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What organism is most targeted in cystitis treatment? What is the drug(s) of choice and duration of treatment?
E. coli; Bactrim (3 days); beta-lactams (5-7 days)
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What drug has a mechanism of action that involves inihibition of enolpyruvate transferase which inhibits cell wall synthesis, has Gram- coverage, is given in 1 large dose, maintains high concentrations in the urine for 48 hours, and can be used in pregnancy??
Fosfomycin
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What organism is most commonly involved in community-acquired pyelonephritis? What is the best oral treatment used and duration of treatment?
E. coli; ciprofloxacin (FQ); 7-10 days (but longer in complicated UTIs)
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What organism is most commonly involved in community-acquired pyelonephritis? What is the best IV treatment used?
E. coli; Ciprofloxacin (FQ)
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What organism is most commonly involved in hospital-aquired (healthcare-associated) pyelonephritis? What are the best types of treatment to use?
P. aeruginosa; antipseudomonals (cefepime or ceftazadime, piperacillin/tazobactum, ciprofloxacin (FQs), meropenem, imipenem, doripenem (group 2 carbepenems), gentamycin (aminoglycosides))
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True or false. Asymptomatic bacteriuria should not be treated unless pregnancy, neonates, UT instrumentation or renal transplants are involved.
True
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True or false. Candiduria is always represented as a colonization rather than an active infection.
True
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What 3 STDs have genital ulcer conditions?
- chancroid
- genital herpes
- syphilis
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What 2 STDs involve urethritis and cervicitis?
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What is the causative agent for Chancroid?
Haemophilus ducreyi
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True or false. Chancroid is characterized by painless ulcers and there is a possibility for co-infection with HSV and syphilis.
False, Chancroid is characterized by painful ulcers and there is a possibility for co-infection with HSV and syphilis.
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What is the drug of choice for Chancroid?
Azithromycin in 1 dose
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What is the main drug of choice for all stages of Syphilis?
Penicillin
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What is the drug of choice for disseminated genital herpes (HSV)? Duration of treatment?
IV acyclovir; 10 days
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What is the drug of choice for genital herpes (HSV)? Duration of treatment?
Valcyclovir (acyclovir); 7-10 days
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What drug can be used for the treatment of the primary and secondary phases of Syphilis?
Benzathine penicillin in 1 dose
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What 3 drugs can be given for treatment of primary or secondary Syphilis if there is a hypersensitivity reaction to penicillin?
- doxycycline
- ceftriaxone
- azithromycin
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What is the treatment regimen for the treatment of the latent and tertiary phases of Syphilis?
Benzathine penicillin, or doxycycline, ceftriaxone or azithromycin if there is a hypersensitivity reaction; 3 doses at 1-week interval
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What is the treatment regimen for neurosyphilis? What if there are complications to this treatment?
Aqueous crystalline penicillin; IM dose of aqueous crystalline penicillin with Probenecid
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What is Jarisch-Herxheimer and how is it treated?
reaction seen soon after Syphilis treatment; inflammatory agents
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What is the drug of choice for Chlamydia? What is another drug option and what is the duration of treatment?
Azithromycin in 1 dose; doxycycline for 7 days
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What is the drug of choice for uncomplicated Gonorrhea?
ceftriaxone in 1 dose
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What is the drug of choice for disseminated Gonorrhea?
IV 3rd generation cephalosporins
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True or false. If treating for Gonorrhea, Chlamydia should also be treated.
True
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What are the 3 main catergories for Vaginosis?
- bacterial
- trichomoniasis
- candiasis
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What is the best treatment for T. vaginalis?
Metronidazole in 1 dose
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What are the 5 organisms involved in Pelvic Inflammatory Disease (PID)?
- N. gonorrhea
- C. trachomatis
- Some Gram- organisms
- Anaerobes
- Streptococcus (maybe)
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What is the empiric recommendation(s) for Pelvic Inflammatory Disease IV treatment?
- Cefotetan or cefoxitin with doxycycline
- Clindamycin with gentamycin
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When would you use oral therapy for Pelvic Inflammatory Disease?
- In mid-moderate disease
- After response to initial IV therapy
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What are the 2 main organisms involved in epididymitis (via vaginal intercourse)?
- C. trachomatis
- N. gonorrhea
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What are the 2 main organisms involved in epididymitis (via anal intercourse)?
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What is the best treatmnent for epididymitis (via vaginal intercourse)?
Ceftriaxone with doxycycline
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What is the best treatmnent for epididymitis (via anal intercourse)?
Ciprofloxacin (FQs)
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