Dosages and Treatments for Genital Conditions

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Questions and Answers

What is the recommended dosage of Acyclovir for a first symptomatic episode of genital herpes in adults?

  • 400 mg TID for 5 to 10 days (correct)
  • 1000 mg daily
  • 800 mg BID for 2 days
  • 200 mg TID for 5 days

For chronic suppressive therapy of genital herpes, which of the following dosages of Valacyclovir is correct?

  • 250 mg BID or 500 mg daily (correct)
  • 250 mg BID
  • 500 mg daily
  • 1000 mg daily if > 9 episodes per year (correct)

What is the recommended application schedule for Imiquimod 3.75% cream for external genital warts?

  • Every other day for 12 weeks
  • Once daily for up to 8 weeks (correct)
  • Three times per week for 16 weeks
  • Twice daily for 4 weeks

What is the correct dosage of Acyclovir for children with the first symptomatic herpes episode?

<p>80 mg/kg/day divided QID for 5 to 7 days (C)</p> Signup and view all the answers

In pregnancy, what is the recommended dosage of Acyclovir for the first symptomatic herpes episode?

<p>Both 200 mg 5 times daily and 400 mg TID for 5 to 10 days are correct (A)</p> Signup and view all the answers

What is the duration of treatment for Podofilox 0.5% solution in treating external genital warts?

<p>3 days on, 4 days off (D)</p> Signup and view all the answers

For immunocompromised hosts with herpes, what is the primary recommendation?

<p>More aggressive therapies and specialist consultation (D)</p> Signup and view all the answers

What is the first-line antibiotic choice for symptomatic bacterial vaginosis?

<p>Metronidazole (A)</p> Signup and view all the answers

What is the usual dosage of cefixime for gonococcal urethritis in adults?

<p>400 -800mg single dose (B)</p> Signup and view all the answers

Which organism is the most probable cause of acute cystitis in females?

<p>E.coli (B)</p> Signup and view all the answers

What is the usual dosage of oral metronidazole for bacterial vaginosis?

<p>500 mg BID for 7 days (C)</p> Signup and view all the answers

What is the usual dosage of TMP/SMX for uncomplicated UTI in females?

<p>2 tabs BID (C), 1 DS tab BID (D)</p> Signup and view all the answers

What is the first-line antibiotic choice for UTI in children?

<p>TMP/SMX (A)</p> Signup and view all the answers

Which antibiotic is recommended as a single-dose treatment for uncomplicated UTI in females?

<p>Fosfomycin (B)</p> Signup and view all the answers

What is the usual dosage of TMP/SMX for children with UTI?

<p>5-10 mg/kg/day trimethoprim divided q12h (D)</p> Signup and view all the answers

Which antibiotic is the first-line treatment for gonococcal urethritis in adults?

<p>Ceftriaxone 250 IM dose (A), Doxycycline 100 mg BID x 7 days/Azithromycin 1 Gram single dose (C), all of them (D), Cefixime 400- 800 po x 1 dose (B)</p> Signup and view all the answers

Which medication is primarily used for overactive bladder management?

<p>Mirabegron (A)</p> Signup and view all the answers

What is the minimum number of attempts recommended for erectile dysfunction assessment?

<p>At least 4 attempts (B)</p> Signup and view all the answers

What is the main aim of bladder training for urgency incontinence?

<p>Increase bladder capacity (A)</p> Signup and view all the answers

Which of the following tests is not typically performed during the initial BPH evaluation?

<p>Serum testosterone (A)</p> Signup and view all the answers

Which of the following medications is least likely to cause erectile dysfunction?

<p>Antibiotics (C)</p> Signup and view all the answers

What is the recommended approach for managing minimal BPH symptoms?

<p>Active surveillance and reassurance (C)</p> Signup and view all the answers

What is a widely recognized non-pharmacological intervention for premature ejaculation?

<p>Start-stop technique, pause &amp; squeeze technique (A), Cognitive behavioral therapy, (C)</p> Signup and view all the answers

Which medication class has been linked to an increased risk of cardiac failure in older BPH patients?

<p>Both alpha-blockers and 5-alpha reductase inhibitors (A)</p> Signup and view all the answers

Which laboratory test is NOT recommended for patients on long-term PDE5 inhibitor therapy?

<p>No testing is needed (C)</p> Signup and view all the answers

What is the first-line approach for managing stress urinary incontinence during pregnancy?

<p>Pelvic floor muscle training (B)</p> Signup and view all the answers

Which examination component is not typically included for urinary incontinence assessment in adults?

<p>Chest X-ray (C)</p> Signup and view all the answers

What are potential causes of sexual dysfunction in older adults?

<p>All of the above (D)</p> Signup and view all the answers

How long should one wait to assess the effectiveness of alpha-blocker treatment for BPH?

<p>4-8 weeks (B)</p> Signup and view all the answers

Which option is the first-line recommended approach for managing vaginal dryness in postmenopausal women?

<p>Local estrogen therapy (D)</p> Signup and view all the answers

Which of the following is a potential complication of untreated long-term bladder outlet obstruction?

<p>All of the above (D)</p> Signup and view all the answers

Which lifestyle modification is known to improve erectile function?

<p>All of the above (D)</p> Signup and view all the answers

What is the suggested initial response for children exhibiting inappropriate sexual behaviors?

