Sexually Transmitted Infection Tutoring Alaina Darby

Which of the following patients is more likely to contract a STI? Single 24 yo woman in a monogamous relationship and using condoms Married 30 yo woman who uses OCDs Single 20 yo male who has sex with men Married 45 yo male who has sex with men C MSM is one of the highest risks

FH is a 22 yo AAF with HSV type 1 FH is a 22 yo AAF with HSV type 1. Which of the following is the least likely symptom in this patient? Cold sores Labial ulcers Encephalitis Genital ulcers D

FR is a 23 yo homosexual WM who has developed painful, ulcerated lesions on his genitalia. What is not a goal of treatment? Cure Decrease pain Decrease duration Prevent complications A

FR is a 23 yo homosexual WM who has developed painful, ulcerated lesions on his genitalia. The following are his lab values: WBC 14 (H) ALT 80 (H) HgB 11 (L) SCr 1.7 (H) Why would his condition be considered severe? Elevated WBC Low HgB High ALT High SCr C

FR is a 23 yo homosexual WM (100 kg) who has developed painful, ulcerated lesions on his genitalia. The following are his lab values: WBC 14 (H) ALT 80 (H) HgB 11 (L) SCr 1.7 (H) How would you treat him initially? IV acyclovir 1g q8h IV acyclovir 1g q12h PO acyclovir 1g q8h PO acyclovir 1g q12h A

FR is a 23 yo homosexual WM (100 kg) who has developed painful, ulcerated lesions on his genitalia. After 3 days, his condition has not improved. How would you treat him? IV acyclovir 1g q8h for 4 more days IV acyclovir 1g q8h for 7 more days PO acyclovir 1g q8h for 4 more days PO acyclovir 1g q8h for 7 more days A

FR is a 23 yo homosexual WM (100 kg) who has developed painful, ulcerated lesions on his genitalia. On day 4, his condition has improved. How would you treat him? IV acyclovir 400mg q8h for 6 more days IV acyclovir 400mg q8h for 10 more days PO acyclovir 400mg q8h for 6 more days PO acyclovir 400mg q8h for 10 more days C

FR is a 23 yo homosexual WM (100 kg) who has developed painful, ulcerated lesions on his genitalia. He is now on oral acyclovir therapy and was sent home. What is the most important counseling point? Take with food Take with plenty of water Wear sunscreen Separate from antacids B

FR is a 23 yo homosexual WM (100 kg) FR is a 23 yo homosexual WM (100 kg). Two months later, he again develops painful, ulcerated lesions on his genitalia. Which would not be a potential treatment? PO acyclovir 800mg q8h x 2 days PO acyclovir 800mg q12h x 5 days PO acyclovir 400mg q8h x 5 days PO acyclovir 400mg q8h x 10 days D

First Episode (7-10 days) Episodic (1-5 days) Suppression Acyclovir 1.2-1.5 g/day 1.2-2.4 g/day 800 mg/day Famciclovir 750 mg/day 250-2000 mg/day 500 mg/day Valacyclovir 2 g/day 1 g/day 500-1000 mg/day

FR is a 23 yo homosexual WM (100 kg) FR is a 23 yo homosexual WM (100 kg). Two months later, he again develops painful, ulcerated lesions on his genitalia. Which would be a potential treatment if the HSV is determined to be acyclovir resistant? Famcyclovir 125mg q12h Foscarnet 4g q8h Valacyclovir 500mg q12h Valacyclovir 1g Qday B

BN is a 29 yo heterosexual WM (80 kg). He has developed painless ulcers. He also has just developed eruptions on the palms and soles of his feet. What stage of syphilis does he have? Primary Secondary Latent Tertiary B

BN is a 29 yo heterosexual WM (80 kg). He has developed painless ulcers. He also has just developed eruptions on the palms and soles of his feet. What is the best method of diagnosing him? CSF VDRL on serology TP-PA on serology Direct fluorescent antibody testing D

BN is a 29 yo heterosexual WM (80 kg). He has developed painless ulcers. He also has just developed eruptions on the palms and soles of his feet. After diagnosis, how would you treat him? Benzathine PCN-G 2.4 million units IM x 1 Benzathine PCN-G 2.4 million units IM x 3 Benzathine PCN-G 2.4 million units IV x 1 Benzathine PCN-G 2.4 million units IV x 3 A

