  1. New sexual partner within 60 days
  2. Multiple sexual partners
  3. Partner with multiple sexual partners
  4. Partner recently treated for STI
  5. Trading sex for money or drugs
  6. Having sex with a sex worker
    7.
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10
Q

What are high risk groups for STI?

A
  1. Young age 15-24
  2. incarcerated
  3. Men having sex with men
  4. History of STI
  5. HIV positive
  6. Pregnant
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11
Q

When is the recommended screening for HIV?

A

All adults and adolescents age 13-75 y/o or all individuals seeking screening for STIs

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12
Q

When is the recommended screening for gonorrhea and chlamydia indicated?

A

Annually for women <25y/o

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13
Q

When is the recommended screening for trichomonas?

A

Recommended in high prevalence settings or females at increased risk for STIs

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14
Q

What are the STI screening recommendations for women 25 and older?

A

Only screen for women with high risk behaviors or in high risk settings.

Screen for chlamydia, gonorrhea, trichomonas, syphillis, hepatitis B if not vaccinated

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15
Q

What is the screening recommendation for hepatitis C?

A

Atleast once in lifetime at age 18 or older

Ongoing screening recommended for men having sex with men, HIV, sex partner with hepatitis C, Patient using prep to prevent HIV

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16
Q

If a patient presents requesting STI testing what should you test for?

A

Chlamydia
Gonorrhea
Trichomonas
Syphillis
HIV

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17
Q

What is the recommended test for chlamydia?

A

NAAT vaginal swab

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18
Q

What is the recommended test for gonorrhea?

A

NAAT vaginal swab

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19
Q

What is the recommended test for trichomonas?

A

NAAT vaginal swab

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20
Q

What is the recommended test for HIV?

A

HIV 1/2 antigen antibody immunoassay combination test followed by confirmatory HIV 1/2 antibody differentiation immunoassay

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21
Q

What is the recommended test for syphillis?

A

Nontreponemal test= RPR VDRL

Treponemal test= FTA-Abs

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22
Q

What are signs of PID?

A

Pelvic pain with either CMT, uterine tenderness or adnexal tenderness

23
Q

Which syphilis serologic test typically stays positive for life and which usually returns to negative after treatment?

A

Treponemal test typically stays positive for life

Nontreponemal test typically seroconverts to negative

24
Q

What is the treatment for the different stages of syphilis?

A

Primary, secondary, early latent= PCN G 2.4mu
Late latent, tertiary= PCN G 2.4mu x 3 doses weekly
Neurosyphillis= IV PCN G

25
Q

What is early latent syphillis?

A

Asymptomatic with positive serologic evidence of T. palladium that was acquired in last 12 months

26
Q

What is late latent syphilis?

A

Asymptomatic with positive serologic evidence of T palladium infection without known timeframe of acquisition

27
Q

What is the alternative treatment for syphillis if PCN allergy?

A

doxycycline 100mg BID for 14-28 days

28
Q

What is a treatment for HIV?

A

Dulotegovir + tenoforvir + lamivudine

29
Q

What is PrEP for HIV?

A

Preexposure prophylaxis for patients without HIV taking antiretrovirals as an effective prevention strategy

30
Q

For patients that are adherent to PrEP how much can transmission be reduced with PrEP?

A

99%

31
Q

What patients are eligible for PrEP?

A

All sexually active patients should be informed about PrEP

Next obtain a sex and drug history to determine if the patient is at high risk of acquiring HIV

High risk= injection drug use, Men having sex with men, transgender women have condoles anal sex, heterosexual couple with partner that is at high risk, being diagnosed with gonorrhea or syphillis

32
Q

What should you do before initiating PrEP?

A

Perform STI testing= Chlamydia, gonorrhea, syphillis, HIV, Hep B and Hep C

Pregnancy test

33
Q

What is the regime for PrEP?

A

Oral= Tenofovir + disoproxil+fumarate+emtricitabine

Injection= cabotegravir LA

34
Q

What can BV increase your risk for?

A

STIs
Preterm birth
endometritis
cuff cellulitis

35
Q

How do you diagnose BV?

A

Amsels criteria= 3 criteria met
Homogenoeus thin white discharge
pH >4.5
Clue cells >20%
+KOH test

36
Q

What is the preferred treatment for BV?

A

PO Flagyl 500mg BID for 7 days
Intravaginal metro gel 0.75% 5g applicator for 5 days
Clindamycin cream 2% 5g applicator for 7 days

37
Q

What is the alternative treatment for BV

A

Tinidazole 1g x 5 days
Secondiazole 2g once

38
Q

What is recurrent BV?

A

3 or more documented BV infections in 1 year

39
Q

How do you treat recurrent BV?

A

Treat current infection with flagyl PO or gel then do suppressive treatment with metro gel 2x/wk for 4-6 months

40
Q

What is the gold standard for diagnosing BV Infection?

A

Gram stain

41
Q

What is the preferred management for yeast infection?

A

Oral or topical azole
Flucanazole 150mg PO
Clotrimazole 1% cream for 7 days

42
Q

How do you diagnose recurrent yeast infection?

A

Vaginal culture

43
Q

How do you define recurrent yeast infection?

A

3 or more documented infections in 1 year

44
Q

What is the management for recurrent yeast infection?

A

Fluconazole 150mg a 3 doses followed by maintenance therapy with fluconazole 150mg weekly for 6 months

45
Q

What is the alternative treatment for chlamydia?

A

Azithromycin 1g PO x 1 dose
Levofloxacin 500mg daily for 7 days

46
Q

What is the preferred treatment for nonpregnant females with chlamydia?

A

Doxycycline 100mg BID for 7 days

47
Q

What is the preferred treatment for pregnant women with chlamydia infection?

A

Azithromycin 1g PO x 1 dose

48
Q

What is the preferred treatment for trichomonas infection?

A

Metronidazole 500mg BID for 7 days

49
Q

What is the alternative treatment for trichomonas?

A

Tinidazole 2g PO x 1 dose

50
Q

Recommended inpatient treatment for PID?

A

Ceftiaxone 1g IV q24hrs + doxycycline + flagyl

or

Cefoxitin 2g IV q6hr + doxycycline

51
Q

Recommended alternative parental regime for PID?

A

Gent+ clindamycin

52
Q

Recommended outpatient treatment for PID?

A

Ceftriaxone 500mg + Doxycycline + flagyl for 14 days

53
Q

When is inpatient management recommended for PID?

A

Pregnancy
Failed outpatient management
Systemic illness
Unable to follow outpatient management
TOA
Surgical emergencies can’t be excluded

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