CMN 572 - FINAL EXAM REVIEW QUESTIONS
Most frequently reported infectious disease in US - Answer -chlamydia
Transmission of chlamydia - Answer -sexual, vertical
Incubation - 7-21 days
C. Trachomatis
Risk factors for chlamydia - Answer -adolescence
New/multiple partners
Hx of STD
Presence of STD
OC user
No barrier contraception
First line treatment for chlamydia - uncomplicated, >8yo - Answer -azithromycin 1g PO
x 1 OR doxy BID x 7 days
First line treatment for chlamydia - pregnant patients - Answer -azithromycin PO x 1
First line treatment for chlamydia - neonatal conjunctivitis/pneumonia, children <45kg -
Answer -erythromycin base or ethylsuccinate 4 doses x 14 days
First line treatment for chlamydia - children >45kg AND <8yo - Answer -azithromycin 1g
PO x 1
First line treatment for chlamydia - LGV - Answer -doxy BID x 21 days
Labs tests for chlamydia - Answer -culture - vaginal/penis, gold standard
NAAT - urine, co-testing for GC
Serology
Need for test for cure with chlamydia in non-pregnant patients? - Answer -not
necessary unless questionable compliance or re-infection suspected; screen at next
healthcare visit
Need for test for cure with chlamydia in adolescents? - Answer -retest 3-4 months after
treatment
Need for test for cure with chlamydia in pregnant patients? - Answer -repeat NAAT 3
weeks after therapy, then again in 3 months
Screening for chlamydia reduces risk for? - Answer -PID-NAAT
Screening guidelines for chlamydia - Answer -sexually active, <25yo - annual
,Sexually active, >25yo - if RF present
Pregnancy - first prenatal visit; if 25yo with increased risk, screen again at third trimester
Is chlamydia reportable? - Answer -yes, in all states
Partner treatment - chlamydia - Answer -evaluate/tx all partners within 60 days
preceding diagnosis
Evaluate/tx most recent partner, even if last sexual contact >60 days
Patient education - chlamydia - Answer -no sex until partner is treated
Abstain from sex until 7 days post treatment
Use latex condoms
Signs and symptoms - chlamydia - Answer -may be asymptomatic
Mucopurulent endocervical discharge, dysuria
Conjunctivitis, urethritis, proctitis, cervicitis
Signs/symptoms of chlamydia in infants - Answer -conjunctivitis, pneumonitis,
pharyngitis, rhinitis
Complications of chlamydia - Answer -PID, salpingitis, endometritis, Fitz-Hugh-Curtis
syndrome
Transmission of gonorrhea - Answer -sexual/vertical
N. Gonorrhoeae
Risk factors - gonorrhea - Answer -new/multiple partners
No condoms
Adolescents
Drug use
Low socio-economic class
Prostitution
African Americans
First line treatment of uncomplicated gonorrhea - Answer -ceftriaxone IM x 1 PLUS
azithromycin 1g PO x 1
First line treatment of gonorrhea - pregnant patients - Answer -ceftriaxone IM x 1 PLUS
azithromycin 1g PO x 1
First line treatment of gonorrhea - pencillin allergy (severe rx - anaphylaxis, SJS) -
Answer -refer to ID
Gemifloxacin PO PLUS azithromycin PO x 1
OR gentamycin IM x 1 PLUS azithromycin PO x 1
Tests for gonorrhea - Answer -culture - urethral for men, cervical for women
, Must do culture if sexual abuse suspected
NAAT - urine
Gram stain - highly specific/sensitive
Test for cure for gonorrhea needed for non-pregnant patients? - Answer -not
recommended if regimen is administered
Test for cure for gonorrhea - persistent s/s - Answer -repeat culture to test for
antimicrobial susceptibility
When to retest for gonorrhea - Answer -in 3 months, if risk of reinfection
Screening guidelines for gonorrhea - Answer -pregnancy - first prenatal visit; if
increased risk, screen again at third trimester
At-risk MWM - at least annual, rectal/pharyngeal GC
Sexually active women - all who are at risk
Is gonorrhea reportable? - Answer -yes, in all states
Partner treatment - gonorrhea - Answer -evaluate/tx all partners within 60 days
preceding diagnosis
Evaluate/tx most recent partner even if last sexual contact >60 days
Patient education - gonorrhea - Answer -no sex until partner treated
Abstain until 7 days post treatment
HIV transmission - higher risk
S/s gonorrhea - Answer -males - symptomatic, females - asymptomatic
Purulent discharge, inflammation of cervix/uterus
Anorectal infection, conjunctivitis, DGI, pharyngeal infection
Men -urethritis, epididymitis, unilateral testicular pain
Women - cervicitis, vaginal d/c, intermenstrual bleeding, dysuria, lower AP,
dyspareunia, easily induced cervical bleeding
Complications of gonorrhea - Answer -PID - infertility, accessory gland infection, Fitz-
Hugh-Curtis syndrome
Syphilis - Answer -chronic infection, progresses in stages
Most contagious stages of syphilis - Answer -primary, secondary
Timing of primary syphilis - Answer -heals in 3-6 weeks spontaneously
Serologic tests sometimes negative
Features of primary syphilis - Answer -chancre - painless, indurated, clean base at
