STD's Flashcards
what is the most common bacterial STD
Chlamydia
what is the preferred test for G/C
NAAT ( nucleic acid amplification test)
When should you collect specimens for G/C
Men: first urine of the morning
W: vaginal swab is = to cervical
MSM should get annual pharyneal and rectal using NAAT
Chlamydia screening, symp, complications
screening: sexual active adlescents and women under 26
d/c : scant clear or cloudy white
complications: cervicitis, urethral syndrome, bartholinitis, endometritis, PID, procitis
Chlamydia tx
uncomplicated ( cervicitis, urethitis, tx partner)
- azithryomcine 1 mg single dose or doxy 7 days
Preg:
- azithryomycin
need to do pre testing and post testing ( 3-4 weeks after therapy)
complicated ( PID, prostatis, epdidiymitis)
- doxy DIB x 14 days
Gonorrhea
Purulent green d/c.
Both genders: procitisis, phargynitis
if dessiminated : miratory arthiritis , synovits, rash, fever, chills
Gonorrhea TX
uncomplicated : cervix, urthra, pharynx
- ceftriazone + azithryromcin (1) / doxy x 7 days
if they have gonorrhea must tx for chylamdia
- complicated (PID epididymitis, prostatistis)
- Ceftriazone + doxy 14 days
Proctitis or proctorcolitis screening
annual for MSM hx of unprotected receptive anal intercourse. New sexual partner in the < 60 days.
acute onset of purulent rectal discharge, anorectal pain, and tenesmuc ( frequent urges of passing stool)
swab anus for GC
TX: complicated
- ceftriazone + doxy 14
PID presentaton/labs/tx/partner/complications
sexually active < 24 year old with new onset one sided pelvic pain w/ mucopurulent vaginal discharge. New sexual partner. pelvic pain while walking, pain with intercourse ( dysapreunia), postive cervical motion tenderness w/ or w/o adnexal pain
Labs: r/o preg, HIV, G/C
Male partners: any partner within the last 60 dyas shoudl be tested and tx for g/c
TX: complicated
- ceftriazone + doxy x 14
complications: infertility, ecptopic preg, pelvic abbcess
What is the organism and test for syphilis
treponema pallidum
RPR
VDRL
Primary stage and secondary stage of Syphilis
P: chancre painless, indurated, clean base , can resolve on own in 3-6 weeks
TX: benzathine peniciilin G IN x 1 dose
S: rash on palms and soles, no itch, condylona lata swollen lymph nodes, mucous patches on mouth, throat
Latent stage of spyhilis
usually no symptoms
> 1 year from time of infection
TX: benzathine pencillin IM one dose X 3 weeks
Tertiary spyhilis
soft tiisue tumors, aortic aneurysms
TX: benzathine pencillin IM one dose X 3 weeks
Jarisch-Herxheimer reaction
common immune reaction after starting syphilis tx (myalgias, fever, headache, tachycardia)
Fitz High Curtus Syndrome
complicated case of PID w/ G/c
what are two most common strains of HPV that cause cancer
16 #18
what is the tx for HPV ( pt applied)
Pt applied methods ( cant use if preg) - Imiquimod 3/75 or 5 cream or Podofilox Sinecatchins
what is the tx for HPV ( provider applied)
cryotherapy ( can use w/ preg
tricholeacetic aced or bichloroactici be applied to warts
W/ preg and HIV for HPV
screen pap every 6 months
Gardasil
HPV vaccine at ages 11-12 (can be as early as 9) 6-12 month apart ( if completed by 15th bday only need two doses)
for ages 15-26 needs 3 doses 0, 1-2 y, 6 months
Herpes simplex 1
usually oral infection
Herpes simplex 2
gential infection
erythemetous papules that devlop into smal grouped vesicles, easily ruptured - small shallow ulcers
primary episode more severe adn can last up to 2 weeks
labs: HSV PCR DNA
Herpes simplex 2 tx
first episode: Acyclovir po TID x 7-10dyas or Valtrex TID
episode therapy: duration 5 days
Acyclovir TID or Valtrex BID
Supressive therapy ( every day) Acylcovir BID or Valtrex BID
when is a herpes simplex 2 non infectious
never, even if skin has healed, still have low levels of viral shedding
