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Chapter 31. Sexually Transmitted Diseases

IT is a patient who reports to her primary care provider for evaluation of a vaginal discharge, dysuria, and vaginal bleeding. The provider orders several labs and cultures. A Gram stain reveals gram-negative diplococci. The presence of gram-negative diplococci on Gram stain is suggestive of which organism?

a. Treponema pallidum

b. Chlamydia trachomatis

c. Herpes simplex virus-2

d. Neisseria gonorrhoeae

Answer d is correct. N. gonorrhoeae is a gram-negative diplococcus.

Answer a is incorrect. T. pallidum is a spiral-shaped organism that is invisible on light microscopy.

Answer b is incorrect. C. trachomatis is an obligate intracellular pathogen.

Answer c is incorrect. Herpes is a viral organism.

TE is a 33-year-old patient with genital herpes simplex virus (HSV) herpes. Which of the following describes a current goal of therapy for genital herpes infection? Select all that apply.

a. Disease eradication

b. Viral suppression

c. Transmission prevention

d. Decrease recurrence frequency

Answer b is correct. Viral suppression is a goal of therapy for genital herpes.

Answer c is correct. Prevention of disease transmission is a goal of therapy for genital herpes.

Answer d is correct. Decreasing the frequency of recurrence (outbreaks) is a goal of therapy for genital herpes.

Answer a is incorrect. Since genital herpes cannot currently be eradicated, this is not a goal of therapy.

Select the answer that correctly ranks the diseases from those that require the least total number of doses of penicillin to the most.

a. Late latent syphilis, secondary syphilis, neurosyphilis

b. Neurosyphilis, late latent syphilis, secondary syphilis

c. Secondary syphilis, late latent syphilis, neurosyphilis

d. Secondary syphilis, neurosyphilis, late latent syphilis

Answer c is correct. Secondary syphilis is treated with benzathine penicillin G 2.4 MU IM × one dose. Late latent syphilis is treated with benzathine penicillin G 2.4 MU IM once weekly × three doses. Neurosyphilis is treated with aqueous crystalline penicillin G 18 to 24 MU IV daily (3-4 MU IV every 4 hours or by CI) × 10 to 14 days.

Answers a, b, and d are incorrect. Secondary syphilis is treated with benzathine penicillin G 2.4 MU ...

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