STD's

Question 1

Gonorrhea is caused by what organism?

Answer 1

neisseria gonorrhoeae

Question 2

If a gram stain shows gram negative diplococci, the most likely STD is?

Answer 2

gonorrhea

Question 3

A female presenting with mucopurulent vaginal discharge is concerning for which STD?

Answer 3

=green discharge–> gonorrhea

Question 4

A male presenting with white/yellow/green penile discharge is concerning for which STD?

Answer 4

gonorrhea

Question 5

Diagnosis of gonorrhea

Answer 5

gram stain=GN diplococci cervical cx + N. gonorrhoeae using Thayer-Martin media

Question 6

Treatment for gonorrhea

Answer 6

Ceftriaxone 250mg IM + Azithromycin 1gm PO x 1 report to health department

Question 7

Which STD is most likely to involve multiple organ systems?

Answer 7

syphilis

Question 8

What organism causes syphilis?

Answer 8

treponema pallidum

Question 9

3rd most commonly reported infectious disease in US?

Answer 9

syphilis

Question 10

Clinical manifestations of primary syphilis

Answer 10

PAINLESS chancre indurated ulcer erythema at site

Question 11

Clinical manifestations of secondary syphilis

Answer 11

*flu-like sxs

*lymphadenopathy

*generalized macro-papular rash

-malaise -anorexia -alopecia -arthralgias

Question 12

Which stage of syphilis is seropositive but asymptomatic?

Answer 12

latent syphilis

Question 13

Serologic Tests for Syphilis

Answer 13

initial test: VDRL/RPR

confirmatory test: flourescent treponemal antibody absorption

Nontreponemal: VDRL/RPR Treponemal: FTA-ABS (flourescent treponemal antibody absorption); MHA-TP (microhemagglutination assay for antibody to T.pallidum)

Question 14

Which serologic tests are used to confirm syphilis?

Answer 14

treponemal: flourescent treponemal antibody absorption

FTA-ABS , MHA-TP

Question 15

Which serologic test confirms 100% of secondary syphilis cases?

Answer 15

FTA-ABS

Question 16

What is the antibiotic of choice for syphilis?

Answer 16

PCN G

Question 17

What is the treatment for primary, secondary or early syphilis (<1yr) syphilis?

Answer 17

PCN G 2.4 million unit IM

Question 18

What is the treatment for late, latent/indeterminate stage & tertiary syphilis?

Answer 18

PCN G 2.4 million units IM weekly x 3 wks

Question 19

If patient has PCN allergy, what is the treatment for syphilis?

Answer 19

Doxycycline 100mg BID or Erythromycin 500mg PO QID

Question 20

Which is the most common STD in the US?

Answer 20

chlamydia (C in common= C in chlamydia)

Question 21

Chlamydia is caused by what organism?

Answer 21

chlamydia trachomatis

Question 22

Which STDs causes dyspareunia?

Answer 22

chlamydia & trichomonas

Question 23

What are the 4 most common causes of dyspareunia?

Answer 23

-chlamydia -PID: trichomonas -menopause

Question 24

If a male presents with thicky, cloudy penile discharge, which STD is of concern?

Answer 24

chlamydia

Question 25

What is the most definitive test to confirm chlamydia?

Answer 25

culture (\*but takes 3-9d for results)

Question 26

What is the preferred method to test for chlamydia?

Answer 26

EIA (enzyme immunoassay) - 30-120min for result

Question 27

Treatment for chlamydia

Answer 27

Azithromycin 1gm PO x 1` OR Doxycycline 100mg BID x 7 d

Question 28

What are the most common causes of vulvovaginitis?

Answer 28

1. trichomoniasis 2. bacterial vaginosis 3. candidiasis

Question 29

Clinical presentation of trichomonas

Answer 29

-malodorous, frothy yellow-greenish discharge -pruritus -vaginal erythema -"strawberry patches" on cervix & vagina -dyspareunia -dysuria

Question 30

"Strawberry patches" on the cervix are noted on pelvic exam. The most likely diagnosis is?

Answer 30

trichomonas

Question 31

Malodorous, frothy, yellowish-green discharge is concerning for which STD?

Answer 31

trichomonas

Question 32

Clinical presentation of bacterial vaginitis?

Answer 32

\*"fishy" smelling discharge which is watery & gray -vaginal spotting

Question 33

"Fishy" smelling discharge is concerning for which STD?

Answer 33

bacterial vaginosis

Question 34

Diagnostic test for trichomonas?

Answer 34

microscopic wet prep: NS mixture shows motile trichomonads

Question 35

Diagnostic test for bacterial vaginosis?

Answer 35

microscopic wet prep: NS mixture shows clue cells

Question 36

Diagnostic test for candidiasis?

Answer 36

microscopic wet prep: KOH mixture shows pseudo hyphae

Question 37

Treatment for trichomonas?

Answer 37

Flagyl 2g PO x 1

Question 38

Treatment for bacterial vaginosis?

Answer 38

Flagyl 2g PO x 1 -Clindamycin vaginal cream 2% (5g) vag qHS x 7d or 300mg PO BID x 7d

Question 39

Treatment for Candidiasis?

Answer 39

Miconazole (mono-stat) Clotrimazole Terconazole Butaconazole

Question 40

Cause of chancroid?

Answer 40

hemophilis ducreyi

Question 41

If gram stain shows GN bacillus, what is the most likely STD?

Answer 41

chancroid

Question 42

Which STD(s) cause painful ulcers?

Answer 42

chancroid herpes

Question 43

Treatment for chancroid

Answer 43

Azithro 1gm PO x 1 OR Ceftriaxone 250mg IM x 1

Question 44

Which STD has no cure?

Answer 44

herpes

Question 45

Which STD is associated with painful genital lesions?

Answer 45

herpes \*lesions that Hurt= Herpes

Question 46

Initial clinical presentation of herpes?

Answer 46

fever malaise dysuria \*\*painful/pruritic ulcers usu x 12d

Question 47

Clinical presentation of recurrent herpes

Answer 47

less painful/pruritic ulcers, usu x 5d

Question 48

Most definitive test for herpes?

Answer 48

viral culture

Question 49

Treatment of herpes?

Answer 49

-symptomatic tx w/drying & antipruritic agents -Acyclovir -Famciclovir -Valacyclovir

Question 50

Which drug is especially helpful for asymptomatic viral shedding of HSV2?

Answer 50

Valacyclovir (valtrex) \*10% of ppl shed all the time