<p>Psychoeducation and behavioral interventions (D)</p> Signup and view all the answers

What is the primary focus of pelvic floor muscle exercises in managing stress urinary incontinence?

<p>Strengthen pelvic floor muscles (D)</p> Signup and view all the answers

Which is NOT a common side effect of alprostadil injections?

<p>Dizziness (D)</p> Signup and view all the answers

What dietary change is suggested for managing urinary symptoms?

<p>Reducing alcohol consumption (D)</p> Signup and view all the answers

What is a significant risk when prescribing alpha-blockers?

<p>Potential orthostatic hypotension (A)</p> Signup and view all the answers

Which effect do antimuscarinic medications have in BPH management?

<p>They expand bladder capacity (D)</p> Signup and view all the answers

Which is a common side effect of anticholinergic medications for BPH?

<p>Dry mouth and constipation (B)</p> Signup and view all the answers

When determining treatment options, what should be considered?

<p>Severity of symptoms and complications (B)</p> Signup and view all the answers

What is the freezing margin recommended beyond the wart diameter in cryotherapy?

<p>1-2 mm (C)</p> Signup and view all the answers

What is the risk of vertical transmission when a primary herpes outbreak occurs at delivery?

<p>30-40% (C)</p> Signup and view all the answers

How long should Imiquimod 5% cream be washed off after application?

<p>6-10 hours (B)</p> Signup and view all the answers

What is the duration of treatment for neonatal herpes affecting only skin, eye, and mucous membranes?

<p>14 days (D)</p> Signup and view all the answers

How often should chronic suppressive therapy for herpes be reassessed?

<p>Every 6-12 months (D)</p> Signup and view all the answers

By what percentage is recurrent genital herpes reduced with suppressive therapy?

<p>70-80% (A)</p> Signup and view all the answers

What is the maximum treatment area recommended for provider-administered therapies?

<p>≤ 10 cm² (A)</p> Signup and view all the answers

Which antibiotic is identified as the first-line treatment for symptomatic UTI in nursing home residents?

<p>TMP/SMX 1DS BID x 7 days (B), Amoxicillin 500 MG TAB TID (C)</p> Signup and view all the answers

What is the usual dosage of Nitrofurantoin prescribed for recurrent cystitis in females?

<p>50-100 mg QID (D)</p> Signup and view all the answers

Which of the following is a second-line antibiotic for treating recurrent cystitis in females?

<p>Norfloxacin (C)</p> Signup and view all the answers

What is the typical dosage range of Cephalexin prescribed for UTI in children?

<p>25-50 mg/kg/day divided q6h (A)</p> Signup and view all the answers

Which organism is a common cause of symptomatic UTI in nursing home residents?

<p>E.coli (D)</p> Signup and view all the answers

What is the usual dosage of Trimethoprim for UTI treatment in nursing home residents?

<p>100 mg BID (A), 200 mg once daily (C)</p> Signup and view all the answers

Which antibiotic is suggested as a third-line choice for UTI in children?

<p>Cefixime (C), Amoxicillin/Clavulanate (D)</p> Signup and view all the answers

What is the usual dosage of Ciprofloxacin for UTI in nursing home residents?

<p>500 mg (extended release) once daily (C), 250 mg BID (D)</p> Signup and view all the answers

Which antibiotic is the first-line choice for early relapse of cystitis in females?

<p>TMP/SMX (B)</p> Signup and view all the answers

What is the primary goal of bladder training for urgency incontinence?

<p>Increase bladder capacity (A)</p> Signup and view all the answers

Which medication class is associated with an increased risk of new cardiac failure in patients over 66 years with BPH?

<p>Both B and C (A)</p> Signup and view all the answers

What is the recommended duration of treatment with alpha-blockers before assessing their effectiveness in BPH?

<p>4-8 weeks (C)</p> Signup and view all the answers

Which of the following is not typically included in the initial laboratory tests for BPH evaluation?

<p>Serum testosterone (C)</p> Signup and view all the answers

What is the recommended approach for patients with minimal BPH symptoms?

<p>Reassurance and active surveillance (C)</p> Signup and view all the answers

Which type of urinary incontinence commonly occurs due to increased abdominal pressure during activities such as sneezing or exercise?

<p>Stress incontinence (C)</p> Signup and view all the answers

What is the primary goal of bladder training in patients with urgency incontinence?

<p>Delay urination and improve bladder control (C)</p> Signup and view all the answers

Which medication class is primarily used for treating urgency urinary incontinence?

<p>Antimuscarinics (B)</p> Signup and view all the answers

What should be monitored closely when prescribing antimuscarinics to elderly patients?

<p>Risk of cognitive decline or dementia (C)</p> Signup and view all the answers

Which lifestyle change is NOT recommended for individuals managing urinary incontinence?

<p>Increased alcohol consumption (A)</p> Signup and view all the answers

For pelvic floor muscle exercises to be effective, what is the recommended time frame to see significant improvement?

<p>6-8 weeks (B)</p> Signup and view all the answers

Which type of urinary incontinence is characterized by an inability to sense a full bladder, commonly found in patients with neurological issues?

<p>Overflow incontinence (C)</p> Signup and view all the answers

Which statement best describes mixed incontinence?

<p>Involves both stress incontinence and urgency incontinence (A)</p> Signup and view all the answers

How long should a patient typically wait to evaluate the effectiveness of antimuscarinic medications for urgency incontinence?

