Phar 352 - Sexually Transmitted Infections

Front 1

What are the risk factors of Sexually Transmitted Infections?(7)

Back 1

1) Sexually Active

2) New sexual partner in last 2 months

3) Partner has/had STIs

4) Anal sex

5) Age <25 yrs

6) >2 partners in previous years

7) No contraception or non-barrier methods

Front 2

What are the common signs of STIs in Females?

Back 2

1) Cervicitis

2) Vaginitis

3) Dysuria

4) Vaginal Bleeding

5) Lower Abdominal Pain

6) Dyspareunia [pain during intercourse]

7) Vaginal Discharge 8) Dysuria

Front 3

What are the common signs of STIs in Males?

Back 3

1) Urethral Discharge

2) Urethritis

3) Dysuria

4) Epididymial pain

5) Urethral Itch

6) Testicular Pain/Swelling

Front 4

What are the common signs of STIs in Neonates?

Back 4

1) Conjunctivitis

2) Sepsis

Front 5

What are the common signs of Cervicitis/Urethritis?

Back 5

1) Inflammation of cervix/urethra with or without urethral discharge

2) Discharge is mucoid, mucopurulent or purulent

3) Dysuria

4) Pruritis

5) Erythema

Front 6

What are the most common organisms of Cervicitis/Urethritis?

Back 6

Chlamydia trachomatis and Neisseria gonorrhea

Front 7

"For all the women with Cervicitis test with NAAT" True or False?

Back 7

TRUE

Front 8

"There is no need to treat recent (60 days) contacts if they are asymptomatic" True or False?

Back 8

FALSE

Front 9

"Patients with Cervicitis should abstain from intercourse during treatment and for 7 days after therapy" True or False?

Back 9

TRUE

Front 10

What is the causative organism of Pelvic Inflammatory Disease?

Back 10

Mostly Chlamydia and Gonorrhea. Anaerobes and Aerobic gram -ves

Front 11

What is the causative organism of Lymphoma Venerum?

Back 11

Chamydia L1, L2, L3 serovants

Front 12

What is the causative organism of Syphilis?

Back 12

Treponema pallidum

Front 13

What is the causative organisms of Genital Herpes?

Back 13

HSV 1 (mouth) and HSV-2 (genital)

Front 14

What is the causative organisms of Chancroid?

Back 14

Haemophilus ducreyl GNR

Front 15

What is the causative organims of Trichomoniasis?

Back 15

Trichomonias Vaginalis

Front 16

"PID can ONLY be spread via sexual transmission" True or False?

Back 16

False, can go from IUDs

Front 17

What is the incubation period of Gonoccal Infections?

Back 17

2-7 days

Front 18

What is the incubation period of Chlamydial infections?

Back 18

2-6 weeks

Front 19

What is the incubation period of Syphilis?

Back 19

10-90 days (3 weeks)

Front 20

What is the incubation period of Chancroid?

Back 20

5-14 days

Front 21

Which is the most common STI?

Back 21

Chlamydial Infection

Front 22

What is the diagnosis methods of Syphilis?

Back 22

1) Darkfield Examination

2) Ab test for primary/secondary syphilis

3) Fluroscent Abs

Front 23

What are the symptoms of Pelvic Inflammatory Disease?

Back 23

Inflammation of upper female genital tract

1) Mucopurulent vaginitis/cervicitis

2) Inter-menstrual or postcoital bleeding

3) Dyspareunia

4) Lower abdominal pain

5) Pelvic adnexal tenderness

6) Cervical motion tenderness

7) Pritoneal Inflammation

Front 24

What are the symptoms of primary Syphilus infection?

Back 24

Ulcer lesions on penis [rarely fever]

Front 25

What are the symptoms of secondary Syphilus infection?

Back 25

1) Macular Rash

2) General flu symptoms

Front 26

What are the symptoms of tertiary Syphilus infection?

Back 26

Lesions on Skin + Bones --> Neuroshyphilus

Front 27

What are the symptoms of primary Genital Herpes?

Back 27

1) Painful sores (blisters)

2) Painful Inguinal Lymphadenopathy

3) Systemic symptoms: fever&myalgia

[wet ulcers -> dry crusts]

Front 28

What are the symptom of secondary Genital Herpes?

Back 28

Less severe version of primary almost no systemic symptoms

Front 29

What are the symptoms of Trichomoniasis infections?

