CMN 572 STD REAL ESTATE EXAM
QUESTIONS WITH CORRECT
ANSWERS
Clinical manifestations of primary syphilis? - Answer-Chancre develop at site of
inoculation and progress to ulcers, typically painless, indurated, and highly infectious
Regional Lymphadenopathy: classically rubbery, painless, bilateral
**Serologic tests for syphilis may not be positive during early primary syphilis**
Secondary Syphilis: - Answer-Secondary lesions occur several wks after primary
appears; Mucocutaneous lesions most common- SXS include: palmar/plantar rash,
lymphadenopathy, malaise, mucous patches, etc...
**Serologic tests are usually highest in titer during this stage**
Latent Syphilis - Answer-Host suppresses infection, but positive serologic tests. May
occur between primary/secondary stages, between secondary relapses, and after
secondary stage
Early Latent: < 1 year
Late Latent: >/= 1 year
How do we diagnose syphilis? - Answer-Darkfield microscopy= identification of
Treponema Pallidum
Serologic tests- Allow a presumptive diagnosis; The use of one type of serologic test is
INSUFFICIENT for diagnosis
What is the tx for primary, secondary, and early latent syphilis? - Answer-PCN G 2.4
million Units IM in Single Dose
*If NON-PREGNANT, and allergic to PCN, use Doxy OR Tetracycline
Therapy for late latent syphilis? - Answer-PCN G 2.4 million Units IM x 3 doses (1 wk
intervals)
Therapy for syphilis in pregnancy? - Answer-PCN
Syphilis Follow Up? - Answer-Primary/Secondary: Reexamine at 6 and 12 months
Latent: Reexamine at 6,12,24 months
HIV infected: 3,6,9,12,24 months (primary/secondary) and 6,12,18,24 months (latent)
Management of Sex Partners in syphilis - Answer-Contact w/ in 90 days should be
tested and treated presumptively
, HPV - Answer-Very common STD, low risk can cause genital warts, high risk can cause
cervical cancer
Most infections are transient, asymptomatic, w/ no clinical consequence
Clinical Manifestations of HPV? - Answer-Genital warts, cervical cell abnormalities,
anogenital squamous cell cancers, recurrent respiratory papillomatosis
Diagnosis of genital warts? - Answer-Visual inspection w/ bright light; Dx can be
confirmed by biopsy if dx is uncertain, immunocompromised patient, warts are
pigmented, indurated, or fixed, lesions are unresponsive to standard treatment,
persistent ulceration/bleeding is present
Diagnosis of cervical cell abnormalities? - Answer-Cytology detects squamous cell
changes, Nucleic acid testing
Treatment of genital warts? - Answer-Removal
Podofilox (external, patient-applied)
Imiquimod (external, patient-applied)
Sinecatechins (External, patient applied)
cryotherapy (external, provider administered)
TCA/BCA, Surgical Removal (external, provider administered)
What is PID? - Answer-Inflammatory disorders associated w/ ascending spread of
microorganisms
What are the most common pathogens associated w/ PID? - Answer-N. Gonorrhoeae
and C. Trachomatis
What is the minimum criteria needed for PID Dx? - Answer-Uterine tenderness, or
adnexal tenderness, or cervical motion tenderness
* Additional criteria to increase specificity includes: temperature of 101, vaginal
mucopurulent d/c, elevated WBC on microscopy, elevated ESR, CRP, + Gonorrhea or
chlamydia test
What is more specific criteria needed for PID Dx? - Answer-Endometrial biopsy,
transvaginal sonography or MRI, laparoscopy
What is criteria for hospitalization w/ PID? - Answer-Pregnancy, non-responsive to oral
therapy, severe illness (n/v/fever/abscess), HIV infection w/ low CD4 count,
What is the oral regimen for PID? - Answer-Ceftriaxone 250mg IM in single dose PLUS
Doxycycline 100 mg po BID x 14 days with OR without Metronidazole 500mg po BID x
14 days
What follow up is required for pID? - Answer-Improvements should be seen w/in 72
hours- if not, hospitalization is usually required.