<p>4-8 weeks (B)</p> Signup and view all the answers

What common factor contributes to the prevalence of urinary incontinence in older females?

<p>Hormonal changes post-menopause (C)</p> Signup and view all the answers

What is the minimum number of doses required per week for PrEP to be effective in MSM/TGW?

<p>≥4 doses/week (D)</p> Signup and view all the answers

Which of the following is a contraindication for PrEP?

<p>Positive HIV test (B)</p> Signup and view all the answers

How often should STI screening occur while on PrEP?

<p>Every 3 months (A)</p> Signup and view all the answers

Which test is recommended to monitor kidney function in patients on PrEP?

<p>Serum creatinine and eGFR (B)</p> Signup and view all the answers

What should be done if a patient on PrEP shows symptoms of acute HIV infection?

<p>Defer PrEP and repeat HIV test in 1-3 weeks (C)</p> Signup and view all the answers

Which population is DESCOVY FDA-approved for as PrEP?

<p>MSM/TGW only (A)</p> Signup and view all the answers

What is the recommended frequency for monitoring lipid panels with FTC/TAF (DESCOVY)?

<p>Every 12 months (D)</p> Signup and view all the answers

Which drug interaction requires monitoring when prescribing TRUVADA for PrEP?

<p>NSAIDs (D)</p> Signup and view all the answers

What is the potential effect of TRUVADA on bone mineral density?

<p>Decrease (C)</p> Signup and view all the answers

What action should be taken for a patient with a recent high-risk exposure who is eligible for PrEP?

<p>Refer for nPEP (B)</p> Signup and view all the answers

What modification in dosing may be recommended for individuals who experience more than 9 episodes of genital herpes per year?

<p>Increase to 500 mg daily or 1000 mg daily (D)</p> Signup and view all the answers

Which of the following best describes the recommended treatment duration for Imiquimod 3.75% cream on external genital warts?

<p>Once daily for up to 8 weeks (C)</p> Signup and view all the answers

For a child experiencing a first symptomatic episode of herpes, what is the correct dosing of Acyclovir?

<p>80 mg/kg/day divided QID for 5 to 7 days (D)</p> Signup and view all the answers

What is the correct dosage of Acyclovir for pregnant individuals experiencing their first symptomatic episode of herpes?

<p>200 mg QID or 400 mg TID (C)</p> Signup and view all the answers

During treatment of external genital warts, what is the suggested duration for Podofilox 0.5% solution?

<p>3 days on, 4 days off (B)</p> Signup and view all the answers

What is the primary recommendation for managing herpes in immunocompromised hosts?

<p>More aggressive therapies and consultation with a specialist (B)</p> Signup and view all the answers

What is the maximum duration for Sinecatechins 10% ointment treatment?

<p>Up to 16 weeks (D)</p> Signup and view all the answers

What is a potential complication of long-term bladder outlet obstruction in BPH?

<p>Hydronephrosis (A), Urinary tract infections (B), Bladder stones (C)</p> Signup and view all the answers

What is the first-line recommended approach for stress urinary incontinence during pregnancy?

<p>Pelvic floor muscle training (A)</p> Signup and view all the answers

Which medication is primarily indicated for urgency urinary incontinence management?

<p>Mirabegron (D)</p> Signup and view all the answers

What is the recommended time frame to wait before evaluating the effectiveness of pelvic floor muscle exercises?

<p>6-8 weeks (A)</p> Signup and view all the answers

Which of the following lifestyle changes is advised against for individuals managing urgency urinary incontinence?

<p>Increased alcohol consumption (D)</p> Signup and view all the answers

What is the primary objective of bladder training in patients with urgency incontinence?

<p>Increase bladder capacity (B)</p> Signup and view all the answers

Which class of medications may heighten the risk of new cardiac failure in older patients with BPH?

<p>Alpha-blockers (B)</p> Signup and view all the answers

Which first-line method is recommended for stress urinary incontinence during pregnancy?

<p>Pelvic floor muscle training (C)</p> Signup and view all the answers

Which of the following components is not typically assessed in a physical examination for urinary incontinence?

<p>Chest X-ray (B)</p> Signup and view all the answers

What is the advised duration for treatment with alpha-blockers before evaluating their efficacy in BPH?

<p>4-8 weeks (D)</p> Signup and view all the answers

Which complication is associated with prolonged bladder outlet obstruction in BPH?

<p>All of the above (D)</p> Signup and view all the answers

What is the recommended strategy for managing patients with minimal symptoms of BPH?

<p>Reassurance and active surveillance (B)</p> Signup and view all the answers

Which type of urinary incontinence is primarily caused by involuntary contractions of the bladder muscle?

<p>Urgency incontinence (C)</p> Signup and view all the answers

What is the typical first-line treatment for stress urinary incontinence?

<p>Pelvic floor muscle exercises (B)</p> Signup and view all the answers

Which non-pharmacological approach is least effective for managing urgency urinary incontinence?

<p>Botulinum toxin injections (C)</p> Signup and view all the answers

Which demographic is more likely to experience urinary incontinence?

<p>Older females (B)</p> Signup and view all the answers

How long does it typically take to notice benefits from antimuscarinic medications in urgency incontinence?