Back 29

1) Painful vagina

2) Itchiness

3) Dysuria

4) Dyspareunia

5) Erythema

6) Foul smelling

7) Vaginal Discharge

Front 30

"Unprotected oral sex is NOT a safer sex activity for prevention of GUD" True or False?

Back 30

TRUE

Front 31

What are some of the complications of Pelvic Inflammatory Disease?

Back 31

1) Chronic Pelvic Pain

2) Ectopic Pregnancy

3) Infertility

Front 32

What are the first line empiric therapies for Gonococcal Infection?

Back 32

1) Ceftriaxone 250mg IM x1dose + Azithromycin 1g PO x 1dose

2) Cefixime 800mg PO x 1dose + Azithromycin 1g PO x 1dose

Front 33

What are the second line empiric therapies for Gonococcal Infections?

Back 33

1) Spectinomycin 2g IM x1dose + Azithromycin 1g PO x 1dose

2) Azithromycin 2g PO x 1dose

Front 34

What are the resistance issues with Gonococcal Infections?

Back 34

1) Tetracyclines

2) FluroQuinolones

3) Quionolines

Front 35

What are the first line empiric therapies for Pelvic Inflammatory Disease (mild-moderate)?

Back 35

1) Ceftriaxone 250mg IM x1dose + Doxycycline 100mg PO BID x 14days

2) Cefoxitin 2g IM x1dose + Probenecid 1g PO concurently x 1dose + Doxycycline 100mg PO BID x 14days

Front 36

What are the second line empiric therapies for Pelvic Inflammatory Disease (mild-moderate)?

Back 36

1) Ofloxacin 400mg PO BID x14days

2)Levofloxacin 500mg PO daily x14days

Front 37

When would you add metronidazole/clindamycin to the regimens for PID (mild-moderate)?

Back 37

1) Abscess

2) Peritonitis

3) HIV

4) IUDs

5) History of PID

6) Suspected Bacterial Vaginits

Front 38

What are the first line empiric therapies for Pelvic Inflammatory Disease (mod-severe)?

Back 38

1) Cefoxitin 2g IV q6hrs + Doxycyline 100mg PO BID x 14days

[iv therapy my be d/c after 24hrs if patient shows clinical improvement]

Front 39

What are the second line empiric therapies for Pelvic Inflammatory Disease (mod-severe)?

Back 39

1) Clindamycin 900mg IV q8hr + Gentamicin 5-7mg/kg IV q24hr + Doxycyline 100mg BID x 14days/ Clindamycin 450mg PO QID x 14days

Front 40

What are the first line empiric therapies for Chlamydial Infection?

Back 40

1) Azithromycin 1g PO x 1dose

2) Doxycyline 100mg PO BID x 7days

Front 41

What are the second line empiric therapies for Chlamydial Infections?

Back 41

1) Ofloxacin 300mg PO BID x 7days

2) Erythromycin base 500mg PO QID x 7days

3) Erythromycin base 1g/day (in divided doses) x 14days

Front 42

What is the recommended drug therapies for Pregnant Chalmydial infections?

Back 42

1) Erythromycin base (NOT ESTOLATE)

2) Azithromycin 500mg TID x 7days

3) Amoxicillin 500mg TID x7days

Front 43

What are the first line empiric therapies for Syphilis (Early Latent)?

Back 43

1) Benzathine Penicillin G 2.4MU IM x1dose

Front 44

What are the second line empiric therapies for Syphilis (Early Latent)?

Back 44

1) Doxycyline 100mg BID PO x 14days

Front 45

What is one notable side effect with Benzathine Penicillin G?

Back 45

Jarish Herxhemer (flu-like)[fever, chills, malasie, mylagia] response which can start within 4hrs of tretment and lasts for 12-24 hrs and give false impression of allergic reaction

Front 46

What are the first line empiric therapies for Syphilis (Late Latent)?

Back 46

1) Benzathine Penicillin G 2.4MU IM weekly x 3weeks

Front 47

What are the second line empiric therapies for Syphilis (Late Latent)?

Back 47

1) Doxycycline 100mg PO BID x 28days

Front 48

What are the first line empiric therapies for Neurosyphilis?

Back 48

1) Penicillin G 3-4MU IV q4h x10-14 days

Front 49

What are the second line empiric therapies for Neurosyphilis?

Back 49

Desensitization for the penicillin

Front 50

What are the first line empiric therapies for Primary Genital Herpes?

Back 50

1) Acyclovir 200-400mg TID - 5x/day x5-10days

Front 51

What are the second line empiric therapies for Primary Genital Herpes?

