STDs Flashcards
What is + whiff amine test?
For BV, presence of a fishy odor when 10 percent potassium hydroxide (KOH) is added to a sample of vaginal discharge.
What physical exam findings suggest PID?
Cervical motion, uterine, or adnexal tenderness, Abnormal cervical or vaginal mucopurulent discharge
Lady is diagnosed with gonorrhea by NAAT urine screen. How should she be treated?
Treat for both gonorrhea and chlamydia, as infection is commonly concomitant. 250 mg Ceftriaxone IM + 1g Azithromycin PO x 1
When diagnosed with chlamydia, gonorrhea or trichomoniasia, should the sexual partner be treated in addition to patient?
YES
Treatment of uncomplicated chlamydia?
1 g azithromycin single dose OR 100 mg doxycycline bid for 7 days
Is doxycycline safe in pregnant women?
NO
A pregnant women is diagnosed with uncomplicated chlamydia at point of antenatal screening. How should you treat?
Single dose azithromycin 1 g. Doxycycline is not an option during pregnancy.
What is recommended screening for gonorrhea and chlamydia?
annual screening when < 24 and in high risk older adults
A man presents with a painless ulcer. What test do you send?
RPR or VDRL as this is likely syphillis. If +, confirm with FTA-ABS.
Does treatment of syphillis vary with stage?
NO. All treated with IV Penicillin G.
Women comes in for abdominal pain. On physical exam she has mucopurulent drainage from cervical os and cervical motion tenderness. How should she be treated?
Presumptive treatment for PID, likely secondary to ascending gonorrhea and/or chlamydia infection. Tx is ceftriaxone 250 mg IM + doxycycline 100 mg PO bid for 14 days
Strawberry cervix and frothy discharge are buzz words for which STI?
Trichomoniasis
Treatment for trichomoniasis?
2g dose oral metronidazole
Before microscopy, what quick test can help determine cause of vaginitis?
pH strip, if > 4.5 likely BV
A patient has yellow-green discharge in vaginal vault. What diagnostic tests can you run?
1) wet mount to visualize trichomonid flagellates and many WBCs
2) pH should be < 4.5
3) Culture of swab
Why use KOH prep of wet mount?
KOH kills cellular debris making it easier to visualize yeast buds and hyphae when suspect vaginal candidiasis
What is the Whiff test?
Production of fishy odor when 10% KOH solution is added to discharge. Consistent with BV.
You suspect BV. What can aid in diagnosis?
1) Wet mount for clue cells.
2) KOH whiff test
3) pH > 4.5
4) Thin white/grayish d/c on side of vaginal vault walls
Patient presents for white d/c and itchiness. Vaginal area is erythematous with excoriations and d/c is curd like. Wet mount microscopy shows hyphae with KOH prep. How should you treat.
Classic picture for vaginal candidiasis. Treat with vaginal suppository or single oral dose of fluconazole 150 mg
Patient has cervicitis with mucopurulent drainage from endocervical os but no tenderness on bimanual exam. Test comes back + for chlamydia. How to treat?
1g azithromycin PO single dose + 250mg Ceftriaxone IM
Lady has abdominal pain and cervical motion tenderness. How to treat?
250 mg Ceftriaxone IM + 100 mg doxycycline bid for 14 days
If you have gonorrhea infection, treat for chlamydia as well?
YES
If chlamydia infection, treat for gonorrhea infection as well?
NO
Are treatments for trichomoniasis, chlamydia and candida vaginitis all available in single dose preparations?
YES