<p>4-8 weeks (A)</p> Signup and view all the answers

Which type of incontinence is characterized by involuntary leakage of urine associated with physical activity?

<p>Stress incontinence (C)</p> Signup and view all the answers

What is a common side effect of antimuscarinic medications that may affect elderly patients?

<p>Diminished cognitive function (C)</p> Signup and view all the answers

What lifestyle modification is generally recommended to help improve outcomes for urinary incontinence?

<p>Caffeine reduction (A)</p> Signup and view all the answers

Which of the following types of urinary incontinence may occur due to bladder overflow?

<p>Overflow incontinence (C)</p> Signup and view all the answers

Which test is generally not indicated for men when evaluating urinary conditions?

<p>PSA test (C)</p> Signup and view all the answers

What is the minimum number of doses of PrEP required per week for it to be effective in MSM/TGW?

<p>≥4 doses/week (C)</p> Signup and view all the answers

Which condition is contraindicated for the use of PrEP?

<p>Positive HIV test (C)</p> Signup and view all the answers

What is the recommended frequency for STI screening for an individual on PrEP?

<p>Every 3 months (A)</p> Signup and view all the answers

Which test is important to monitor kidney function in patients on PrEP?

<p>Serum creatinine and eGFR (D)</p> Signup and view all the answers

How often should pregnancy testing be conducted in individuals using PrEP?

<p>Every 3 months (D)</p> Signup and view all the answers

What should be done if a patient on PrEP shows signs of acute HIV infection?

<p>Defer PrEP and repeat HIV test in 1-3 weeks (A)</p> Signup and view all the answers

Which drug interaction should be monitored when prescribing TRUVADA for PrEP?

<p>NSAIDs (C)</p> Signup and view all the answers

What is the recommended frequency for lipid panel monitoring with FTC/TAF (DESCOVY)?

<p>Every 12 months (A)</p> Signup and view all the answers

Which of the following is NOT recommended for monitoring individuals on FTC/TAF (DESCOVY)?

<p>Pregnancy testing every 6 months (C)</p> Signup and view all the answers

What is the recommended action if a patient using PrEP shows symptoms indicative of acute HIV infection?

<p>Defer PrEP and repeat HIV test in 1-3 weeks (C)</p> Signup and view all the answers

How long should PrEP be continued after the last potential HIV exposure in heterosexual individuals?

<p>28 days (C)</p> Signup and view all the answers

Which of the following is NOT a standard baseline investigation for initiating PrEP?

<p>CD4 count (B)</p> Signup and view all the answers

What is the recommended frequency for urinalysis for individuals on PrEP?

<p>Optional, based on expert opinion (C)</p> Signup and view all the answers

What is the correct interval for cryotherapy applications?

<p>Every 1-2 weeks (A)</p> Signup and view all the answers

What is the recommended timing for podophyllin resin removal after application?

<p>3-4 hours (B)</p> Signup and view all the answers

By what percentage does suppressive therapy reduce recurrent genital herpes?

<p>70-80% (B)</p> Signup and view all the answers

When using Sinecatechins ointment, what amount should be applied?

<p>0.5 cm (B)</p> Signup and view all the answers

What is the first-line treatment for symptomatic bacterial vaginosis?

<p>Metronidazole (D)</p> Signup and view all the answers

What is the single-dose treatment recommended for uncomplicated UTI in females?

<p>Fosfomycin (A)</p> Signup and view all the answers

For gonococcal urethritis in adults, what is the usual dosage of cefixime?

<p>400 mg single dose (A)</p> Signup and view all the answers

Which of these organisms is the most common cause of acute cystitis in females?

<p>E. coli (C)</p> Signup and view all the answers

What is the usual dosage of TMP/SMX for uncomplicated UTI in children?

<p>5-10 mg/kg/day trimethoprim divided q12h (B)</p> Signup and view all the answers

What is the recommended usual dosage of oral metronidazole for bacterial vaginosis?

<p>500 mg BID for 7 days (A)</p> Signup and view all the answers

What is the usual dosage of ceftriaxone IM for gonococcal urethritis in children under 12 years?

<p>TMP/SMX (D)</p> Signup and view all the answers

What is the usual dosage of Trimethoprim for uncomplicated UTI in females?

<p>200 mg once daily (A)</p> Signup and view all the answers

What is the HIRI-MSM score threshold to indicate a 2% risk of incident HIV?

<p>≥10 (B)</p> Signup and view all the answers

What is the appropriate follow-up period for prescribing PrEP after the initial month?

<p>3 months (C)</p> Signup and view all the answers

Which of the following populations has the highest incidence of HIV diagnoses in Canada?

<p>Indigenous peoples (A)</p> Signup and view all the answers

Which medication is recommended for individuals with a history of fractures or osteoporosis?

<p>DESCOVY (B)</p> Signup and view all the answers

What percentage of HIV cases in Saskatchewan is attributed to people who inject drugs?

<p>50% (A)</p> Signup and view all the answers

How frequently should HIV testing be conducted after starting PrEP?

<p>Every 3 months (C)</p> Signup and view all the answers

Which population is specifically recommended for screening and treating asymptomatic bacteriuria?

<p>During pregnancy and/or pre-operative genitourinary procedures (A)</p> Signup and view all the answers

Which antibiotic is recognized as the first-line treatment for asymptomatic bacteriuria when necessary?