Back 51

1) Famciclovir 250mg TID - 5x/day x 5-10days

2) Valacyclovir 1g BID x 5-10days

Front 52

What are the recommended empiric therapies for Pregnant Primary Genital Herpes?

Back 52

Valacyclovir and Acyclovir are both safe for Pregant patients

Front 53

What are the recommended empiric therapies for Severe Cases of Genital Herpes?

Back 53

1) Acyclovir 5mg/kg IV q8h x5-10days

Front 54

What are the first line empiric therapies for Secondary Genital Herpes?

Back 54

1) Acyclovir 200-400mg TID - 5x/day x3-5days (or 800mg PO BID x 3-5days)

Front 55

What are the second line empiric therapies for Secondary Genital Herpes?

Back 55

1) Famciclovir 125mg PO TID - 5x/day x3-5days

2) Valacyclovir 500mg PO BID x3-5days (or 1g BID PO x3-5days)

Front 56

What are the first line empiric therapies for Genital Herpes Suppression?

Back 56

1) Acyclovir 200-400mg TID 5x/day x6-12months

Front 57

What are the second line empiric therapies for Genital Herpes Suppression?

Back 57

1) Famciclovir 250mg BID - 5x/day x 6-12months

2) Valacyclovir 500mg PO daily x 6-12months

Front 58

What are the recommended empiric therapies for Chancroid?

Back 58

1) Azithromycin 1g PO x 1dose

2) Ciprofloxacin 500mg PO x 1dose

3) Ceftriaxone 250mg IM x 1dose

4) Erythromycin Base 500mg QID x 7days

Front 59

What are the first line empiric therapies for LymphoGranuloma Venerum?

Back 59

1) Doxycycline 100mg PO BID x 21days

Front 60

What are the second line empiric therapies for LymphoGranuloma Venerum?

Back 60

1) Erythromycin base 500mg PO QID x21days

2) Azithromycin 1g once weekly x 3doses

Front 61

What are the patient applied products for Human Papilloma Virus?

Back 61

1) Imiquimod 3.75% cream qd HS x 8weeks

2) Imiquimod 5% cream x3/week HS x16 weeks 3) Podofiloux/Podophyllotoxin 0.5% solution apply to wart q12hrs for x3/week x 4 weeks

Front 62

What are the physican applied products for Human Papilloma Virus?

Back 62

1) Podophyllin 25% x 6weeks

2) Trichloroacetic acid 50-80% solution x 6weeks 3) Cryotherapy apply weekly x 4 weeks

Front 63

What are the first line empiric therapies for Trichomniasis?

Back 63

1) Metronidazole 2g PO x 1dose

Front 64

What are the second line empiric therapies for Trichmoniasis?

Back 64

2) Metronidazole 500mg PO BID x 7days

Front 65

"HPV is considered the most common sexually transmitted infection in the US" True or False?

Back 65

TRUE

Front 66

"HPV 16, 18, 31 and 45 account for 50% of cervical cancers" True or False?

Back 66

FALSE, accounts for 80%

Front 67

"HPV can cause many types of cancer other than cervical cancer" True or False?

Back 67

TRUE

Front 68

"HPV 6, 11 are responsible for >90% of Anogenital warts" True or False?

Back 68

TRUE

Front 69

What are the characteristics for Gardasil HPV vaccines?

Back 69

Gardasil:

1) Quadrivalent Vaccine (HPV-4)

2) Protects agianst HPV 6, 11, 16, 18

3) Indicated for women 9-26 years of age

4) Given at 0,2 and 6 months

5) Protects for 5 years

Front 70

What are the characteristics for Cervarix HPV vaccines?

Back 70

Cervarix:

1) Bivalent Vaccine (HPV-2)

2) Protects against HPV 16 and 18

3) Indicated for women 10-25 years of age

4) Given at 0,1 and 6 months

5) Protects for 6.4 years

Front 71

"Gardasil has 60% efficacy in 16-26 yr olds in preventing Cervical Cancers" True or False?

Back 71

False, 98% efficacy

Front 72

"Gardasil has 100% effiacy in 16-26 yr olds in preventing vulvular/vaginal cancers and warts" True or False?

Back 72

TRUE

Front 73

"Cervarix has no effect in preventing Genital Warts" True or False?

Back 73

TRUE

Front 74

"Vaccine has a decline in Genital Warts for Heterosexual men AND Bisexual, Homosexual" True or False?

Back 74

FALSE