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80 Cards in this Set
- Front
- Back
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Choice treatment for Neisseiria Gonnorhea |
High dose of Ceftriaxone |
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Groups at high risk for chlamydia |
Twenties Women AA and Hispanics |
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How is chlammydia transferred in children? |
sexual assault and verticle transmission |
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Complications in women with Chlammydia |
Cervicitis, urethritis, proctitis, conjuntivitis, infertillity issues, upper respiratory infection in re-infection |
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Symptoms of Chlammydia |
Clear discharge in women Enlarged sccrotum in Men Urethritis, proctitis, conjunctivitis, epididitis, arthritis |
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Diagnosis of Chlammydia |
vaginal and cervical swab, mucopurrulent cervical discharge, inflamed cervix, NAAT:GCCT nucleic amplified exam |
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Treatment of Chlammydia |
Azithromycin 1 gram/ dose |
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Alternative treatment of Chlammydia |
Doxycycline 100mg Twice a day for 7 days |
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Instructions for treatment of Chlammydia
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Abstain from sex for 7 days treat partners within last 3 months |
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Treatment for Lymphogranuloma Venereum (LGV) |
Doxycline 100 (PO) for 21 days or Erythromycin 500 g Q6H (PO) |
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What classifies chlammydia as complicated? |
Previous STD , Diabetes, Pregnancy
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Treatment of Chlammydia in pregnancy |
Azithromycin or Amoxicillin 500 mg Q8H for 7 days |
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Treatment for chlammydia in children |
Ethylsuccinate 50 mg/kg/day divided Q6H for 14 days |
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Folllow up in chlammydia |
Prevention- frequent screening find partners past 3 months physical exams Retest in 3 months |
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chlammydia follow up in Pregnancy |
Re- test in 3 weeks after therapy and again in 3 months |
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Gram stain of N. Gonorrhea |
Gram negative dipplococci |
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Risks for Gonorrhea |
less than 25 y/o, risky sexual behavior, African Americans, Penial , rectal, pharyngeal, conjunctivitis |
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Symptoms of Gonorrhea in Males |
Urethritis, epididymitis, milky discharge, dysuria |
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Symptoms of Gonorrhea in females |
Cervicitis, Batholins Abcess Glands, Skene's ,Fitz hugh Curtis syndrome(Perihepatitis) |
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Gonorrhea treatment? |
Ceftriaxone 250mg (Rocephin) (IM) + AZT 2g/dose 1xday |
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Alternate dose of Gonorrhea tretment |
Rocephin (ceftriaxone) 250 mg + Doxycycline 100mg for 7 days |
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Treatment Of gonorrhea in the pharynx |
Ceftriaxone (Rocephin) 250 mg (IM) + (AZT 1g or Doxycycline 100 mg BID X 7days |
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Treatment of Syphyllis |
Penicillin 2.4 million units injection |
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Bacterial Vaginosis treatment |
Metrodinazole |
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Anaerobes below the belt treatment |
Flagyl
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Anaerobes above the belt |
Clindamycin |
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Risks for Herpes |
ages 14-50 women |
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First Herpes infection |
Primary (most severe) |
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Symptoms of Herpes |
vessicles, Headache, fever, malaise, myalgia, (2-4 wk durations |
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Lifecycle of herpes outbreak |
Papule-vesicle-pustule-ulcer-crust -healed |
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Prodromal symptoms |
12-24hrs prior, localized tingling/itching (4-6 days) |
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Location of herpes and shedding |
Vulva, penile, and perianal |
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When lesion are present what diseases do you test for? |
Herpes and Syphillis |
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Treatment of Herpes (Class) |
Antivirals Acyclovir, valcyclovir, famiclovir |
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Acyclovir Dosage |
Primary; Oral- 400mg Q8H 7-10days Suppressive therapy: 400 mg BID Episodal: |
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Valacyclovir Dosage |
Primary: 1g PO BID 7 days Suppressive : 500mg -1g QD Episodic: 500-1g Q12-24 5 days |
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Famicloyvir Dosage |
Primary:: 250 mg Q8H 7-10 days Suppressive 250 mg BID Episodic: 125-1000mg Q12-24H (divided dose) 2-4 days |
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Acyclovir Treatment for Herpes in AIDs
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400-800 mg (PO) Episodic : 400mg Q8H 5-10days |
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Famocyclovir Treatment for Herpes in AIDs |
500mg (PO) Q12H Episodic ; 500mg Q12H 5-10 days |
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Vacyclovir Treatment of Herpes in AIDS |
500mg (PO) Q12H Episodic 1g Q12H 5-10 days |
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Treatment in pregnancy |
acyclovir |
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which drug reduces sexual transmission |
Valcyclovir |
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What are the three types of vaginosis? |
Bacterial Vaginosis (BV) Vulvo vaginal Candidias (VVC) Trichomonias (STD) |
