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Ambulatory Care of Women > STIs > Flashcards

STIs Flashcards

1
Q

Who is considered high risk?

A
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2
Q

Who is considered high risk?

A
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3
Q

What do you screen pregnant women for?

A

Syphillus, G/C, heptatitis BsAg

And again at 36 weeks if high risk (

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4
Q

Medication for crabs?

A

Permethrin 1% cream
Malathion
Ivermectin

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5
Q

When do most HSV transmission occur?

A

during asymptomatic period

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6
Q

Incubation for HSV?

A

2-12 days, average 4 days

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7
Q

Recurrence rate of HSV?

A

78%, 5% recurrence in 5 days. 20% are asymptomatic

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8
Q

Average duration of HSV for primary? Where? How long does it last?

A

12 days. Cervix. 2-4 weeks

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9
Q

Gold standard for HSV?

A

Viral Culture

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10
Q

Best test for healing lesions?

A

Antigen detection test

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11
Q

First episode treatment for HSV?

A
  • Acyclovir 400 mg TID x 7-10 days
  • Or Acyclovir 200 mg 5 times per day
  • or Famciclovir 250 mg TID
  • or Valacyclovir 1000 mg BID x 7-10 days
  • May extend treatment if healing is incomplete after 10 days
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12
Q

Daily Suppression for HSV?

A

Acyclovir 400 mg BID
Famciclovir 25 mg BID
Valacyclovir 500-1000 mg daily

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13
Q

Daily Suppression for HSV?

A

Acyclovir 400 mg BID
Famciclovir 25 mg BID
Valacyclovir 500-1000 mg daily

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14
Q

What do you screen pregnant women for?

A

Syphillus, G/C, heptatitis BsAg

And again at 36 weeks if high risk (

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15
Q

Medication for crabs?

A

Permethrin 1% cream
Malathion
Ivermectin

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16
Q

When do most HSV transmission occur?

A

during asymptomatic period

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17
Q

Incubation for HSV?

A

2-12 days, average 4 days

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18
Q

Recurrence rate of HSV?

A

78%, 5% recurrence in 5 days. 20% are asymptomatic

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19
Q

Average duration of HSV for primary? Where? How long does it last?

A

12 days. Cervix. 2-4 weeks

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20
Q

Gold standard for HSV?

A

Viral Culture

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21
Q

Best test for healing lesions?

A

Antigen detection test

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22
Q

First episode treatment for HSV?

A
  • Acyclovir 400 mg TID x 7-10 days
  • Or Acyclovir 200 mg 5 times per day
  • or Famciclovir 250 mg TID
  • or Valacyclovir 1000 mg BID x 7-10 days
  • May extend treatment if healing is incomplete after 10 days
23
Q

Episodic therapy for HSV?

A

Acyclovir 800 TID x 2 days
Famiciclovir 1000 mg BID x 1 day
Valcyclovir 2 g BID x 1 day

24
Q

Daily Suppression for HSV?

A

Acyclovir 400 mg BID
Famciclovir 25 mg BID
Valacyclovir 500-1000 mg daily

25
Most common cause of HPV strains?
6 and 11
26
What perscentage of HPV strains resolve without treatment?
80%
27
Provider applied treatment for HPV?
Cryotherapy, laser, surgery Trichloroacetic Acid Bichloroacetic acid
28
Patient applied therapy for HPV?
Podofilox Dimiquimod and IMiquimod Sinecatechins
29
What is no longer recommended for HPV?
Podopyllin Resin
30
Who should receive HPV vaccine and when should you stop?
Boys and girls starting at age 9 Stop at 21 for males Stop at 26 for females HIV of MSM- all do 26
31
two major signs of cervicitis?
1. Purlenet or mucopurulent endocervical exudate | 2. Sustained bleeding easily induced by mental passage of cotton swab
32
Other symptoms of Cervicitis?
May be asymptomatic, inter menstrual spotting/post coital bleeding, increased vaginal discharge
33
Treatment for cervicitis?
Azithromycin 1 g or doxycycline 100 mg BID x 7 days | If persistent, refer to GYN for mycoplasma gentalium work up.
34
Most common STD?
Chlamydia
35
Symptoms of chlamydia?
Most are asymptomatic. Cervicitis. Urethritis, PID, perihepaittis, reactive arthritis.
36
Incubatino period for chlamydia
7-21 days.
37
When do you retest for chlamydia?
3-4 months and at next visit.
38
Tests for chlamydia?
Nucleic acid amplification test- good Non NAAT- titers- difficult to interparate Culture is gold standard
39
Treatment of chlamydia?
Azithromycin 1 g or doxycycline Erythromycin base or ethylsuccinate 7 days Ofloxacin 300 mg BID x 7 days Levofloxacin 500 mg PO QD x 7 days
40
Complications of gonorrhea?
Bartholin's and Skene gland infections, PID, and Fiz- Hugh- Curtis Syndrome- perihepatitis
41
Symptoms for gonorrhea for men and women?
Men- burning with urination | Women- PID
42
Diagnosis of gonorrhea?
Culture, non culture | Amplified tests NAAT
43
Treatment of gonorrhea?
No fluoquinolones Rocephin 250 mg IM x1 Oral cefixime 400 mg
44
What to do if if patient is resistance?
Send to ID doctor
45
Primary infection of syphilis? How long does it last? Associated symptoms?
Ulcer, 1-6 weeks, rubbery, painless, bilateral lymphadenopathy
46
Signs of Secondary infection?
Mucous patches, condylomata lata, alopecia, serologic testing highest at this phase
47
Describe latent phase?
Patient is seroreactive, but no evidence of infection. Can occur between 1, 2, and 3rd fase
48
Describe the two step process?
1. VDRL or RPR | 2. Treptomonal test FTA-ABS, or TP-PA
49
How do you follow treatment?
Titers should decrease
50
Treatment of syphilis?
Benzathine penicillin G 2.4 million units
51
What to do if patient has pencillin allergy for syphilis?
Consult ID
52
What is a Jarisch-Hexheimer Reaction?
Self limited reaction to anti-treptomonal therapy. Fever, malaise, N&V, usually within 24 hours after therapy
53
When do you follow up for Syphilis?
6 and 12 months

Ambulatory Care of Women (8 decks)

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