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Questions and Answers
A 24-year-old female presents with lower abdominal pain, fever, and vaginal discharge for 4 days. On exam, cervical motion tenderness is noted. What is the most likely diagnosis?
A 24-year-old female presents with lower abdominal pain, fever, and vaginal discharge for 4 days. On exam, cervical motion tenderness is noted. What is the most likely diagnosis?
A 30-year-old male reports dysuria and a purulent penile discharge. NAAT confirms Neisseria gonorrhoeae. What is the recommended treatment?
A 30-year-old male reports dysuria and a purulent penile discharge. NAAT confirms Neisseria gonorrhoeae. What is the recommended treatment?
A 19-year-old woman presents with yellow-green, frothy vaginal discharge and vulvar itching. A wet mount reveals motile organisms. What is the most appropriate treatment?
A 19-year-old woman presents with yellow-green, frothy vaginal discharge and vulvar itching. A wet mount reveals motile organisms. What is the most appropriate treatment?
A 32-year-old male presents with a painless ulcer on the penis and rubbery, painless lymphadenopathy. What is the next best diagnostic step?
A 32-year-old male presents with a painless ulcer on the penis and rubbery, painless lymphadenopathy. What is the next best diagnostic step?
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A 27-year-old female with recurrent vulvovaginal candidiasis is treated with fluconazole weekly for six months. What defines recurrent infection?
A 27-year-old female with recurrent vulvovaginal candidiasis is treated with fluconazole weekly for six months. What defines recurrent infection?
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A 45-year-old man develops fever, arthralgia, and pustular rash involving the palms. He recently tested positive for gonorrhea. What is the most likely diagnosis?
A 45-year-old man develops fever, arthralgia, and pustular rash involving the palms. He recently tested positive for gonorrhea. What is the most likely diagnosis?
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A patient presents with painful grouped vesicles on the genital area. What is the gold standard diagnostic test for the suspected infection?
A patient presents with painful grouped vesicles on the genital area. What is the gold standard diagnostic test for the suspected infection?
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A 22-year-old woman presents with pelvic pain, fever, and cervical motion tenderness. What is the outpatient treatment of choice for her condition?
A 22-year-old woman presents with pelvic pain, fever, and cervical motion tenderness. What is the outpatient treatment of choice for her condition?
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A 16-year-old girl presents for her HPV vaccine series. What is the recommended dosing schedule if the first dose was received at age 11?
A 16-year-old girl presents for her HPV vaccine series. What is the recommended dosing schedule if the first dose was received at age 11?
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A patient with primary syphilis is treated with benzathine penicillin G. What side effect should they be warned about?
A patient with primary syphilis is treated with benzathine penicillin G. What side effect should they be warned about?
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A 35-year-old woman presents with foul-smelling, thin, white vaginal discharge. The pH of the vaginal fluid is >4.5, and a whiff test is positive. What is the most likely diagnosis?
A 35-year-old woman presents with foul-smelling, thin, white vaginal discharge. The pH of the vaginal fluid is >4.5, and a whiff test is positive. What is the most likely diagnosis?
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A pregnant woman tests positive for Chlamydia during her first prenatal visit. What is the most appropriate treatment?
A pregnant woman tests positive for Chlamydia during her first prenatal visit. What is the most appropriate treatment?
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A 28-year-old male presents with dysuria and clear penile discharge. NAAT testing is negative for gonorrhea and chlamydia. What is the next best step?
A 28-year-old male presents with dysuria and clear penile discharge. NAAT testing is negative for gonorrhea and chlamydia. What is the next best step?
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A 29-year-old female presents with genital ulcers and tender inguinal lymphadenopathy. Darkfield microscopy confirms Treponema pallidum. What stage of syphilis does she have?
A 29-year-old female presents with genital ulcers and tender inguinal lymphadenopathy. Darkfield microscopy confirms Treponema pallidum. What stage of syphilis does she have?