BN is a 29 yo heterosexual WM (80 kg). He has developed painless ulcers. He also has just developed eruptions on the palms and soles of his feet. How would you determine response? CSF VDRL on serology TP-PA on serology Direct fluorescent antibody testing B

BN is a 29 yo heterosexual WM (80 kg) BN is a 29 yo heterosexual WM (80 kg). He now has ophthalmic manifestations. What stage of syphilis does he have? Primary Secondary Latent Tertiary D

What would you use for a patient with primary syphilis that has a PCN allergy to best treat them? Benzathine PCN-G Desensitization and PCN-G Doxycycline Ceftriaxone B

JB has urethritis and Reiter’s syndrome JB has urethritis and Reiter’s syndrome. This is the second recurrence this year. How should he be treated? Azithromycin + Metronidazole Azithromycin + Doxycycline Metronidazole Doxycycline A

AK is a 32 yo WF with chlamydia AK is a 32 yo WF with chlamydia. She missed several doses of her OCD, so now she is pregnant. How should you treat her? Doxycycline Azithromycin Amoxicillin Erythromycin B

AK is a 32 yo WF with chlamydia AK is a 32 yo WF with chlamydia. She missed several doses of her OCD, so now she is pregnant. How should you treat her baby (2.5 kg) after it is born if he has conjunctivitis? Amoxicillin 75 mg/kg TID x 14 days Amoxicillin 225 mg/kg TID x 14 days Erythromycin 30 mg QID x 14 days Erythromycin 120 mg QID x 14 days C

Which of the following should be used to treat FR if he presents with urethritis, pharyngitis and dysuria with red diplococci on culture? Ceftriaxone 250mg IM + azithromycin 1g PO Ceftriaxone 250mg IM + doxycycline 100mg PO BID Cefixime 400mg PO + azithromycin 1g PO Cefixime 400mg PO + doxycycline 100mg PO BID A

Which of the following is preferred in a 3 week old with a gonorrhea infection? Erythromycin Cefotaxime Ceftriaxone Cefixime B

Your patient has vaginitis. You see clue cells on culture Your patient has vaginitis. You see clue cells on culture. Which of the following is the cause? Bacterial vaginosis Candidiasis Trichomoniasis A

Your patient has vaginitis. The pH is 5 Your patient has vaginitis. The pH is 5. Which of the following is least likely? Bacterial vaginosis Candidiasis Trichomoniasis B

Your patient has vaginitis Your patient has vaginitis. There is an amine odor when treated with KOH. Which of the following is most likely? Bacterial vaginosis Candidiasis Trichomoniasis A

Your patient has vaginitis with clue cells Your patient has vaginitis with clue cells. Therapy should provide coverage for which types of pathogens? Gram negative bacteria Anaerobic bacteria Gram positive bacteria Fungi B

Your patient has vaginitis with yeast on microscopic exam Your patient has vaginitis with yeast on microscopic exam. Which of the following treatments is appropriate if she is pregnant? Oral fluconazole for 1 day Oral fluconazole for 7 days Intravaginal mitraconazole for 7 days Intravaginal mitraconazole for 14 days C

Your patient has PID and is pregnant Your patient has PID and is pregnant. What is the best option for treatment? Cefotetan IV x 2 days + doxycycline PO x 2 days Cefoxitan IV x 2 days + doxycycline PO x 2 days Cefotetan IV x 2 days + doxycycline PO x 14 days Cefoxitan IV x 2 days + doxycycline PO x 14 days C

Pelvic Inflammatory Disease and Epididymitis Outpatient Treatment Ceftriaxone x 1 day Doxycycline x 14 days Metronidazole x 14 day (optional) Treat 2 weeks “Tricycle” +/- Metro Epididymitis Ceftriaxone x 1 day Doxycycline x 10 days Treat 10 days “Tricycle”

Know HPV Vaccination schedule! Males Gardasil ONLY (3 doses) Females Gardasil (3 doses) Cervarix (3 doses) Cervarix (…only women have a cervix so only women can get this one!!) 9-25 yo HPV 16 & 18 Gardasil (This is the one you hear about most often because it is better! More ages, more strains, and both genders.) 9-26 yo HPV 6, 11, 16, & 18