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Chapter 31. Sexually Transmitted Diseases

AS is a 27-year-old patient with a new diagnosis of a chlamydia infection. The patient is concerned about the infection, the treatment, and complications from the infection. Complications of chlamydia genital infection include which of the following?

a. Granulomatous and cardiovascular diseases

b. Vesicular lesions on the external genitalia

c. Pelvic inflammatory disease and infertility

d. General paresis, dementia, and sensory ataxia

Answer c is correct. Without appropriate and timely treatment for chlamydia, complications such as PID, ectopic pregnancy, premature delivery, and infertility can result.

Answer a is incorrect. Granulomatous and cardiovascular diseases are manifestations of tertiary syphilis and represent some of the long-term complications of syphilis.

Answer b is incorrect. Vesicular lesions on the external genitalia are manifestations of genital herpes infection.

Answer d is incorrect. General paresis, dementia, and sensory ataxia are clinical manifestations of late neurosyphilis, a form of tertiary syphilis.

TD is 27-year-old man who presents to a local STD clinic with complaints of painful urination and urethral discharge over the past 4 days. He is sexually active, reporting one partner within the past 30 days. He has no known drug allergies. A diagnosis of chlamydia is made. Select the most appropriate therapy for TD.

a. Doxycycline

b. Azithromycin + cefixime

c. Ceftizoxime

d. Acyclovir + ofloxacin

Answer a is correct. Doxycycline is a recommended agent for the treatment of chlamydia.

Answer b is incorrect. While azithromycin is a recommended agent for the treatment of chlamydia, cefixime is not necessary to be added. Cefixime in combination with azithromycin is an alternative regimen for the treatment of gonorrhea.

Answer c is incorrect. Ceftizoxime is not a recommended therapy for chlamydia, although it is an alternative agent for gonorrhea treatment.

Answer d is incorrect. Acyclovir is an antiviral agent and would not be effective against a chlamydia bacterial infection. Although ofloxacin is an alternative agent for chlamydia treatment, this combination is inappropriate.

Which of the following is a contraindication to doxycycline therapy? Select all that apply.

a. Age less than 8 years

b. Concomitant use of QTc interval-prolonging drugs

c. Diabetes mellitus

d. Documented penicillin allergy

Answer a ...

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