HIV is the initial infection the followed by AIDS approximately 10 years later. AIDS is defined by a CD4 count less than what?
200 cells/mm - (which indicates prophylaxis for opportunistic infections)
Routine annual screening for Chlamydia Trachomatis & Gonnorhea in all sexually active females younger than what age?
25
When should you repeat testing if a patient tested positive for Ghonorrhea?
3 months due to high rates of reinfection
Most common STD in US?
Chlamydia Trachomatis
Treatment for Chlamydia Trachomatis?
Azithromycin 1g PO
OR
Doxy 100mg BID x 7 days
DNA probe used for screening on what 2 STDs?
Ghonnorrea & Chlamydia
What infection is most likely to produce a purulent green discharge from vagina or penis?
Ghonorrhea
Uncomplicated infections of cervix, urethra, rectum, & pharynx should be treated with what first line? (3 things)
Ceftriaxone 250mg IM + Azithromycin 1g PO -OR- Doxycycline 100mg PO x 7 days
(Rocephin IM + Chlamydia Tx)
Treatment of Syphillis?
Benzathine PNC (Bicillin) 2.4 million u IM
Which STI is associated with a positive chandelier test?
PID
Which STD is associated with involuntary weight loss?
HIV
What is Trichomoniasis treated with?
2g Flagyl single dose
Treatment of HSV?
Antiviral such as acyclovir
What is used to diagnose Bacterial vaginosis and yeast?
Wet Prep
What is the confirmatory test of HIV?
Western Blot
What test is used to screen for HIV?
ELISA
(Western Blot confirms)
Ghonorrea should always be cotreated with what other infection?
Chlamydia
What antibiotic should you prescribe pregnant patients with Chlamydia?
Azithromycin
If pt has Chlamydia should you co-treat for ghonorrea?
No, unless indicated
Gen probe should only be used where?
Urethra & Cervix
What is Fritz-Hugh-Curtis Syndrome?
Chlamydia/Gonococcal infection of the liver capsule resulting in extensive scarring of the liver capsule and abdominal contents.
How should Fritz-Hugh-Curtiz Syndrome be treated?
Treated as a complicated gonorheal/chlamydial infection (14 day treatment)
Where might a patient have pain if they have Fritz-Hugh-Curtis Syndrome? Why?
RUQ - because it’s where your liver capsule is
An acute febrile reaction that can occur in the first 24 hours after treatment that is most likely to occur after treatment for early syphillis is called?
Jarisch-Herxheimer Reaction
A pt has STD symptoms with new onset red swollen knee (or another joint) may be caused by what infection?
Disseminated Ghonorrea Infection
RPR or VDRL is used for screening for which infection?
Syphillis
What test is used to confirm Syphillis?
FTA-ABS
How much decreased should a patient’s titers be if they’re responding to Syphillis treatment?
Four Fold
Any patient with Syphillis or men who are queer what should you test them for also?
HIV
Secondary signs of Syphillis are what?
Maculopapular rash on palms/soles
Which test tests for HIV virus directly? (Antigen Test)
HIV PCR
First line drug to treat for PCP in patients who have a CD4<200?
Bactrim DS (use dapsone 100mg PO if allergic to sulfa)
A patient has leukoplakia of the tongue and recurrent candidiasis (thrush). What should you rule out?
HIV infection
When should a pregnant women with HIV begin taking (zidovudine) AZT to help reduce the perinatal transmission by 70%?
2nd trimester
Where is HSV-1 located?
Mouth
Where is HSV-2 located?
Genitals
What 2 HPV strains are carcinogenic?
16 &18
What medicine do you treat genital warts with?
Imoquimod (Aldara) 5% Cream
(Apply Thin Layer 3x/week @ bedtime for 16 weeks. Do not cover. Leave on skin 6-10 hours the wash off.)