What does the p24 antigen indicate in HIV infection?
Appears early in HIV infection and enables earlier detection
The p24 antigen is crucial for timely diagnosis of HIV.
What is the preferred test for HIV screening?
Fourth-generation HIV 1/2 combination antibody with p24 antigen test
This test is recommended for its effectiveness in detecting HIV.
If there is a strong suspicion of HIV infection, which test should also be ordered?
HIV RNA polymerase chain reaction (PCR) test
This test detects the HIV virus directly.
First line treatment for gonorrhea positive culture
Ceftriaxone 500 mg IM
If patient has cephalosporin allergy, gentamycin IM plus azithromycin 2 g orally and screening for gonorrhea again in three months is recommended 
What is the Jarisch-Herxheimer reaction?
An immune reaction caused by treatment of the spirochete Treponema pallidum with benzathine penicillin G IM
This reaction occurs when large amounts of treponema are killed, releasing foreign antigens.
What symptoms are associated with the Jarisch-Herxheimer reaction?
- Fever
- Chills
- Headache
- Myalgia
- Tachycardia
- Increased respiratory rate
Symptoms occur in the first few hours after treatment and peak in 6 to 8 hours.
What is the treatment for the Jarisch-Herxheimer reaction?
- Corticosteroids
- Antipyretics
- General supportive measures
These treatments help alleviate symptoms during the reaction.
Name two other spirochete bacteria that may elicit the Jarisch-Herxheimer reaction.
- Borrelia burgdorferi (Lyme disease)
- Leptospira (leptospirosis, Weil’s disease)
These bacteria can also cause similar immune reactions.
Reportable nationally sexually transmitted infections 
Chlamydia, gonorrhea, syphilis, and chancroid
Best indicator that the patient is responding to anti retroviral therapy for HIV infection 
Increase in CD4 count and decrease in viral load
Majority of HPV strains
HPV 16 and HPV 18
Characteristic of secondary syphillis
Rash
Primary syphillis
Chancre
Treatment for late latent syphilis or tertiary syphilis
Penicillin G benzathine 2.4 million units IM once weekly for three weeks. 
If patient is allergic to PCN, doxycycline is an alternative
According to the CDC all sexually active female patients who are 25 years old should be screamed for a chlamydia and gonorrhea, true or false
True
What medications is indicated to prevent pneumocystis pneumonia in patients with with CD4 count less than 200 cells/MCL
Bactrim
What is the recommended dosage of Valacyclovir for a first episode of genital herpes simplex virus (HSV) infection?
1,000 mg orally twice a day for 7 to 10 days
Antiviral therapy should be started within 72 hours of lesion appearance.
What are the characteristic lesions of HSV infection?
- Grouped 2- to 4-mm vesicles
- Underlying erythema
- Progression to vesicles, pustules, erosions, and ulcerations
Vesicles and pustules may have an umbilicated appearance due to central depression.
What systemic symptoms may occur during the first episode of genital HSV?
- Fever
- Headache
- Malaise
- Myalgias
These symptoms are common during the initial outbreak.
True or false: Topical antiviral therapy is recommended in the treatment of genital herpes.
FALSE
Topical antiviral therapy is not recommended for genital herpes treatment.
What are the alternative antiviral medications for treating a first episode of genital HSV?
- Acyclovir 400 mg three times daily
- Famciclovir 250 mg three times daily
These alternatives can be used alongside Valacyclovir.
Specimen of choice when screening male patients for chlamydia and gonorrhea
First catch urine 
Preferred medical treatment for a patient who is pregnant with anogenital warts or condylomata acuminata
TRICHLOROACETIC acid 
Cauliflower, shape flesh colored warts that may vary in size and generalize in the Vulva and perinium area
Condylomata acuminata or anogenital warts