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A 25-year-old male presents with fever, chills, and painful unilateral scrotal swelling. What is the most likely cause?
A 25-year-old male presents with fever, chills, and painful unilateral scrotal swelling. What is the most likely cause?
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A 23-year-old woman presents with diffuse, non-pruritic maculopapular rash on her palms and soles. She has fever and generalized lymphadenopathy. What is the most likely diagnosis?
A 23-year-old woman presents with diffuse, non-pruritic maculopapular rash on her palms and soles. She has fever and generalized lymphadenopathy. What is the most likely diagnosis?
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A 30-year-old male with a history of genital herpes presents with recurrent painful vesicles. What is the best option for long-term suppression?
A 30-year-old male with a history of genital herpes presents with recurrent painful vesicles. What is the best option for long-term suppression?
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A 33-year-old woman presents with painless genital warts. Which HPV types are most commonly associated with her condition?
A 33-year-old woman presents with painless genital warts. Which HPV types are most commonly associated with her condition?
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A patient presents with pelvic pain and purulent vaginal discharge. She has no known allergies. What is the inpatient regimen for this condition?
A patient presents with pelvic pain and purulent vaginal discharge. She has no known allergies. What is the inpatient regimen for this condition?
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A 40-year-old man with untreated HIV presents with a painless, beefy-red ulcerative lesion in the perineal area. What is the most likely diagnosis?
A 40-year-old man with untreated HIV presents with a painless, beefy-red ulcerative lesion in the perineal area. What is the most likely diagnosis?
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A 25-year-old male presents with dysuria and purulent penile discharge. Gram stain shows intracellular gram-negative diplococci. What is the next best step in treatment?
A 25-year-old male presents with dysuria and purulent penile discharge. Gram stain shows intracellular gram-negative diplococci. What is the next best step in treatment?
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A 30-year-old female presents with malodorous vaginal discharge and vaginal itching. A wet mount shows “clue cells.” What is the first-line treatment?
A 30-year-old female presents with malodorous vaginal discharge and vaginal itching. A wet mount shows “clue cells.” What is the first-line treatment?
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A 22-year-old female presents with diffuse yellow-green vaginal discharge and vulvar irritation. Wet mount reveals motile flagellated organisms. What is the associated complication during pregnancy?
A 22-year-old female presents with diffuse yellow-green vaginal discharge and vulvar irritation. Wet mount reveals motile flagellated organisms. What is the associated complication during pregnancy?
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A 28-year-old male presents with painful genital ulcers and tender inguinal lymphadenopathy. PCR testing confirms Haemophilus ducreyi. What is the treatment of choice?
A 28-year-old male presents with painful genital ulcers and tender inguinal lymphadenopathy. PCR testing confirms Haemophilus ducreyi. What is the treatment of choice?
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A 20-year-old woman with multiple sexual partners presents with dysuria and mucopurulent cervical discharge. Cervical motion tenderness is present. NAAT confirms Chlamydia trachomatis. What is the recommended follow-up?
A 20-year-old woman with multiple sexual partners presents with dysuria and mucopurulent cervical discharge. Cervical motion tenderness is present. NAAT confirms Chlamydia trachomatis. What is the recommended follow-up?
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A 45-year-old male presents with grouped vesicles on an erythematous base on his genitalia. He reports similar episodes in the past. What is the recommended management?
A 45-year-old male presents with grouped vesicles on an erythematous base on his genitalia. He reports similar episodes in the past. What is the recommended management?
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A 32-year-old woman presents for routine cervical cancer screening. She is 32 years old and has no history of abnormal results. What is the recommended screening interval?
A 32-year-old woman presents for routine cervical cancer screening. She is 32 years old and has no history of abnormal results. What is the recommended screening interval?
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Flashcards
Flashcards
Flashcards
Cards used for reinforcing memory through active recall.
Active Recall
Active Recall
Retrieving information from memory to enhance learning.
Testing Effect
Testing Effect
Improved retention of information through retrieval practice.
