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STIs Flashcards

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1
Q

Painless genital lesions

A

syphilis, LGV, Granuloma Inguinale

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1
Q

painful genital lesions

A

HSV, Haemophilus Ducreyi

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2
Q

describe appearance of HSV lesions

A

superficial, vesicular, erythematous base

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3
Q

Best diagnosis of HSV lesions

A

PCR

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4
Q

What to test if there is concern for HSV resistance

A

culture to get sensitivities

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5
Q

describe syphilis lesions

A

single, well circumscribed with heaped up borders and clean base

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6
Q

describe chancroid lesions

A

indurated, tender, suppurative inguinal LAD with kissing lesions n thigh

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7
Q

describe LGV lesions

A

ulcer, painful LAD, groove sign

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8
Q

proctitis can be seen with

A

LGV, HSV, MPOX

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9
Q

describe granuloma inguinale lesions

A

progressive serpiginous without LAD, beefy red lesions that bleed when biopsied

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10
Q

what is the drug of choice to treat syphilis in pregnancy

A

penicillin, no alternatives

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11
Q

features of primary syphilis

A

chancre, LAD

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12
Q

features of secondary syphilis

A

systemic symptoms, fever, malaise, sore throat, rash, LAD

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13
Q

features of syphilis hepatitis on labs

A

alk phos is very high compared to AST and ALT

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14
Q

what test to do if a patient is diagnosed with cardiovascular syphilis

A

need LP- they will have asymptomatic neurosyphilis

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15
Q

alternative therapy of early syphilis

A

doxycycline x 14 d

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16
Q

alternative therapy of late latent syphilis

A

doxycycline x 4 weeks

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17
Q

complication of J-H reaction in pregnancy

A

can induce early labor

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18
Q

alternative treatments for neurosyphilis

A

procaine penicillin IM plus probenecid for 10-14 d
Ceftriaxone IV or IM x 10-14 d

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19
Q

syphilis screening in pregnancy

A

during 1st trimester
screen high risk in 28 w and at the time of delivery

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20
Q

special circumstance for syphilis screening in pregnancy

A

if they have stillbirth after 20 weeks

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21
Q

indications for c/section with HSV

A

active lesions or prodromal symptoms

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22
Q

HSV suppressive therapy indicated in HIV

A

with CD4 < 200 if they have history of HSV and they are going to start ART- x 6 months

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23
Q

how to diagnose HSV in asymptomatic patients

A

Glycoprotein G EIA assays

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24
Gg2 +
genital herpes
25
Gg1+
either oral or genital- can't tell difference
26
when to use HSV IgM
never
27
how to diagnose chancroid
culture
28
treatment of chancroid
azithromycin 1g PO x 1 dose or CTX 250 mg IM x 1 dose
29
how to diagnose GI
biopsy
30
what stain to use for GI diagnosis
wright giemsa stain
31
feature of GI pathology
Donovan bodies within macrophages
32
treatment of GI
Doxycycline x 3 weeks or resolution of lesion Azithromycin x 3 weeks TMP-SMXw
33
who should be tested for m. genitalium
men with persistent urethritis or epididymitis women with persistent cervicitis or PID men or women with persistent proctitis symptoms *anyone who doesn't respond to initial therapy
34
treatment of choice for m. genitalium
moxifloxacin 400 mg qd 7-14 days
35
treatment of trich in women
metronidazole x 1 week or tinidazole 2g PO x 1
36
treatment of trich in men
metronidazole 2g x 1 dose or tinidazole 2g x 1
37
screening of trich in HIV women
annually
38
prefer treatment of trich in women
1 week of metronidazole
39
options for treatment failure trich with metronidazole
tinidazole 2g po x 1 metronidazole 2g PO x 5d tinidazole 2g po qd x 5d
40
do partners of BV infection need to be treated?
no
41
pH in BV
> 4.5
42
positive whiff test in BV
amine odor with KOH
43
treatment of BV
metronidazole 500 mg BID x 7d Clindamycin 300 mg PO TID x 7d or topical metronidazole or clindamycin
44
screening of BV during pregnancy
only screen symptomatic patients
45
criteria for hospitalization in PID
pregnant TOA can't rule out appendicitis didn't respond to PO therapy N/V, fever/systemically ill no reliable outpatient therapy
46
treatment of outpatient PID
CTX 500 mg x 1 IM Doxy 100 mg BID.x 14d Metronidazole 500 mg BID x 14d
47
Inpatient therapy of PID
Cefotetan 2g BID or Cefoxitin 2g q6h plus Doxycycline 100 mg BID
48
treatment of epididymitis in young people
CTX 500 mg x 1 and Doxy 100 mg BID x 10 d
49
who should be screened for chlamydia
sexually active women 25 years or younger and older women with risk factors (multiple sex partners)
50
post infectious complication of chlamydia
reactive/reiter's arthritis
51
preferred test for chlamydia dx in women
vaginal swab NAAT
52
preferred test for chlamydia test in men
first catch urine NAAT
53
treatment of chlamydia in pregnancy
azithromycin
54
when to screen treated persons for chlamydia
3 months after treatment, rates of reinfection are high
55
treatment of choice in gonorrhea
ceftriaxone 500 mg IM x 1
56
treatment of pharyngeal GC
only CTX
57
follow up test for pharyngeal GC
need test of cure 7-14 d after therapy
58
treatment of GC conjunctivitis
1g CTX
59
complications of DGI
hepatitis endocarditis meningitis
60
risk factor for DGI
terminal complement deficiency
61
second line treatment for urogenital or rectal GC
cefixime 800 mg x 1 gentamicin 5 mg/kg x 1 IM + 2g azithromycin
62
Differential if person fails doxycycline for treatment of NGU
reinfection mycoplasma genitalium trichomonad vaginalis HSV
63
trichomonas can be seen in what population? less common in what population
MSW MSM
64
HPV vaccines during pregnancy?
don't give, can just pick up where you left off after they deliver
65
molluscum treatment
curettage, cryotherapy, topical cidofovir
66
pediculosis pubis, if nits are on the upper shaft, treatment?
no, old infection, no need for pretreatment
67
treatment of pediculosis pubis if treatment failure
permethrin cream or pyrethrins topical malathion lotion or ivermectin if treatment failure
68
lindane in crabs?
don't use associated with seizures and aplastic anemia
69
treatment of scabies
permethrin cream ivermectin and day 1 and 14
70
crusted scabies or Norwegian scabies seen in what population
HIV, immunocompromised
71
treatment of crusted/norwegian scabies
ivermectin on days 1 ,15, 19
72

IDBR (23 decks)

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