STD cases Flashcards
32yo Man presents with purulent urethral discharge. He claims that his condom broke
Dx: Gonorrhea
Allergies: NIL
Suggest treatment and duration.
First line Treatment: Single dose of
- Ceftriaxone IM 250mg
- Azithromycin PO 1g
27yo F presents with purulent urethral discharge. She claims that her husband used a condom but it broke
Dx: Gonorrhea
Allergies: Macrolides (Anaphylaxis)
Suggest treatment and duration
- Ceftriaxone IM 250mg one dose
- Doxycycline 100mg BD for 7d
27yo Man presents with purulent urethral discharge. He claims that his husband used a condom but it broke
Dx: Gonorrhea
Allergies: Penicillins (Anaphylaxis)
Suggest treatment and duration
Two options for penicillin allergy
1) Spectinomycin IM 2g + Azithromycin PO 2g, single doses
2) Gentamicin IM 240mg + Azithromycin PO 2g, single doses
32yo Man presents with purulent urethral discharge
Dx: Chlamydia
Allergies: NIL
Suggest treatment and duration
Either:
- Azithromycin PO 1g single dose (preferred)
OR
- Doxycycline PO 100mg BD 7d (less preferred due to potential compliance issue + more resistance)
29yo F presents with purulent urethral discharge and dysuria
Dx: Chlamydia
Allergies: Macrolides (Anaphylaxis)
Suggest treatment and duration
- Doxycycline PO 100mg BD 7d
OR one of the following:
- Levofloxacin 500mg OD 7d
- Ofloxacin 300mg BD 7d
30yo M diagnosed with latent Syphilis. It is unknown how long it has been latent for
Allergies: NIL
Suggest treatment and duration
IM Benzathine Pen G 2.4Mu once a week, three doses
26yo F diagnosed with primary syphilis. She has severe allergy to penicillins. Suggest treatment and duration
Doxycycline PO 100mg BD 14d
49yo M diagnosed with syphilis. He has lesions, imparied movement and some decrease in cardiac output. He has severe allergy to penicillin
Suggest treatment and duration
Doxycycline PO 100mg BD 28d
case is tertiary syphilis
51yo F is diagnosed with syphilis. She is very confused and has difficulty walking. She is minimally responsive to visual cues.
Suggest treatment and duration
Case: Neurosyphilis Either: - IV Crystalline PenG 3-4Mu q4h OR - IM Procaine PenG 2.4Mu OD PLUS probenacid 500mg QDS
Duration: 10-14d
42yo M is diagnosed with syphilis. He has blurred vision and has hearing loss. He is unable to walk straight. He is allergic to penicillin
Suggest treatment and duration
Case: Neurosyphilis
- Ceftriaxone IV 2g q24h 10-14d, desensitise if cross-allergy is confirmed
29yo M is diagnosed with syphilis. He says he has localised lesions at the shaft of his penis. He has NKDA
Suggest treatment and duration
Case: Primary Syphilis
- IM Benzathine Pen G 2.4Mu, single dose
30yo F presents with spots all over his skin which started 1 day ago. He has NKDA
Diagnosis: Chicken Pox
Suggest treatment and duration
- Acyclovir PO 800mg five times a day
OR - Valcyclovir PO 1g TDS
Duration: 7d
28yo M presents with HSV-2 infection. He has no hx of herpes infection before. NKDA. He is generally well
Suggest treatment and duration
Either:
- Acyclovir PO 400mg TDS 7-10d OR
- Acyclovir PO 200mg five times a day 7-10d
(Acyclovir IV 5-10mg/kg q8h 2-7d + PO acyclovir for total of 10d for severe cases only, hence not for this)
OR
- Valacyclovir PO 1g BD 7-10d
27yo F presents was treated for genital herpes. After counselling, she mentioned that she wants to receive chronic suppressive therapy to reduce risk of transmission and also decrease the frequency of recurrence of herpes.
Suggest a therapy and treatment duration
- Acyclovir PO 400mg BD
OR - Valacyclovir 500mg/1g OD
Duration: up to patient
27yo F presents with genital herpes and her sx manifested just this morning around 12h ago. It is her first recurrence of sx. She has NKDA, and does not want chronic suppressive therapy as she is afraid that she will “occasionally miss a pill or two “
Suggest a therapy and treatment duration
Case: Recurrent/episodic herpes
1) 5-day regimens
- Acyclovir PO 400mg TDS
- Acyclovir PO 800mg BD
- Valacyclovir PO 1g OD
2) Other days regimen
- Acyclovir PO 800mg TDS 2d
- Valacyclovir PO 500mg BD 3d