Memory Tip
Memory Tip
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Definition
Definition
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Hint
Hint
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Concept
Concept
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Atomic Concepts
Atomic Concepts
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Visualization
Visualization
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Progressive Learning
Progressive Learning
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Study Notes
STI Study Notes
- Epidemiology of STIs: Rates of certain STIs (like Chlamydia, Gonorrhea, Syphilis, and HPV) are rising. COVID-19 impacted routine testing and treatment access.
STI Prevention
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Behavioral Interventions: Education on safe sex practices is crucial, as is screening high-risk populations.
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Vaccinations: HPV vaccination is recommended, with specific schedules based on age. Routine vaccination is recommended for adolescents aged 11-12, with catch-up schedules for those older.
Common Presentations and Associated STIs
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Genital Ulcers: Herpes simplex virus (HSV) presents with painful vesicles; Treponema pallidum (syphilis) presents with painless chancres; and Haemophilus ducreyi (chancroid) with painful ulcers and tender lymphadenopathy.
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Urethritis/Cervicitis: Neisseria gonorrhoeae often presents with a purulent discharge, while Chlamydia trachomatis, and Mycoplasma genitalium show mild or no symptoms. In the case of trichomonas vaginalis frothy and yellowish vaginal dischage is present.
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Vaginal Discharge: - Different types of vaginal discharge have key characteristics. Bacterial vaginosis (BV) may present with a fishy odor and clue cells; vulvovaginal candidiasis (VVC) with a thick, white, curd-like discharge and vaginal pH over 4.5.
Diagnostic Tools
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NAAT (Nucleic Acid Amplification Tests): The gold standard for detecting gonorrhea, chlamydia, and trichomoniasis.
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Wet Mount Microscopy: Essential for detecting clue cells for bacterial vaginosis and motile trichomonads for trichomoniasis.
Treatment Guidelines
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Gonorrhea: Ceftriaxone 500 mg IM single dose, with considerations for additional treatments if Chlamydia is also present.
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Chlamydia: Doxycycline is recommended for non-pregnant patients and azithromycin for the pregnant patient.
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Trichomoniasis: Metronidazole 2 g PO single dose or 500 mg PO BID for 7 days; the partner needs treatment as well.
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Bacterial Vaginosis (BV): Metronidazole 500mg PO BID x 7 days
Complications
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Pelvic Inflammatory Disease (PID): Untreated PID can lead to infertility.
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Congenital Syphilis: Significant morbidity and mortality can result from untreated syphilis during pregnancy.
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HPV Complications: HPV 16 and 18 are strongly linked to cancers of the cervix, anus, vulva, vagina, penis, and oropharynx, while HPV 6 and 11 are responsible for over 90% of genital warts.
Special Populations
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Pregnancy: Certain treatments should be adapted and certain STIs need to be treated very carefully during pregnancy. Doxycycline, for example, should be avoided.
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Neonatal STIs: Ophthalmia neonatorum is a concern for Chlamydia or Neisseria gonorrhoeae.
High-Yield Visual Clues
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Strawberry cervix: Trichomonas vaginalis.
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Beefy-red ulcers: Granuloma inguinale.
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Maculopapular rash: Secondary syphilis.
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Grouped vesicles: Genital herpes.
Follow-Up and Prevention
- Retesting: Retesting for gonorrhea, chlamydia, and trichomoniasis is recommended.
- Screening Guidelines: Annual STI screening is recommended, particularly for sexually active individuals.
Special Conditions
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Recurrent Vulvovaginal Candidiasis: Defined as ≥3 episodes/year, treated with weekly fluconazole.
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Jarisch-Herxheimer Reaction: A self-limiting, febrile reaction following penicillin treatment for syphilis.
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Description
This quiz covers the epidemiology, prevention strategies, and common presentations of sexually transmitted infections (STIs). It focuses on rates of STIs, the importance of behavioral interventions, and specific vaccinations like HPV. Understand symptoms associated with STIs such as genital ulcers and urethritis.