<p>Nitrofurantoin (B)</p> Signup and view all the answers

Which of the following is NOT required as part of the baseline investigations for PrEP?

<p>Chest X-ray (B)</p> Signup and view all the answers

What is the recommended daily dosing for TRUVADA when used as PrEP?

<p>1 tablet once daily (C)</p> Signup and view all the answers

What is the common dosage of TMP/SMX when treating asymptomatic bacteriuria?

<p>2 tabs BID (B), 1 DS tab BID (C)</p> Signup and view all the answers

What is a common transient side effect of PrEP?

<p>Headache (D)</p> Signup and view all the answers

Which organism accounts for the majority (60-70%) of asymptomatic bacteriuria cases?

<p>E.coli (B)</p> Signup and view all the answers

In the on-demand "2-1-1" method of PrEP, how many tablets are taken 2-24 hours before sexual activity?

<p>2 tablets (C)</p> Signup and view all the answers

What is the standard dosage of Fosfomycin for asymptomatic bacteriuria treatment?

<p>3 g dissolved in 1/2 cup of cold water once (D)</p> Signup and view all the answers

What is the first-line antibiotic recommended for acute cystitis in pregnant women?

<p>Cephalexin (A)</p> Signup and view all the answers

How is Nitrofurantoin typically dosed for acute cystitis in pregnant women?

<p>50-100 mg QID (C)</p> Signup and view all the answers

Which antibiotic can be used as a second-line treatment for acute cystitis affecting pregnant women?

<p>Amoxicillin (B)</p> Signup and view all the answers

What is the usual dosage of TMP/SMX for acute cystitis in pregnant women?

<p>1 DS tab BID (A), 2 tabs BID (B)</p> Signup and view all the answers

Which organisms are frequently implicated in causing acute cystitis in pregnant women?

<p>E.coli, Klebsiella, Proteus, Enterococci (C)</p> Signup and view all the answers

Flashcards

Genital Herpes Dosage (Adults)

400 mg of Acyclovir, taken three times a day, for 5 to 10 days, for initial symptomatic episodes.

Genital Herpes Suppressive Therapy (Valacyclovir)

250 mg Valacyclovir twice daily, or 500 mg daily for common suppressive therapy. Increase to 1000 mg daily if having more than 9 episodes a year.

Imiquimod Cream for Genital Warts

Apply Imiquimod 3.75% cream once daily for up to 8 weeks for external genital warts.

Children's Acyclovir Dosage

80 mg/kg/day divided into four doses for 5 to 7 days for the first symptomatic herpes episode.

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Acyclovir Dosage in Pregnancy

Acyclovir 200 mg five times a day or 400 mg TID for 5 to 10 days is both acceptable in pregnancy.

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Podofilox Solution for Genital Warts (Duration)

Apply Podofilox 0.5% solution for 3 days, then take a 4-day rest.

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Herpes Treatment (Immunocompromised)

More aggressive therapies and specialist consultation are crucial for immunocompromised hosts.

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BPH Treatment Goal

The primary aim of pharmacological therapy for BPH is to alleviate urinary symptoms and enhance the patient's quality of life.

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Alpha-Blockers and Cardiovascular Risk

Elderly patients or those with pre-existing heart conditions should be carefully monitored when prescribed alpha-blockers due to potential cardiovascular risks.

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Antimuscarinic Action in BPH

Antimuscarinic medications help manage urgency associated with BPH by increasing bladder capacity and reducing detrusor overactivity.

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Anticholinergic Side Effect

Dry mouth and constipation are common side effects associated with anticholinergic medications used for BPH management.

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Choosing BPH Treatment

The choice between an alpha-blocker and a 5-alpha reductase inhibitor for BPH treatment should be influenced by the severity of symptoms and the presence of complications like urinary retention or obstruction.

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Mirabegron's role

Mirabegron is a medication used to manage bladder overactivity.

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Bladder training goal

The primary goal of bladder training for urgency incontinence is to increase bladder capacity.

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Initial BPH lab test exclusion

Serum testosterone is not typically included in the initial lab tests for BPH evaluation.

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Minimal BPH symptom approach

Reassurance and active surveillance are the recommended approaches for patients with minimal BPH symptoms.

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BPH med class cardiac risk

Alpha-blockers and 5-alpha reductase inhibitors are associated with a heightened risk of cardiac failure in older BPH patients.

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Stress urinary incontinence during pregnancy

Pelvic floor muscle training is the recommended first-line approach for stress urinary incontinence during pregnancy.

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Urinary incontinence physical exam exclusion

Chest X-ray is not a typical component of a physical exam for urinary incontinence.

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Alpha-blocker effectiveness assessment timeframe

The recommended duration for assessing the effectiveness of alpha-blockers in BPH is 4-8 weeks.

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Long-term BPH complication

Long-term bladder outlet obstruction in BPH can lead to urinary tract infections, bladder stones, and hydronephrosis.

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Pelvic floor exercise goal

The primary goal of pelvic floor muscle exercises (PFME) in stress urinary incontinence is to strengthen the pelvic floor muscles.

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First-line treatment for symptomatic bacterial vaginosis

Metronidazole is the first-line treatment for symptomatic bacterial vaginosis.

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Usual dosage of oral metronidazole for bacterial vaginosis

The usual dosage of oral metronidazole for bacterial vaginosis is 500 mg twice a day for 7 days.

