1. Sexually Transmitted Infection Tutoring
Alaina Darby

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. First Episode
(7-10 days)
Episodic
(1-5 days)
Suppression
Acyclovir
g/day
g/day
800 mg/day
Famciclovir
750 mg/day
mg/day
500 mg/day
Valacyclovir
2 g/day
1 g/day
mg/day

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

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

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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

30. 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”

31. 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