STI Pharm

Question 1

Tx of Chlamydia (3)

Answer 1

• **Azithromycin single dose
• Doxycycline x 7 days oral
• Amoxicillin during pregnancy oral

Question 2

Tx of Gonorrhea

Answer 2

Ceftriaxone

Question 3

Tx sexual partner in what infections?

Answer 3

Chlamydia, gonorrhea, syphilis, trichomonas, lice/nits

Question 4

Tx of syphilis

Answer 4

Benzathine penicillin G**, IM.

– Primary (Secondary,early latent) Syphilis

Question 5

If someone with syphilis (or any bacteria) is tx with penicillin - what are two guidelines that must be followed?

Answer 5

• do NOT interrupt the process

- desensitized this time only - if reinfected, give abx course again.

Question 6

Three types of vaginitis

Answer 6

• Fungal - vulvovaginal candidiasis
• Protozoan - trichomonas
• Bacterial - gardnerella, mycoplasma

Question 7

Tx vulvovaginal candidiasis with?

Answer 7

• Fluconazole single dose oral

- Miconazole … vaginal application (immediate sx relief)

Question 8

Tx trichomonas with?

Answer 8

• Metronidazole* 2 gm x 1 oral (same recommendation for pregnant)
• Tinidazole 2 gm x 1 oral

Question 9

Tx bacterial vaginosis (gardnerella, mycoplasma) with?

Answer 9

• Metronidazole - bid x 7d oral

- Clindamycin vaginal Cr x 5-7 d (or metronidazole vaginal)

Question 10

Tx of pubic lice, crabs, scabies

Answer 10

• Permethrin**** - Apply at bedtime, wash well in morning (wash bedding!)
• Ivermectin (oral, topical)

Question 11

Spermicides are associated with what lesions?

Answer 11

genital lesions

Question 12

Refrain from intercourse during what stages of HSV?

Answer 12

prodrome and active lesions

Question 13

Multiple lesions, shallow, heaped border, clean margins - what?

Answer 13

Herpes

Question 14

Tx genital herpes with what?

Instruct pt to do what with along with treatment?

Answer 14

No cure - suppressive therapy: acyclovir, famciclovir, valacyclovir. Must drink water with to avoid crystallization in renal tubules!

Question 15

Condoms are better for what type of infections?

Answer 15

Prevention of STDs transmitted by fluids (GC, CT, trichomonas, HIV)»_space;> STDs transmitted by skin-skin (HSV, HPV, syphilis, chancroid)

Question 16

tx first episode of genital herpes v. recurrent episodes?

Answer 16

First episode = tx for 7-10 days

Recurrent = tx 5 days

Question 17

Herpes with difficult to heal bed sores or pressure ulcers and/or prolonged extensive genital or perianal disease - think what?

Answer 17

HIV infection

Question 18

Describe primary, secondary, tertiary, latent syphilis

Answer 18

• Primary: Painless ulcers at inoculation site
• Secondary: Rash and adenopathy
• Tertiary: Cardiac, neurologic, ophthalmologic and gummatous manifestations (condylomata lata)
• Latent: no sx, but + serology

Question 19

Rash associated with secondary syphilis presents how on hands (and feet?)?

Answer 19

Crosses lines on palm

Question 20

Punched out, well demarcated, clean edge, slightly heaped edge in sphilis - what is this?

Answer 20

syphilitic chancre

Question 21

describe syphylitis lesions of the mouth

Answer 21

• Palate - soft, fleshy lesions

- Tongue - perfectly demarcated lesions

Question 22

• Very common
• Often asymptomatic in women
• Men have urethritis
• Women-dysuria, vaginal discharge, postcoital bleeding
• May present with PID

Answer 22

Chlamydia

Question 23

Describe discharge in chlamydia

Answer 23

thick milk

Question 24

Describe expedited partner therapy

Answer 24

for chlamydia/GC (only?)
• Allows practitioner to treat a potentially infected partner
• No existing patient-practitioner relationship need exist
• State law governs whether the script has to have a name
• Can be designated by disease type (Chlamydia or GC) or by type of practitioner

Question 25

Chlamydia screening guidelines: • Annual screening of sexually active women ___ age with ____ • Sexual risk assessment may indicate ____ screening for some women • Rescreen women ___ months after ___ due to high prevalence of repeat infection

Answer 25

* Annual screening of sexually active women 25 yrs with risk factors * Sexual risk assessment may indicate more frequent screening for some women * Rescreen women 3-4 months after treatment due to high prevalence of repeat infection

Question 26

``` What is this? • Less common than Chlamydia • May be asymptomatic in women • Or present with dysuria, yellow discharge, vaginal bleeding, vaginal pain • May present with PID ```

Answer 26

Gonorrhea

Question 27

``` Extra genital manifestations of? • Septic arthritis • Purpuric skin lesions • Pharyngitis (esp aggressive strep throat in young person) • Endocarditis • Fitz Hugh Curtis syndrome ```

Answer 27

Gonorrhea

Question 28

Describe septic arthritis of gonorrhea

Answer 28

GC will eat the joint

Question 29

Bilster over joint - think?

Answer 29

gono

Question 30

Young person with gallbladder issue and guck under diaphragm - what is this and its infectious association

Answer 30

Fitz Hugh Curtis syndrome, gono

Question 31

Describe difference between male/female gono discharge.

Answer 31

- Men: Dysuria and discharge appear in men within 2-5 d -95% symptomatic - Women: 65% have dysuria or abnormal discharge

Question 32

* Women present with malodorous, frothy yellow discharge * Strawberry cervix * See flagellated organisms on wet prep

Answer 32

Trichomonas

Question 33

Tx of papillomavirus (HPV) • Primary goal for treatment of visible warts is the ____ • Therapy may reduce but probably does not _____ • Difficult to determine if treatment reduces transmission

Answer 33

* Primary goal for treatment of visible warts is the removal of symptomatic warts * Therapy may reduce but probably does not eradicate infectivity * Difficult to determine if treatment reduces transmission

Question 34

HPV vaccine against what serotypes. Curative?

Answer 34

16, 18 | not curative