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NURG 603 STIs EXAM STUDY GUIDE
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NURG 603 STIs EXAM STUDY GUIDEGonorrhea (GC)
Causative Organism
Most common Symptoms
i. Causative organisms
1. N. Gonorrhoea
2. Assume concomitant infection with C. trachomatis unless ruled out by
appropriate testing
ii. most common symptoms
1. Frequently asymptomatic
2. Urinary frequency and dysuria
3. Purulent vaginal discharge: greenish yellow
4. Bartholin’s gland infection, abscess, or cyst formation is highly suggestive of
infection with N. gonorrhoea
5. Urethritis (men): mucopurulent or purulent discharge from the urethra
Gonorrhea (GC)
Diagnostic Testing
iii. test/tests used for diagnosis
1. Test endocervical, vaginal, or urine specimens by culture, nucleic hybridization,
or NAAT (should also always TEST FOR CHLAMYDIA TOO)
,2. Gram stain in symptomatic men (not recommended as definitive testing for
women or asymptomatic men)
3. Urine screening for adolescents reluctant to have pelvic examination or where
the pelvic exam is not feasible
4. Pharyngeal & anorectal infections should be considered based on sexual
practices elicited during sexual history
5. Reportable
Gonorrhea (GC)
Treatment
iv. Treatment
1. Ceftriaxone 250 mg IM plus azithromycin 1 g PO in a single dose
2. Cefixime 400 mg PO one-time dose (if ceftriaxone not an option)
3. Additional to gonorrhoea treatment
a. plus azithromycin 1 g PO in a single dose
b. (Or) Doxycycline 100 mg PO BID x 7 days (for coverage of Chlamydia)
Gonorrhea (GC)
Patient Education
ACOG Recommendations
v. education you would give someone with the following suspected diagnoses
1. Advise all patients with gonorrhoea to be retested in 3 months
2. Encourage re-testing whenever these patients seek medical care within the
following 12 months
3. Sexual partners need treatment
vi. latest ACOG or CDC screening guidelines (if applicable)
1. ACOG recommends annual screening in sexually active adolescents to 24 (or 25
,and younger??) years of age
Chlamydia
Causative Organism
Most common symptoms
i. Causative organisms
1. Gram-negative obligate intracellular bacterium
2. Most frequently reported infectious disease in the US
3. Reportable
ii. most common symptoms
1. Often asymptomatic
2. Abnormal vaginal discharge with cervical inflammation
3. Salpingitis: infection of the fallopian tubes caused by ascending infection
Chlamydia
Diagnostic Testing
i. test/tests used for diagnosis
1. Culture
2. Direct immunofluorescence
3. Enzyme immunoassay (EIA)
4. Nucleic acid hybridizations tests ( NAATs)[most sensitive] and FDA approved
for urine
a. Swabs: vagina, urethral, rectal, oral
Chlamydia
Treatment
i. Treatment
, 1. Azithromycin 1 gram PO in a single dose or
2. Doxycycline 100 mg PO twice a day for 7 days
Chlamydia
Patient Education
ACOG recommendations
i. education you would give someone with the following suspected diagnoses
1. abstain from intercourse x 7 days
2. treat sexual partners
ii. latest ACOG or CDC screening guidelines (if applicable)
1. All sexually active women under the age of 25 should be screened annually
2. Women over 25 with risk factors should be screened annually
3. Test of cure recommended 4 weeks after treatment for pregnant women
4. Test of cure not advised unless: therapeutic compliance is in question, symptoms
persist, or re-infection is suspected
5. Retest in 3 months after treatment (not as TOC (test of cure) rather b/c they are
likely to get re-infected)
HSV-1 & HSV-2
Causative Organism
Common Symptoms
i. causative organisms
1. Herpes Simplex Virus II (HSV II)
2. Herpes Simplex Virus I (increasing due to oral sex)
3. Most cases of recurrent genital herpes are caused by HSV 2, and most of these
patients have not been diagnosed with genital herpes
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