inoculation site
Most frequently reported infectious disease in US - Answer -chlamydia
Transmission of chlamydia - Answer -sexual, vertical
Incubation - 7-21 days
C. Trachomatis
Risk factors for chlamydia - Answer -adolescence
New/multiple partners
Hx of STD
Presence of STD
OC user
No barrier contraception
First line treatment for chlamydia - uncomplicated, >8yo - Answer -azithromycin 1g PO
x 1 OR doxy BID x 7 days
First line treatment for chlamydia - pregnant patients - Answer -azithromycin PO x 1
First line treatment for chlamydia - neonatal conjunctivitis/pneumonia, children <45kg -
Answer -erythromycin base or ethylsuccinate 4 doses x 14 days
First line treatment for chlamydia - children >45kg AND <8yo - Answer -azithromycin 1g
PO x 1
First line treatment for chlamydia - LGV - Answer -doxy BID x 21 days
Labs tests for chlamydia - Answer -culture - vaginal/penis, gold standard
NAAT - urine, co-testing for GC
Serology
Need for test for cure with chlamydia in non-pregnant patients? - Answer -not
necessary unless questionable compliance or re-infection suspected; screen at next
healthcare visit
Need for test for cure with chlamydia in adolescents? - Answer -retest 3-4 months after
treatment
Need for test for cure with chlamydia in pregnant patients? - Answer -repeat NAAT 3
weeks after therapy, then again in 3 months
Screening for chlamydia reduces risk for? - Answer -PID-NAAT
Screening guidelines for chlamydia - Answer -sexually active, <25yo - annual
,Sexually active, >25yo - if RF present
Pregnancy - first prenatal visit; if 25yo with increased risk, screen again at third trimester
Is chlamydia reportable? - Answer -yes, in all states
Partner treatment - chlamydia - Answer -evaluate/tx all partners within 60 days
preceding diagnosis
Evaluate/tx most recent partner, even if last sexual contact >60 days
Patient education - chlamydia - Answer -no sex until partner is treated
Abstain from sex until 7 days post treatment
Use latex condoms
Signs and symptoms - chlamydia - Answer -may be asymptomatic
Mucopurulent endocervical discharge, dysuria
Conjunctivitis, urethritis, proctitis, cervicitis
Signs/symptoms of chlamydia in infants - Answer -conjunctivitis, pneumonitis,
pharyngitis, rhinitis
Complications of chlamydia - Answer -PID, salpingitis, endometritis, Fitz-Hugh-Curtis
syndrome
Transmission of gonorrhea - Answer -sexual/vertical
N. Gonorrhoeae
Risk factors - gonorrhea - Answer -new/multiple partners
No condoms
Adolescents
Drug use
Low socio-economic class
Prostitution
African Americans
First line treatment of uncomplicated gonorrhea - Answer -ceftriaxone IM x 1 PLUS
azithromycin 1g PO x 1
First line treatment of gonorrhea - pregnant patients - Answer -ceftriaxone IM x 1 PLUS
azithromycin 1g PO x 1
First line treatment of gonorrhea - pencillin allergy (severe rx - anaphylaxis, SJS) -
Answer -refer to ID
Gemifloxacin PO PLUS azithromycin PO x 1
OR gentamycin IM x 1 PLUS azithromycin PO x 1
Tests for gonorrhea - Answer -culture - urethral for men, cervical for women
, Must do culture if sexual abuse suspected
NAAT - urine
Gram stain - highly specific/sensitive
Test for cure for gonorrhea needed for non-pregnant patients? - Answer -not
recommended if regimen is administered
Test for cure for gonorrhea - persistent s/s - Answer -repeat culture to test for
antimicrobial susceptibility
When to retest for gonorrhea - Answer -in 3 months, if risk of reinfection
Screening guidelines for gonorrhea - Answer -pregnancy - first prenatal visit; if
increased risk, screen again at third trimester
At-risk MWM - at least annual, rectal/pharyngeal GC
Sexually active women - all who are at risk
Is gonorrhea reportable? - Answer -yes, in all states
Partner treatment - gonorrhea - Answer -evaluate/tx all partners within 60 days
preceding diagnosis
Evaluate/tx most recent partner even if last sexual contact >60 days
Patient education - gonorrhea - Answer -no sex until partner treated
Abstain until 7 days post treatment
HIV transmission - higher risk
S/s gonorrhea - Answer -males - symptomatic, females - asymptomatic
Purulent discharge, inflammation of cervix/uterus
Anorectal infection, conjunctivitis, DGI, pharyngeal infection
Men -urethritis, epididymitis, unilateral testicular pain
Women - cervicitis, vaginal d/c, intermenstrual bleeding, dysuria, lower AP,
dyspareunia, easily induced cervical bleeding
Complications of gonorrhea - Answer -PID - infertility, accessory gland infection, Fitz-
Hugh-Curtis syndrome
Syphilis - Answer -chronic infection, progresses in stages
Most contagious stages of syphilis - Answer -primary, secondary
Timing of primary syphilis - Answer -heals in 3-6 weeks spontaneously
Serologic tests sometimes negative
Features of primary syphilis - Answer -chancre - painless, indurated, clean base at
inoculation site
