STDs- Kutzer- EXAM 4

SAID FOCUS ON LEARNING OBJECTIVES!!!!!!!!!!!!!!! tests on drugs, doses, and durations of therapy. DOSES DOSES DOSES!!!!!!

A patient with gonorrhea should also be treated for…

chlamydia

WHAT ARE THE TX OPTIONS for uncomplicated gonorrhea of the cervix, urethra, and rectum?

(include drug, dose, and route of admin)

• MUST KNOW

• Recommended: Ceftriaxone 500mg IM once

• Alternative:

  • Gentamicin 240mg IM + Azithromycin 2g once

  • cefixime 800mg orally once

WHAT ARE THE TX OPTIONS for uncomplicated gonorrhea of the pharynx (throat)?

(include drug, dose, and route of admin)

• MUST KNOW

• Recommended:

  • Ceftriaxone 500mg IM once

Chlamydia is what kind of bacteria? Where does it replicate? Who does it infect?

• KNOW THIS, LO

• it is an intracellular bacteria

• requires cellular material from host cells to replicate

• only infects humans

How can chlamydia be detected? How can it NOT be detected?

• KNOW THIS, LO

• CANNOT be detected via a gram stain

• Detection—> NAAT testing can be done

  • get cell scraping from women and men

WHAT ARE THE TX OPTIONS for uncomplicated chlamydia?

(include drug, dose, and route of admin)

• MUST KNOW, LO

• Recommended:

  • Doxycycline 100mg BID for 7 days

  • SAID ONLY REMEMBER DOXYCYCLINE IN LECTURE!!!!!!!!!!!!!!!!!!!!!

• Alternative:

  • Azithromycin 1g one dose or levofloxacin 500mg once daily for 7 days

What is Trichomoniasis? Is more reported in men or women? Are symptoms present?

• said in LECTURE—> KNOW THIS!!!!!!!!!

• Trichomoniasis infect squamous epithelium of genital tract

• reported more in WOMEN, versus men

• minimal/no symptoms if untreated infections can last years

What can Trichomoniasis lead to?

• said in LECTURE—> KNOW THIS!!!!

can lead to—→

• premature rupture of membranes in pregnancy

• premature delivery

• low birth rate

Symptoms of Trichomonas in male and females?

• LO

• male: asymptomatic, urethral discharge, dysuria, itching

• female: asymptomatic, discharge, dysuria, pain with sex

WHAT ARE THE TX OPTIONS for symptomatic/asymptomatic Trichomonas tx in MEN?

(include drug, dose, and route of admin)

• MUST KNOW, LO

• Said in LECTURE—> JUST KNOW MEN

Recommended:

• Metronidazole 2g PO in a single dose

• KNOW THIS ONE

Alternative:

• Tinidazole 2g orally in a single dose

What is PID?

• not that imp

inflammatory disorder of the upper female genital tract

What is the PID treatment targeted towards empiric coverage?

(drug, dose, route, frequency)

• KNOW THIS!!!!!!!—→ IN LECTURE SAID KNOW

• Ceftriaxone 1g IV q12 hours + Doxycycline 100mg PO BID for 14 days + metronidazole 500mg PO BID for 14 days

• alternatives for ceftriaxone:

  • cefotetan 2g IV q 12 hrs

  • cefoxitin 2g IV q 6 hrs

What organism causes syphilis?

• LO

Treponema pallidum, a spirochete

What is the treatment for primary, secondary, or early latent syphilis than is LESS THAN 1 YEAR DURATION?

(drug, dose, route, duration)

• SAID TEST QUESTION!!!!!!!! (on less than 1 yr, v. over 1 year)

adult benzathine penicillin G 2.4 million units IM in a SINGLE DOSE

What is the treatment for late latent, syphilis of unknown duration, tertiary syphilis or treatment after failure?

(drug, dose, route, duration)

• SAID TEST QUESTION!!!!!!!!

• LO

adult benzathine penicillin G 2.4 million units IM ONCE WEEKLY FOR 3 WEEKS

What is the ONLY syphilis treatment that can be IV?

• “know this”

Aqueous crystalline penicillin G (NOTE: NOT AQUEOUS PROCAINE PENICILLIN G)

What is the treatment for the FIRST clinical episode of genital herpes?

(drugs, route, dose, duration, frequency)

• said in lecture—> “KNOW ALL 3”

• Acyclovir 400mg PO TID for 7-10 days

• Famciclovir 250mg PO TID for 7-10 days

• Valacyclovir 1g PO BID for 7-10 days

WHAT HPV TYPES ARE ASSOCIATED WITH CERVICAL NEOPLASM?

16 and 18

What is the prevention dose for HPV infection in 9-14 years old?

Gardasil 9, 0.5 ml IM on day 1, second dose administered 6-12 months after 1st dose