Family Nurse Practitioner 1: STI with complete verified solutions 2025

discharge, dysuria, pelvic pain, cervical friability; 80% asymptomatic

What is the presentation for chlamydia?

Nucleic Acid Amplification Tests (NAATs)

Use of PCR to amplify DNA of an unknown microorganism that cannot be cultured

NAAT with urine clean catch

What is the preferred way to diagnose chlamydia and gonorrhea?

1 g PO azythromycin single dose; 100 mg doxycycline PO bid x 7 days (not in pregnant or possibility of pregnancy)

What is the treatment for chlamydia?

notify partners; avoid sexual contact during and for 7 days after treatment

What is the teaching that should go along with a diagnosis of chlamydia?

gonorrhea

bacterial STI that is most commonly spread from male to female than opposite; women have more problems with joint infection in advanced infections

conjunctivitis and blindness

What can exposure to gonorrhea from an infected mother cause in an infant?

rocephin 250 mg IM once plus azithromycin 1g PO once

What is the treatment plan for gonorrhea?

acyclovir 400 mg po tid x 7-10 days

What is the recommended treatment for an outbreak of HSV?

> 6 recurrences per year

When is daily suppressive therapy for HSV recommended?

acyclovir 400 mg bid x 1 year

What is the recommended suppressive therapy for HSV when indicated?

Trichloroacetic acid

What is the recommended treatment for genital warts associated with HPV?

chancre

a firm, round, painless genital or anal ulcer with a clean based and indurated margins that occurs with syphillis

chancre, localized lymphadenopathy, 3 weeks duration which resolves without therapy

What are the signs of a primary syphillis presentation?

non-pruritic skin rash often involving the soles of the feet and palms of the hands; painless white mucous membrane lesions; flu like fever, lympadenopathy, sore throat, hair loss, headaches, weight loss, muscle aches, fatigue; resolution without treatment possible

What are the signs of a secondary syphilis presentation?

gumma, CV functional problems, slow deterioration of nerve function

What are the s/s of tertiary syphilis presentation?

gumma

a characteristic soft, gummy lesion caused by bacteria that invade organs throughout the body; found in the tertiary stage of syphilis; found in various organs, most notably the liver

use of one test is insufficient for diagnosis

What is important to remember when assessing for syphilis?

RPR, VRDL

What are the nontreponemal tests used for syphilis?

PCN G 2.4 million units IM single dose; peds 50,000 units/kg up to adult dose

What is the plan for the treatment of primary syphilis?

PCN G 7.2 million units IM total over 3 doses in 1 week intervals

What is the plan for the treatment of late syphilis?

tetracycline or doxycycline

What meds may be used in the treatment of syphilis in patients that have a PCN hypersensitivity?

dysuria, itching, irritation, cervical motion tenderness, vaginal discharge may be yellow green (occasional frothy); cervical petechial hemorrhages (strawberry cervix)

What is found on presentation of trichomoniasis?

metronidazole or tinidazole 2gm po single dose

What is the recommended treatment for trichomoniasis?

vaginal antifungal

What is the recommended treatment for trichomoniasis in women in the first trimester of pregnancy?

flu like symptoms, night sweats, decreased CD4 counts that can rebound and remain symptom free for years

What symptoms may occur within the first 2-6 weeks after HIV infection?

CD4 count < 200, the appearance of one or more opportunistic infections

What is the criteria for the diagnosis of AIDS vs HIV?

CBC, CMP, lipids, STI panel, Hep A, B, and C; TB test, confirmatory test

What are the labs included in the workup of a newly diagnosed HIV patient?

ELISA confirmed by Western Blot

What is the recommended testing protocol for HIV?

HAART, therapy for OIs and malignancies, prophylaxis for OIs based on CD4 count, immunizations

What is included in the treatment of HIV?

Truvada

What is the new drug used as pre exposure prophylaxis for HIV?

ART and follow guidelines for repeat testing (6,3,6,1)

What is the post exposure prophylaxis for HIV?