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First-line treatment for gonococcal urethritis in adults

Cefixime is the first-line treatment for gonococcal urethritis in adults.

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Usual dosage of cefixime for gonococcal urethritis in adults

The usual dosage of cefixime for gonococcal urethritis in adults is 400 mg as a single dose.

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First-line treatment for UTI in children

TMP/SMX (Trimethoprim/Sulfamethoxazole) is the first-line treatment for UTI in children.

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Usual dosage of TMP/SMX for children with UTI

The usual dosage of TMP/SMX for children with UTI is 5-10 mg/kg/day of trimethoprim divided every 12 hours.

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Second-line treatment for UTI in children

Amoxicillin is recommended as a second-line treatment for UTI in children if TMP/SMX is not effective.

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Single-dose treatment for uncomplicated UTI in females

Fosfomycin is recommended as a single-dose treatment for uncomplicated UTI in females.

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Most probable cause of acute cystitis in females

E. coli is the most probable cause of acute cystitis in females (80-90%).

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Potential drug causes of erectile dysfunction

Opioids, antipsychotics, and anticonvulsants can potentially cause erectile dysfunction.

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Non-pharmacological intervention for premature ejaculation

Start-stop technique, Kegel exercises, and cognitive behavioral therapy are potential non-pharmacological interventions for premature ejaculation.

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Medication for epilepsy improving sexual function

Lamotrigine may improve sexual function in patients with epilepsy.

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Monitoring patients on PDE5 inhibitor therapy

Liver function tests, renal function tests, and complete blood counts are recommended for monitoring patients on long-term PDE5 inhibitor therapy.

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Causes of sexual dysfunction in older adults

Cardiovascular disease, diabetes, and hormonal changes are potential causes of sexual dysfunction in older adults.

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Vaginal dryness treatment in postmenopausal women

Local estrogen therapy is a recommended first-line intervention for vaginal dryness in postmenopausal women.

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Lifestyle modification for erectile function

Smoking cessation, regular physical activity, and limiting alcohol consumption can improve erectile function.

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Initial approach for children with inappropriate sexual behavior

Psychoeducation and behavioral interventions are the recommended initial approach.

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Side effect of alprostadil injections

Penile pain, priapism, and penile fibrosis can be side effects of alprostadil injections.

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Risk of PDE5 inhibitors in cardiovascular disease

Patients with cardiovascular disease need to be careful about taking PDE5 inhibitors.

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Freezing Margin for Cryotherapy

The recommended distance to freeze beyond the wart's edge during cryotherapy is 1-2 mm.

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Vertical Transmission of Herpes at Delivery

The risk of vertical transmission of herpes to a newborn during delivery when a primary herpes outbreak occurs is 30-40%.

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Imiquimod Wash-off Time

Imiquimod 5% cream should be washed off 6-10 hours after application.

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Neonatal Herpes Treatment Duration

Neonatal herpes involving only skin, eyes, and mucous membranes requires a 14-day treatment course.

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Maximum Treatment Area for Providers

For provider-administered therapies, the maximum recommended treatment area is 10 cm².

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Suppressive Therapy's Impact on Herpes Recurrence

Suppressive therapy effectively reduces recurrent genital herpes by 70-80%.

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Podophyllin Removal Timing

Podophyllin resin should be removed 3-4 hours after application.

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First-line UTI Treatment (Children)

Trimethoprim/Sulfamethoxazole (TMP/SMX) is the first-line treatment for UTIs in children.

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Second-line UTI Treatment (Children)

Amoxicillin is recommended as a second-line treatment for UTIs in children if TMP/SMX is not effective.

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First-line UTI Treatment (Nursing Home)

Trimethoprim/Sulfamethoxazole (TMP/SMX) is the first-line treatment for symptomatic UTIs in nursing home residents.

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Second-line UTI Treatment (Nursing Home)

Ciprofloxacin is recommended as a second-line treatment for UTIs in nursing home residents.

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First-line UTI Treatment (Recurrent Cystitis)

Trimethoprim/Sulfamethoxazole (TMP/SMX) is the first-line treatment for early relapse of cystitis in females.

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Second-line UTI Treatment (Recurrent Cystitis)

Norfloxacin is recommended as a second-line treatment for recurrent cystitis in females.

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Single-dose UTI Treatment (Females)

Fosfomycin is recommended as a single-dose treatment for uncomplicated UTIs in females.

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Usual Dosage for Amoxicillin (Children)

The usual dosage of Amoxicillin for UTIs in children is 25-50 mg/kg/day divided every 6 hours.

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Usual Dosage for Cephalexin (Children)

The usual dosage of Cephalexin for UTIs in children is 25-50 mg/kg/day divided every 6 hours.

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Initial lab test exclusion for BPH

Serum testosterone is typically not included in the initial lab tests for BPH evaluation.

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BPH with minimal symptoms - Approach

Reassurance and active surveillance are recommended for patients with minimally bothersome BPH symptoms.

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Medications increasing cardiac risk in BPH

Alpha-blockers and 5-alpha reductase inhibitors increase the risk of new cardiac failure in patients over 66 years old with BPH.

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Urinary Incontinence Types

There are several types of urinary incontinence, including stress incontinence (leakage with physical activity), urgency incontinence (sudden urge to urinate), overflow incontinence (inability to fully empty the bladder), and functional incontinence (physical or cognitive limitations causing leakage).

