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32 Cards in this Set
- Front
- Back
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The 5 P's for Risk Assessment |
Partners, Pregnancy, Protection, Practices, & Past hx |
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Contraception Methods that impact STDs |
Pre-exposure vaccination, Latex condoms, circumcision |
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Contraception that DOESN'T impact STDs |
Diaphragms, surgical sterilization, hysterectomy
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Hepatitis A/B vaccination population |
MSM, IVUD, HIV+ pts, and chronic liver disease |
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Expedited partner therapy allowed when |
partner is unlikely to seek medical attention |
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Systemic signs of HSV infection |
Fever, Headache, Malaise, Myalgia |
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Complications of HSV infection |
Urinary retention, HSV Meningitis/Encephalitis, Super infectoin (pelvic cellulitis, fungal vaginitis) |
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Virologic tests for HSV |
PCR is the PREFERRED standard test. Viral culture is for CSF |
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The antivirals of choice for HSV infection |
Acyclovir, Valacyclovir, and Famciclovir |
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Acyclovir & Valacyclovir ADE of note |
Renal function impairment and increased LFTs
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Primary treatment dosing of Acyclovir |
400 mg po TID for 7 - 10 days (or 200 mg 5x/d) |
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HSV Encephalopathy dosing |
Acyclovir 5-10 mg/kg IV q8h |
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Recurrent Treatment dosing of Acyclovir |
400 mg BID x5 days or 800 mg BID x5days or 800 mg TID x2days |
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Suppressive Treatment dosing of Acyclovir |
Acyclovir 400 mg po BID |
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Primary stage of syphilis infection |
Painless chancre for 1 - 8 weeks |
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Secondary stage of syphilis infection |
Mucotaneous rash 2○to hematogenous or lymphatic spread, 8 weeks after primary infection |
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Latent Syphilis stage of infection |
Early latency within 1 year of infection, asymptomatic but with positive serology. Treat regardless |
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Tertiary and Neuro-syphilis stage |
Years to decades after initial infection. |
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Gummas are |
soft tumor like balls that can form anywhere on the body and are destructive. Tertiary syphilis |
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Syphilis diagnosis |
Direct microscopy or serology (up to 20% of pts will be serologically negative) |
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Treatment of primary, secondary, or early latent Syphilis |
2.4 MU PCN G in benzathine IM x1 |
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Treatment of late latent, tertiary, or negative CSF Syphilis |
2.4 MU PCN G in benzathine IM q3weeks |
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Alternate syphilis abx (primary/secondary/early latent) |
Doxycycline, Tetracycline, Ceftriaxone (no ceftriaxone for late latent) |
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Syphilis f/u and evaluation |
VDRL or RPR at 6/12 months for primary/secondary and 6/12/24 for latent and q6months for tertiary |
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Titer drop for syphilis monitoring |
4 fold titer drop |
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Jarisch-Herxheimer Reaction |
Flu-like Sx (HA, fever, chills, malaise, arthralgia, myalgia |
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Organisms causing urethritis |
N. gonorrhoeae, Chlamydia trachomatis, Ureaplasm urealyticum, Mycoplasma genitalium
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Diagnosis of Urethritis |
Dysuria, urethral pruritis, mucopurulent discharge. Gram (-) diplococci should be managed as N. gonorrhea. >2 WBC per oil immersion field.
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Uncomplicated gonorrhea treatment |
Ceftriaxone 250 mg IM once + Azithromycin 1 gram po once.
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Chlamydia presentation |
onset in 7-21 days and frequently asymptomatic
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Uncomplicated chlamydia treatment |
Azithromycin 1 gm po once or Doxycycline 100 mg po BID x7 days |
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Failed Azithromycin chlamydia treatment |
Levofloxacin po for 7 days |