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Normal Vaginal discharge |
Clear to white odorless viscous Ph 3.8-4.2 |
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Signs and symptoms of vaginitis |
discharge, itching, irritation, odor |
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Signs and symptoms Bacterial Vaginosis |
Discharge:thin, milky, malodorous, (fishy) pH >4.5 , possitive kOH "whiff" high WBC |
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Diagnosing Vaginitis |
Patient history, inspection, appearrance of d/c, collect specimenfor examination |
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signs and symptoms of candidias |
itch, dysuria, thick (clumpy white), erythyma, inflammation, pH <4.5, negative whiff test few to many WBC, psuedomonas hyphae |
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signs and symptoms of trichomatis |
itchy, discharge, asymptomatic, frothy, gray/yellow d/c, malodorous, cervical petchiae, strawberry cervix, pH >4.5, positive whiff test, Motile flagellated protozoa, many wbc |
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Causes of Bacterial Vaginosis |
Premature Ruptured membrane, pre-mature delivery, HIV, Gonnorhea, HSV-2, post op infections, re-occurring BV. |
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Risks of Bacterial Vaginosis |
African American, 2 or more sex partners in 6 months, douching, unprotected, decrease in lactobaccilli |
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Which antifungal is contraindicated in pregnancy |
Fluconazole |
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Treatment of Bacterial Vaginosis |
Metrodinazole 500 mg (PO) BID for 7 days or gel (.75%) Q12-24H Clindamycin cream 2% 5g @ bedtime for 7 days |
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TReatment of Bacterial Vaginosis in pregnancy |
Clindamycin 300 mg (BID) 7 days |
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Organism responsible for Vulvovaginal Candidias |
caused by candida Albicans |
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Symptoms of VVC |
Vulvar pruritis, cottage cheese d/c, Satellite lesions (sometimes), dysuria, Dysparenuria, |
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Diagnosis of VVC |
psuedohyphae, and/or budding yeasts, pH 4.0-4.5 |
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Uncomplicated VVC |
Sporadic , mild to moderate, non immunocomprimised |
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OTC Treatment of uncomplicated VVC |
Clotrimazole 1% cream 5g intravaginally 7-14 days or Clotrimazole 2% for 3 days |
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Prescrption Treatment of uncomplicated VVC |
Butaconazole 2% cream 1 dose intravagin. Nystatin 100,000 sub units vag. tablet QD 14days Fluconazole PO 150mg 1 dose |
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complicated VVC |
RecurrentVVC Svere VVC, Non- albicans organism, diabetic, immunosuppressed |
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Treatment for reoccuring VVC |
Fluconazole 100-150-200 mg PO repeated every 3 days for 7 days or topical for 7-14 days |
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Treatment of severe VVC |
Fluconazole 150mg Q3dys for 7-14 daysPO |
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Non-albicans VVC Treatment |
Boric Acid 600 mg Gel Cap QD 14 days |
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Treatment of VVC in immunocomprimised |
Topical Fluconazole 7-14 days |
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Risk factors fot trichomonias |
Multiple sex partners, low economic,history of STD, unprotected sex |
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Symptoms of Trichomonias |
gray/yellow/green discharge, pruritis, Cervical petachiae (strawberry cervix),can be asymptommatic. in men : gonnococcal urethritis |
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Diagnosis |
Motile trichomonads onn wet mount |
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Treatment for Trichomonias |
Metronidazole 2g (PO) 1 dose *pregnant or Tinidazole 2g (PO) 1 dose |
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Syphillis organism |
Treponema Pallidum (STI) |
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Syphillis transmission |
Sexually transmitted and vertically transmitted (enters through skin and mucous membranes and abrasions during sex.) Most contagious in the primary stage. travels via blood stream with abillity to cross BBB. at any stage. |
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Primary Syphillis |
Chancre stage. very contagioius. macule -papule- ulcer heals in 3-6 weeks lymphadenopathy may not show positve for syphillis in testing |
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Secondary Syphillis |
Lesions appear weeks after primary chancre. Lasts from weeks to months Rash Lyphadenopathy Malaise Alopecia |
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Latent Syphillis |
Supressed, no lesions present. can happen anytime Early< 1 yr Late >1 yr (gummatous lesions, cardiac syphillis) |
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Neurosyphillis |
CNS invasion can happen at any stage lasting from months to years, asymptomatic |
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Congenital Syphillis |
When T pallidum is transmitted to the baby, can cause infant death, cam be transmitted at any stage of pregnancy, early < 2y/o late > 2y/o |
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Treatment of syphillis |
Benzanthine Pen G 2.4 million units (IM) one dose in PCN allergy Doxycycline 100 mg (PO) BID x 14 days |
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Late Latent and Tertiary Syphillis treatment |
Benzanthine Penicillin G 7.2 million units(IM) divided into 3 doses once a week PCN allergy Doxyclycline 100 mg BID PO 28days |
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Treatment of Neurosyphillis |
Aqueous Crystalline Pen G 18-24 million units/day divided Q6H continous IV 10-14 days |
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Jarisch Herxeimher Reaction |
fever malaise n/v chills rash, occurs 24 hrs after therapy tx with anti pyretics |