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Most Common Urinary Incontinence in Adults

Stress incontinence is the most prevalent type of urinary incontinence in adults, usually triggered by activities like coughing, sneezing, or exercise.

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Pelvic Floor Muscle Exercises (PFME)

PFME involve strengthening the pelvic floor muscles that help control urination. They can help with various types of incontinence.

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First-line Treatment for Urgency Incontinence

Antimuscarinics are the first-line medication choice for urgency incontinence, but caution is required in elderly patients due to potential dementia risk.

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Pregnancy and Urinary Incontinence

Stress incontinence is the most common type of incontinence during pregnancy.

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Initial BPH Lab Tests

Serum testosterone is typically not included in the initial lab tests for BPH evaluation.

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Bladder Training for Urgency Incontinence

Bladder training aims to increase bladder capacity, allowing for longer intervals between urination.

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PrEP Doses for MSM/TGW

For PrEP to be effective in men who have sex with men (MSM) and transgender women (TGW), at least four doses per week are needed to be taken.

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PrEP Contraindication

A person who has a positive HIV test cannot take PrEP as it's designed to prevent HIV infection, not treat it.

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PrEP STI Screening Frequency

If you're on PrEP, regular screening for sexually transmitted infections (STIs) is crucial. You should get tested every 3 months.

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PrEP Kidney Function Monitoring

To monitor kidney function, serum creatinine and estimated glomerular filtration rate (eGFR) tests are recommended for people on PrEP.

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Pregnancy Testing on PrEP

Women on PrEP should get a pregnancy test every 3 months, just like the STI screenings.

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PrEP During Acute HIV Infection

If you're on PrEP and develop symptoms of acute HIV infection, stop PrEP and get an HIV test again in 1-3 weeks.

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TRUVADA PrEP: Drug Interaction

When prescribing Truvada for PrEP, monitor for interactions with nonsteroidal anti-inflammatory drugs (NSAIDs).

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TRUVADA's Impact on Bone

Truvada can potentially decrease bone mineral density, so it's good to be aware of this side effect.

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PrEP Duration After Exposure (Heterosexual)

For heterosexual individuals, continue PrEP for 28 days after the last potential HIV exposure.

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Recent High-Risk Exposure: Action

If someone has a recent (within 72 hours) high-risk HIV exposure, refer them for post-exposure prophylaxis (nPEP).

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Acyclovir Dosage for Initial Herpes

For adults with their first symptomatic herpes episode, the recommended Acyclovir dosage is 400 mg three times a day for 5 to 10 days.

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Valacyclovir Suppressive Therapy

For chronic herpes suppression, Valacyclovir is typically prescribed at 250 mg twice a day or 500 mg daily. If a patient has more than 9 episodes per year, the dosage can be increased to 1000 mg daily.

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Acyclovir Prophylaxis for Pregnancy (Previous Infection)

If a pregnant woman has had a herpes infection within the past year, prophylactic Acyclovir can be prescribed at either 200 mg four times a day or 400 mg three times a day.

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What is the INITIAL lab test exclusion for BPH evaluation?

Serum testosterone is typically not included in the initial laboratory tests for BPH evaluation.

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What is the primary goal of pelvic floor muscle exercises?

The primary goal of pelvic floor muscle exercises is to strengthen the pelvic floor muscles to improve urinary control.

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What is the recommended duration of treatment before assessing the effectiveness of pelvic floor muscle exercises?

It's recommended to continue pelvic floor muscle exercises for 6-8 weeks before assessing their effectiveness.

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What is the recommended duration of treatment with alpha-blockers before assessing their effectiveness in BPH?

The recommended duration for assessing the effectiveness of alpha-blockers in BPH is 4-8 weeks.

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BPH Medication Risk

Alpha-blockers and 5-alpha reductase inhibitors can increase the risk of new cardiac failure in BPH patients over 66 years old.

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Minimal BPH: Approach

For patients with minimal BPH symptoms, the recommended approach is reassurance and active surveillance.

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What is bladder training's goal?

The primary objective of bladder training for urgency incontinence is to increase bladder capacity.

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BPH: What is the recommended treatment approach?

Reassurance and active surveillance are recommended for patients with minimal BPH symptoms.

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Bladder Training

Bladder training involves gradually increasing the time between urinations to increase bladder capacity and control urgency incontinence.

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First-line antibiotic for bacterial vaginosis

Metronidazole is the preferred first-line treatment for symptomatic bacterial vaginosis.

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Usual Metronidazole dosage for vaginosis

The standard dosage for oral metronidazole for bacterial vaginosis is 500 mg twice daily for 7 days.

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First-line antibiotic for gonococcal urethritis in adults

Cefixime is the recommended first-line treatment for gonococcal urethritis in adults.

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Usual Cefixime dosage for gonococcal urethritis in adults

The standard dosage for cefixime for gonococcal urethritis in adults is 400 mg as a single dose.

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First-line antibiotic for UTI in children

Trimethoprim/Sulfamethoxazole (TMP/SMX) is the preferred first-line treatment for UTIs in children.

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Usual TMP/SMX dosage for children with UTI

The usual dosage for TMP/SMX for children with UTIs is 5-10 mg/kg/day of trimethoprim divided every 12 hours.

