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STIs Flashcards

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1
Q

Which PID complication?

-RUQ pain and violin string adhesions of liver…

A

perihepatitis/Fitz-Hugh Curtis Syndrome

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2
Q

Patient presents with:

low abdominal pain during/shortly after menses

dyspareunia

cervical motion/adnexial tenderness

purulent discharge

A

acute symptomatic PID

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3
Q

workup for PID…

A 
urine preg
d/c microscopy for WBCs
NAAT
STI/HIV screens
UA
CBC
ESR
CRP
Pelvic US
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4
Q

Tx for mild/moderate PID

A

ceftriaxone 250mg IM + Doxy 100mg BID x 14 days

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5
Q

When should f/u occur with PID Tx?

A

48-72 horus

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6
Q

The below are indications for what tx of PID?

Pregnancy
Refractory
noncompliance
NPO/N/V
high fever
complications/abscess
surg. emergency can't be excluded
A

hospitalize

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7
Q

What abx can be added to ceftriaxone and doxy for PID?

A

+/- metro 500mg PO BID x 14 days

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8
Q

What is an alternative to doxycycline for PID tx?

A

azithro 1gm q weekly x 14 days

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9
Q

This condition confers increased risk for ectopic pregnancy, infertility, hydrosalpinx and chronic pelvic pain

A

PID

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10
Q

When can PID patients resume sexual intercourse?

A

complete therapy, sxs resolved, partners treated

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11
Q

Who should have repeat testing in 3 mo after PID?

A

(+) for GC or chlamydia

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12
Q

MC STI worldwide transmitted thru infected skin/mucosa that can infect anogenital region

A

HPV

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13
Q

MC HPV types and oncogenic potential…

A

6 and 11, low oncogenic

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14
Q

Patient presents with:

soft, flesh colored plaque

cauliflower like lesions on anogenital region

A

HPV

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15
Q

If uncertain dx of an anogenital lesion, what diagnostic can be used?

A

bx

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16
Q

cyto destructive tx for HPV…

A

podofilox

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17
Q

Immune-mediated tx for HPV (2)

A

imiquimod, sinecatechins

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18
Q

Surgical tx for hpv (4)

A

cryo, laser, cautery, excision

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19
Q

how is HPV prevented?

A

vaccine

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20
Q

Patient presents with:

painful genital ulcer

inguinal LAD

can be asymptomatic

A

HSV/genital herpes

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21
Q

incubation for HSV after exposure is…

A

2-12 days

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22
Q

Which class of HSV tests is preferred?

A

virologic (cx, PCR)

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23
Q

Viral cx for HSV has highest dx yield when?

A

early stages

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24
Q

is PCR more or less sensative than viral cx for HSV?

A

more sensitive

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25
presence of HSV-1 Abs can indicate what forms of disease?
anogenital or orolabial
26
is regular herpes screening indicated for general population?
no
27
first episode of HSV tx...
7-10 days antivirals
28
episodic tx of hsv outbreak
1-5 day regimen antivirals (acyclovir, etc.)
29
suppression tx for hsv
QD-BID dosing
30
Screening for which diseases would occur in sexually active women < 25 and older women w. risk factors?
GC chlamydia
31
Screening for _____ should be added to GC and chlamydia where prevalence is high.
trichomonas
32
repeat testing should occur with what diseases?
GC, chlamydia, trich
33
5 Ps of Sexual Hx
Partners (in last year, last sexual contact) Practices (sites) Preg Prevention Protection (STI, condom use) Past Hx STI (pt. and partners)
34
who accounts for 1/2 of all new STIs?
youth
35
This is a d/o of vagina caused by infx, inflammation, change in vaginal flora
vaginitis
36
3 MC causes of vaginitis
candida, BV, trich
37
Is candidiasis considered STI? Do partners need to be tx?
not STI, no partner tx
38
The below are RFs for... DM, Abx, Increased Estrogen, Immunosuppression
candidiasis
39
Patient presents with: Pruritis curd-like adherent white thick d/c
vulvovaginal candidaisis
40
dx for candidiasis can be made via
10% KOH Wet Mount
41
uncomplicated vulvovaginal candidiasis can be tx by...
fluconazole 150mg PO x 1 dose OR clotramazle topical x 1-3 days
42
Complicated (4+ yearly or comorbidities) vulvovaginal candidiasis tx
fluconazole 150 mg PO q 72 hours x 2-3 doses OR topical azole x 7-14 days
43
Pregnant vulvovaginal candidiasis tx...
clotramazole or miconazole topical x 7 days
44
MC cause of vaginal d/c in women of childbearing age
BV
45
is BV an STI?
no
46
what percent of BV presents asymptomatically?
50-75%
47
Patient presents with... thin, off-white vaginal d/c fishy odor this is suspicious for...
BV
48
Amsel's criteria for BV requires 3 of what 4 signs?
thin, white homogenous d/c clue cells wet mount pH > 4.5 (+) whiff test
49
3 dx options for BV
Amsel's criteria, gram stain, DNA probe
50
Tx for BV only needs to occur with patient, not partners. What are the tx options?
metro 500mg PO BID x 7 days metro 0.75% gel intravaginally QD x 5 days
51
What can't be ingested when taking metronidazole for fear of disulfiram like reaction?
etoh
52
What is a major complication of BV?
preterm delivery
53
This is the MC non-viral STI
trich
54
Patient presents with... a. Purulent, malodorous, frothy, thin d/c b. Burning, pruritus, dysuria, dyspareunia c. Post-coital bleeding
Trich
55
What physical exam sign is often found with trich infx?
strawberry cervix: punctate hemorrhages on vagina/cervix
56
Gold Standard Dx for trich...
Vaginal/cervical/urine NAAT
57
trich wet mount may show...
motile organism
58
Tx for patient and partner with Trich...
metro 2g PO x 1 dose no sex for 7 days after tx
59
Trich tx if N/V?
metro 500 mg BID x 5-7 days
60
The below are complications for... a. PID, urethritis, cystitis b. Cervical neoplasia c. Infertility d. Increased HIV risk e. Pregnancy complications (preterm delivery)
trich
61
when should repeat trich testing take placE?
3 mo after tx
62
This is the MC reportable bacterial STI, it has high prevelance in 24 yo and younger
Chlamydia
63
Patient presents with... a. Cervicitis: change in d/c, intermenstrual or post-coital bleeding b. Urethritis: dysuria, frequency a. Mucopurulent endocervical d/c b. Cervix friability, erythema, edema
Chlamydia or GC
64
Gold standard Dx for chlamydia?
vaginal swab NAAT
65
Tx options for patient and partner for chlamydia
azithro 1g PO x 1 OR doxy 100mg PO BID x 7 days
66
Tx for chlamydia if pregnant...
azithro
67
when can you have sex after chlamydia tx?
7 days after completed tx and no sxs
68
Preferred dx for GC?
vaginal/endocervical swab NAAT
69
If resistant GC is suspected, what diagnostic should be used?
Cx
70
Tx for partner and pt w. GC?
avoid sex, STI test Ceftriaxone 250mg IM + Azithro 1g PO x 1 dose

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