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30 Cards in this Set
- Front
- Back
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what is the treatment for Chlamydia
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azithromycin 1g
doxycycline 100mg bid for 7 days treat both pt w/in 60 days |
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how do you treat recurrent/persistent Chlamydia infections
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metronidazole 2g single dose
tinidazole 2g single dose plus azithromycin 1g if not used in initial episode |
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what is the most common cause for tx failure/recurrent infections
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UNTREATED PARTNER
poor compliance T. vaginalis infection tetracycline resistant U. urealyticum (doxycyline pt) |
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what is the workup for a pt to determine if you tx for chlamydia only or gonorrhea as well
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mucopurulent or purulent discharge (more towards gonorrhea)
>5 WBC per oil immersion filed (microscopy) no gram negative diplococci or positive antigen test for C. trachomatis > tx chlamydia only presence of gram negative diplococci or positive PCR or antigen for N. gonorrhea > treat for chlamydia and gonorrhea |
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how does the # of asymptomatic pts compare in pts with gonorrhea
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75% females
5% males |
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males with gonorrhea have a low % of being asymptomatic what presentation is that attributable to
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Urethritis due to purulent discharge , dysuria w/ hazy urine
Anorectal pain is sometimes mistaken as hemorrhoids |
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what is the treatment for gonorrhea
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ceftriaxone 250mg IM single dose
Cefixime 100mg PO single dose PLUS azithromycin 1g single dose or doxycylin 100mg bid for 7days |
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which STD is characterized by painful ulcers
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herpes
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which STD is characterized by painless ulcers
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syphillis
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what are the characteristics of primary and secondary syphillis infections
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primary - painless chancres at sight of inoculation
secondary - mucocutaneous eruptions on hands and soles of feet |
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what is the pathogen that causes syphillis
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T. pallidum, g- spirochetes
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what tests correlate with disease progression in syphillis
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VDRL - used to monitor drug therapy
RPR |
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what are the nontreponemal tests
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VDRL, RPR
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what is the treatment of choice for syphillis
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Benzathine PCN G given via prolonged drug exposure not a single dose
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what is the treatment for syphillis < 1 year and > 1 year
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<1 year benzathine PCN G 2.4MU IM 1 dose
>1 year benzathine PCN G 2.4MU q week for 3 weeks |
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what is the treatment of neurosyphillis/cardiovascular syphillis
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Pen G 18-24 MU IV/day for 21 days
or ceftriaxone 2g for 14 days |
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if a pt has a PCN allergy when being treated for syphilis what should be done
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desensitization or
doxycycline 100mg bid for 2-4 weeks azithromycin 500mg for 10 days (early syphilis) |
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is jarish herxheimer reaction an allergy
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occurs when spirochetes are being killed by antibiotic treatment and spill out their toxins
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what should be done for syphilis followup
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VDRL test @ 6, 12, 24 months
titers should decrease 2-3 tubes q 2-3 months |
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when is syphilis treatment considered a failure
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if titer doesn't decrease <1:18 after 1 year or 4 fold increase in VDRL
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is herpes more severe in recurrent infections or new infections
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new infections
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what is the test of choice for herpes diagnosis
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PCR b/c it is highly specific and sensitive and is the test of choice
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what are the complications of herpes
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urinary retention
meningitis extra genital infections cervical cancer |
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what are the antiviral medications for herpes
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acyclovir
valacyclovir famciclovir |
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when is a mom @ greatest risk of transmitting herpes to their child
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if herpes is acquired near time of delivery
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how does trichomoniasis present
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90% asymptomatic in males
25-50% in females in females - malodorous discharge, yellow-greenish, foamy; irritation; itching |
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how do you diagnose trichomoniasis
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wet mount looking for protozoa
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how do you treat trichomoniasis
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metronidazole 2g
tinidazole 2g cure rate ^ when partner treated treatment failures: retreat w/ metronidazole allergy: desensitize |
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for pt with first episode of Herpes what is the tx
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acyclovir 500 mg PO tid for 7 - 10 days
acyclovir 250 mg PO 5x/day for 7 - 10 days famcyclovir 250 mg PO tid for 7 - 10 days valacyclovir 1g PO bid for 7 - 10 days |
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what is the regimen for daily suppressive therapy with herpes
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acyclovir 400 mg bid
famcyclovir 250 mg bid valacyclovir 500 mg or 1g bid |