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Second-line antibiotic for UTI in children

Amoxicillin is recommended as a second-line treatment option for UTIs in children if TMP/SMX is not effective.

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Organism causing acute cystitis in females

E. coli is the most frequent cause of acute cystitis in females, accounting for 80-90% of cases.

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Asymptomatic bacteriuria - screening?

Asymptomatic bacteriuria should be screened and treated only during pregnancy and before genitourinary surgeries.

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Asymptomatic bacteriuria - first-line treatment?

Nitrofurantoin is the first-line antibiotic for asymptomatic bacteriuria when treatment is necessary.

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Asymptomatic bacteriuria - usual dosage?

The usual dosage for TMP/SMX to treat asymptomatic bacteriuria is 2 tabs BID or 1 DS tab BID.

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Asymptomatic bacteriuria - most common cause?

E. coli is the most common cause of asymptomatic bacteriuria, accounting for 60-70% of cases.

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Fosfomycin dosage?

Fosfomycin, for asymptomatic bacteriuria, is typically given as a single dose of 3 grams dissolved in half a cup of cold water.

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Acute cystitis in pregnant women - first-line?

Cephalexin is the first-line antibiotic for acute cystitis in pregnant women.

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Nitrofurantoin dosage for cystitis in pregnancy

The usual dosage of Nitrofurantoin for acute cystitis in pregnant women is 50-100 mg QID or Macrobid 100 mg BID.

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Second-line cystitis treatment in pregnancy

Amoxicillin is recommended as a second-line treatment for acute cystitis in pregnant women.

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TMP/SMX for cystitis in pregnancy - dosage?

The usual dosage of TMP/SMX for acute cystitis in pregnant women is 2 tabs BID or 1 DS tab BID.

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Acute cystitis in pregnancy - causes

The most probable causes of cystitis in pregnancy include E. coli, Klebsiella, Proteus, and Enterococci.

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PrEP Testing Frequency

After starting PrEP, individuals should get an HIV test every 3 months to monitor for potential infection.

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PrEP Baseline Investigation

Before starting PrEP, a baseline evaluation should include an HIV test, Hepatitis B serology, and creatinine clearance.

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PrEP: Acute HIV Infection

If a patient on PrEP experiences symptoms of acute HIV infection, they should stop PrEP and get an HIV test again in 1-3 weeks.

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PrEP Education Topic

When starting PrEP, patients should be educated about the importance of adherence, potential side effects, and ongoing HIV risk reduction strategies.

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PrEP Duration After Exposure (Hetero)

For heterosexual individuals, continue PrEP for 28 days after the last potential HIV exposure.

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What is PrEP?

PrEP stands for Pre-Exposure Prophylaxis. It's a daily medication that helps prevent HIV infection in people who are at risk.

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Who needs PrEP?

People who are at high risk of getting HIV, such as those who have unprotected sex with multiple partners or those who use needles to inject drugs.

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How often should PrEP be prescribed initially?

PrEP should be prescribed initially for 1 month.

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How often should HIV testing be done after starting PrEP?

HIV testing is recommended every 3 months after starting PrEP.

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What is the daily dose for TRUVADA PrEP?

The recommended daily dose for TRUVADA PrEP is 1 tablet once daily.

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What is the "2-1-1" on-demand method for PrEP?

The "2-1-1" method involves taking 2 tablets 2-24 hours before sexual activity.

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What is a side effect of PrEP?

A common side effect of PrEP is headache, which is usually temporary.

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Who is the "2-1-1" on-demand method recommended for?

The "2-1-1" on-demand method is recommended for men who have sex with men (MSM) and transgender women (TGW) only.

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What is the potential risk of stopping PrEP in Hepatitis B patients?

Stopping PrEP in Hepatitis B patients can lead to a Hepatitis B flare, where the virus becomes more active.

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What medication might be preferred for people with osteoporosis?

DESCOVY might be preferred over TRUVADA for individuals with a history of fractures or osteoporosis.

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Study Notes

  • Acyclovir (genital herpes, adults): 400 mg TID for 5 to 10 days.
  • Valacyclovir (chronic suppressive therapy of genital herpes): 250 mg BID or 500 mg daily; 1000 mg daily if >9 episodes per year.
  • Imiquimod 3.75% cream (external genital warts): Once daily for up to 8 weeks.
  • Acyclovir (genital herpes, children): 80 mg/kg/day divided QID for 5 to 7 days.
  • Acyclovir (genital herpes, pregnancy): 200 mg 5 times daily or 400 mg TID for 5 to 10 days (both a and b are correct).
  • Podofilox 0.5% solution (external genital warts): 3 days on, 4 days off.

Other Treatments and Dosages

  • Sinecatechins 10% ointment (genital warts): Up to 16 weeks.
  • Acyclovir (acute recurrent herpes, children): Either 200 mg 5 times daily or 400 mg TID for 5 days.
  • Podofilox treatment cycles: Maximum of 4 cycles.
  • TCA treatment (genital warts): 80-90% in ethyl alcohol.
  • Valacyclovir (acute recurrent herpes): 500 mg BID for 3 days or 1000 mg daily for 5 days.
  • Famciclovir (chronic suppressive therapy): 250 mg BID.
  • Cryotherapy treatment (genital warts): Maximum 8 weeks.
  • EMLA cream (before TCA treatment): 10-20 minutes.

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