STIs

Question 1

What is the main target of gonorrhea in men? What about in women?

Answer 1

Main target for gonorrhea in men is the urethra causing urethritis. Main target for gonorrhea in women is the cervix (unless pre-pubescent), causing cervicitis

Question 2

These two STIs produce penile discharge in men. Which one is painful and which one is not?

Answer 2

Gonorrhea - PAINFUL

Chlamydia - non as painful

Question 3

When do gonorrhea symptoms reveal themselves?

Answer 3

About 1 week after exposure, fairly quickly

Question 4

Gonorrhea and other STIs can affect any mucosal membranes (i.e. oral pharyngitis) (T/F)

Answer 4

True

Question 5

Gonorrhea can be disseminated into the blood, tendons, and joints in some patients and cause swollen (most likely painful) joints (T/F)

Answer 5

True

Question 6

Gonorrhea can cause ___ lesions that start off as a pustule and then becomes hemorrhagic

Answer 6

skin

Question 7

Gonorrhea in women is very painful when in the ____ gland and women will most likely seek medical help right away

Answer 7

Barthalan’s gland

Question 8

All babies are treated with _____ ointment in the eyes to prevent ocular gonorrhea

Answer 8

erythromycin

Question 9

What is the rapid diagnostic test used to test for gonorrhea and chlamydia?

Answer 9

Nucleic acid amplification test (NAAT)

Question 10

If you think a patient has an STI, you have time for susceptibility testing to come back in order to confirm the infection (T/F)

Answer 10

False, you should treat first and ask questions later

Question 11

Treatment of choice for gonorrhea

Answer 11

Ceftriaxone 500 mg IM in a single dose

Question 12

Alternative gonorrhea treatment

Answer 12

Gentamicin 240 mg IM in a single dose + azithromycin 2g PO in a single dose

Question 13

Disseminated gonorrhea treatment requires ceftriaxone ___ g IM or IV every 24 hours for ___ days

Answer 13

ceftriaxone 1 g IM or IV every 24 hours for 5-7 days

Question 14

Chlamydia looks similar to gonorrhea but with more severity, more discharge, and more pain (T/F)

Answer 14

False, chlamydia has less severity, less discharge, and less pain.

Question 15

When chlamydia infects the cervix, it likes to march up the uterus and infect the ____. Asymptomatic chlamydia can cause ____ leading to scarred and obstructed _____

Answer 15

infects the fallopian tubes. Can cause salpingitis leading to scarred and obstructed fallopian tubes

Question 16

Treatment for chlamydia

Answer 16

Doxycycline 100 mg BID for 7 days

Question 17

Pregnancy treatment for chlamydia

Answer 17

azithromycin 1 g PO in a single dose (because doxy and levo are CI)

Question 18

First infection of HSV2 are usually less severe than recurrent infections (T/F)

Answer 18

False, they are more severe and longer in duration

Question 19

HSV2 produces cold-sore like lesions that are painful (T/F)

Answer 19

True

Question 20

Women with HSV2 may show symptoms of meningitis such as a headache (T/F)

Answer 20

True

Question 21

Treatment for HSV2

Answer 21

acyclovir 400 mg PO TID for 7-10 days
famciclovir 250 mg PO TID for 7-10 days
valacyclovir 1 g PO BID for 7-10 days

Question 22

HSV2 infections have stronger antiviral doses for a longer duration (T/F)

Answer 22

True because HSV2 tends to be more resistant than HSV1

Question 23

Episodic HSV2 therapy can lower the severity of infection and shorten duration of treatment if given as soon as patient starts showing symptoms (T/F)

Answer 23

True, some patients should keep medications at home just in case

Question 24

Difference between HSV2 lesions and shanker syphilis lesions

Answer 24

HSV2 penile lesions are painful. Shanker syphilis lesions are completely painless and they always go away

Question 25

The primary stage of syphilis causes shanker lesions (T/F)

Answer 25

True

Question 26

Secondary syphilis occurs a few ___ after primary syphilis

Answer 26

Weeks

Question 27

Secondary syphilis causes a skin ____ that, unlike amoxicillin reactions, involves the ____ of hands and ____ of feet

Answer 27

skin rash that involves the palms of hands and soles of feet

Question 28

Secondary syphilis can also cause alopecia (T/F)

Answer 28

True

Question 29

Difference between condyloma lata (secondary syphilis) and genital warts

Answer 29

condyloma lata lesions are soft, fleshy, and do not hurt vs. genital warts are rough

Question 30

Tertiary syphilis can cause a ruptured _____, peripheral ____, and ________

Answer 30

Ruptured aorta, peripheral neuropathy, and neurosyphilis

Question 31

____ syphilis will cause malformations, cleft palate, teeth abnormalities

Answer 31

Congenital syphilis

Question 32

Syphilis is diagnosed using ____ testing

Answer 32

serologic testing

Question 33

The only disease where the drug of choice is still only penicillin

Answer 33

Syphilis

Question 34

Treatment of syphilis: ______ 2.4 million units IM in a single dose

Answer 34

benzathine penicillin G

Question 35

Benzathine penicillin G is short-acting and usually given in the arm (T/F)

Answer 35

False, it is long-acting and usually given in the butt because of its high dose

Question 36

Neurosyphilis requires a higher dose of treatment (T/F)

Answer 36

True

Question 37

For penicillin allergies, patients with syphilis are not to be given penicillin (T/F)

Answer 37

False, providers need to try and desensitize and try giving penicillin because it is the only drug of choice

Question 38

Recommended treatment for women who have been sexually assaulted

Answer 38

ceftriaxone + doxycycline + metronidazole (similar to trichomonas)

Question 39

Recommended treatment for men who have been sexually assaulted

Answer 39

ceftriaxone + doxycycline

Question 40

Treatment for genital warts include:

Answer 40

Cryotherapy or surgical removal

Question 41

In patients <15 years, they receive a 3 dose series of HPV vaccine (T/F)

Answer 41

False, they receive a 2 dose series whereas in patients >15 up to 26 years receive the 3 dose series