Flashcards in STIs Deck (58):
What are some of the symptoms during seroconversion of HIV
What is the time frame of seroconversion for HIV
process from being negative to positive takes about 3 weeks to 6 months
What does AIDS=
What is the initial screening test for HIV?
ELISA (>99.9% sensitivity)
What is the confirmatory test for HIV?
western blot test for confirmatory
What is the normal CD4 count
What are the 2 most important indicators of HIV
Absolute CD4 count and the viral load
What is the viral load testing?
PCR: quantatative copies of HIV-branched DNA or RNA
results correlate closely with profession to HIV
should ideally be zero or undetectable
What do you give to HIV patients in prevention of pneomocystis jiorvecci ?
How do you prevent drug resistance to AART therapy?
take at the SAME TIME every day
What is chancroid
Hemophilud ducreyi, a gram negative bacillus
What should you test for in a patient with chancroid
syphilis and HSV
s/sx of chancroid
Women- usually asymptomatic
Men- Single or multiple superficial PAINFUL ulcer surrounded by an erythematous hall
Ulcers may be necrotic or severely erosive
How do you diagnose chancroid?
If not T.Pallidum or HSV (by inspection or culture) and coexisting tender inguinal lymphadenopathy, is suggestive of chancroid. Definitive is by morphology
How do you treat chancroid
Azithromycin (zithromax) 1 gram by mouth x1 dose OR
Ceftriaxone (rocephin) 250mg IMx1 dose OR
Ciprofloxacin (cipro) 500mg by mouth twice daily for 3 days
What is sensitivity
The degree to which those who have a disease screen/test positive
What is specificity?
The degree to which those who do not have the disease with screen/ test negative
What are the 3 causes of dysuria
What are the causes of dysparunia
What is the lab for chlamydia
Culture is the most definitive (takes 3-9days)
Enzyme immunoassay (EIA) methods are preferred (low cost, fast results )
What is the treatment for chlamydia?
Azithromycin (zithromax) 1 gram by mouth x1 dose OR
Doxy 100mg PO BID x7days
Alternatives include erythromycin, ofloxacin, levofloxacin
What are the reportable STIs
Gon, chlamydia, syphillis
What is the other name for genital warts?
What virus causes genital warts?
What are the symptoms of genital warts?
single or multiple soft, fleshy, papillary or sessile PAINLESS keritinized growths around the anus, vaginal penile urethra or perineum
How do you diagnose genital warts?
ASCUS or SIL on PAP smear
colposcopy if flat lesions
biopsy of at risk for cervical intraepithelial neoplasia (CIN)
tx for condyloma acuminata
keratolytic agents: podophyllin (pododerm), trichloroacetic acid (TCA) or bichloracetic acid (BCA)
Referral for cryo, laser….
What does Gardasil prevent and age range
types 6, 11, 16, 18
females and males aged 9-26
What is the most common symptom of Gonorrhea
80% of females are asymptomatic
how will the discharge for gonorrhea be different from chlamydia
will be mucopurulent and green
Diagnostics for gonorrhoeae
Gram stain of discharge smear shows gram - diplococci and WBC
Cervical culture for N gonorrhoeae using modified thayer-martin media
Treatment of gonorrh
ceftriaxone (rocephin) 250mg IM x1 dose to treat gone
PLUS azithromycin (zithromax) 1 gram orally x1 dose to over chlamydia
Report to health department
When are the Hep B vaccinations administered?
0,1, and 6 months
What do yo give in a Hep B exposure
HBIG 0.06 ml/kg in a single dose within 14 days of exposure
What kind of immunity is HBIG
What kind of immunity are toxoids
What are some symptoms of gonorrhea in males?
white/ yellow penile discharge
What are the s/sx of herpes
initial: Fever, dysuria, PAINLESS/puritic ulcers for usually 12 days
recurrent: less painful/ puristic ulcers for usually 5 days
What is the management of herpes
symptomatic treatment with drying and antipyretic agents
Acyclovir for topical , oral, Iv
Valacyclovir: especially useful for asymptomatic viral shedding of HSV2
What are the s/sx of lymphgranuloma Venereum
2-3mm PAINLESS vesicle, BUBO, or non-indurated ulcer
REGIONAL ADENOPATHY follows in approx 1 month and is the most common finding
stiffness and aching in groin followed by unilateral swelling of the inguinal region
Diagnosis of lymphogranuloma venereum
definitive diagnosis requires isolating C. Trachomatis from a specimen
treatment of lymphogranuloma venereum
doxy 100mg BID x21 days
aspirate bubos to prevent ulcerations
What does molluscum contagioum look like?
Lesions are 1-5mm, smooth, firm, shiny flesh colored to pearly white papules
What is the offender in syphilis?
What does the primary stage of syphilis look like?
Chancre is PAINLESS
located at the site of exposure
What does the secondary stage of syphilis look like?
Highly variable rash on palmar and plantar surfaces: mucous patches
What does the latent stage of syphilis look like?
symptomatic but seropositive
What does the tertiary stage of syphilis look like?
What is the initial serological test for syphilis?
What are good confirmatory tests for syphilis?
Fluorescent treponemal antibody absorption (FTA-ABS)
Microhemagglutination assay for antibody T pallidum
Treatment for primary, secondary, or early syphilis less than 1 year
PCN G 2.4million units IM
Treatment for late, latent, indeterminate length, and tertiary stage
PCAN G IM weekly x 3 weeks
tx for syphilils if PCN allergic
doxy 100mg PO BID or erythromycin 500mg PO QID
what are early signs of HIV/ serconversion?
fever, nightsweats, weightloss
what is the preferred method of testing for chlamydia
enzyme immunoassay; its low cost and only takes about 30-120 minutes
what are the diagnostic tests for herpes
papanicolau tzanck testing
what stage of syphilis does lymphadenopathy appear