Upper and lower Tract infections

Question 1

What are the screening guidelines for Ghonnorhea and Chlamidia?

Answer 1

Ghono and Chlam: Annual screen if Sexually active
Those with dev disabilities
Nucleic Acid amplification most sensitive
Self collected vaginal swab acceptible

Question 2

What are the screening guidelines for Hep C?

Answer 2

One time testing if born from 1945-1965 and unknown status

Question 3

What are the screening guidelines for HIV?

Answer 3

Screen at least once age 13-64 yrs
Annual screen based on risk factors
Opt out screening

Question 4

What are the risk factors for STDs?

Answer 4

History of multiple partners
Sexual contact with STI person
Repeated STIs
Attendance at clinic for STI
Inconsistent condom use, sex work, drug use

Question 5

How is a detailed sexual history obtained?

Answer 5

Open ended questions
Understandable language
Normalizing language

Question 6

What is the best way to prevent STIs?

Answer 6

Delay Coitarche
Limiting # partners 
Limiting exposure to risk patients 
Encourage immunization
Increase condom usage
Partner notification and treatment

Question 7

What STIs are reportabe in ALL STATES?

Answer 7

Ghonorrhea, syphillis, chlamidia, HIV, AIDS

Question 8

What are the considerations in HPV vaccine?

Answer 8

Protects against 6,11,16,18
6/11 cause wwarts
16/18 cause cervical cancer

Question 9

What are the considerations in Hep A vaccine?

Answer 9

Postexposure prophylaxis up to 2 weeks after exposure

Question 10

What are the considerations in Hep B vaccine?

Answer 10

Recommended for all unvaccinated uninfected persons evaluated for STD

Question 11

What are the best type of condoms?

Answer 11

Latex

Question 12

What is the proper use of male condoms?

Answer 12

Water based lubricant prevents breakage
New condom with each sex act
avoid teeth, nails

Question 13

Which STDs should be re-tested in the 3rd trimester of pregnancy?

Answer 13

HIV
Syphilis
Chlamidia
Hep C

Question 14

How is HIV screened for vs Confirmed?

Answer 14

Screen: Ez immunoassay

Rapid Test

Question 15

WHat type of bacteria is Haemophilus ducrei?

Answer 15

G(-) Streptobacillus

Question 16

What is the Tx of Chancroid?

Answer 16

Azithromycin or
Ceftriaxone IM or
Cipro BID
Erythromycin tid

Question 17

How is herpesvirus infection diagnosed?

Answer 17

Culture
PCR
Serology

Question 18

What are stages of Herpes Infection?

Answer 18

Primary
Non-primary first episode
Recurrent

Question 19

How is systemic syphilis diagnosed?

Answer 19

Darkfield Exam
Direct Fluorescent Ab
VDRL, RPR
Fluorescent treponemal Ab

Question 20

What are the stages of Syphilis and symptoms?

Answer 20

1) Chancre at site
2) Rash, mucocutaneous, LAN
3) Aortitis, iritis, uveitis, auditiry abn, Gummas
Latent)

Question 21

How is neurosyphilis treated?

Answer 21

Aqueous crystalline PCN Daily
Procaine
Probenicid
Repeat CSF exam every 6 mon until cell count normal

Question 22

What are the US findings of Congenital syphilis?

Answer 22

Hepatomegaly
Ascites
Hydrops
Thickened placenta

Question 23

What are the S and S of Vaginitis?

Answer 23

Discharge
Malodor
Pruritis
Burning
Swelling
Dysparunia
Dysuria

Question 24

How is Vaginitis diagnosed?

Answer 24

Vaginal pH
Amine (whiff) test
Saline Microscopy
KOH microscopy
DNA amplification
Fungal Culture

Question 25

What is the Tx of Chlamidia?

Answer 25

``` Azithromycin or Doxycycline Erythromycin Ofloxacin Levofloxacin ```

Question 26

What is the Tx for Gonorrhea?

Answer 26

Ceftriaxone AND Azithromax

Question 27

How is PID Treated?

Answer 27

Cover Ghon, Chlam, Anaerobes, Bact vaginitis

Question 28

What is the criteria for Hospitalization in PID?

Answer 28

``` Surgical EM cant be excluded PReggo Non-compliant Unable to tolerate PO meds Tubovarian abcess ```

Question 29

What causes Granuloma INguinale?

Answer 29

Klebsiella Granulomatosis | Tx with Doxycycline

Question 30

How is HPV condyloma diagnosed?

Answer 30

``` Clinical Diagnosis uncertain Dx unresponsive to Tx Immunocomprimise Pigmented , indurated, fixed, bleeding, or ulcerated ```

Question 31

WHat is recurrent respiratory papillomatosis?

Answer 31

HPV passed to infants and infects the airway

Question 32

How is Trichomonas diagnosed? | Treatment?

Answer 32

Wet mount Culture Trich antigens Metronidozole

Question 33

How can molluscum contagiosum be diagnosed?

Answer 33

Umbilicated center of lesions | Self limited

Question 34

What are the common microbes that cause Cystitis?

Answer 34

E Coli (75-95%) Proteus Mirabilus Klebsiella Staph Saprophyticus

Question 35

What is the Tx of Cystitis?

Answer 35

Nitrofurantoin TMP-SMX Fosfomycin Fleuroquinolones