STD Modules- Quiz Questions

Which one of the following statements most accurately reflects recommendations for syphilis screening in pregnant women? Routine screening is not recommended unless the woman has HIV infection. Routine screening is not recommended unless the woman has a prior documented sexually transmitted disease. Routine screening is recommended and should be performed at the first prenatal visit; repeat syphilis screening may be indicated in the early third trimester and at delivery. Routine screening is recommended and should be performed only at delivery

Routine screening is recommended and should be performed at the first prenatal visit; repeat syphilis screening may be indicated in the early third trimester and at delivery. Routine screening for syphilis in pregnancy is recommended by the CDC and the American College of Obstetrics and Gynecology; the screening for syphilis should be performed at the first prenatal visit. Women who are at high risk for syphilis or live in areas of high syphilis morbidity should have repeat screening performed at around 28 weeks gestation and again at delivery.

Which one of the following most accurately describes the recommendation from the Centers for Disease Control and Prevention regarding screening for Neisseria gonorrhoeae in sexually active men who have sex with men? One-time screening is recommended for men aged 18-25 years of age Routine screening should be performed every 3 months Routine screening is not recommended Routine screening should be performed at least annually

Routine screening should be performed at least annually

In 2018, which region of the United States had the highest rate of reported gonorrhea (cases per 100,000 population)?

South In 2018, the South had the highest rate of infection with N. gonorrhoeae in the United States, with 194.4 cases per 100,000 population. The lowest was in the Northeast (138.4. cases per 100,000 population).

In 2018, approximately how many cases of Chlamydia trachomatis infections were reported in the United States? 725,000 4,750,000 1,750,000 250,000

1,750,000

In the United States, which one of the following age groups has the highest prevalence of human papillomavirus (HPV) infection? 15 to 19 20 to 24 25 to 29 30 to 34

20 to 24 In the United States, HPV is one of the most common sexually transmitted infections. The prevalence of HPV infection is highest from ages 20 to 24.

Based on 2018 data from the Gonococcal Isolate Surveillance Project (GISP), which one of the following is an accurate estimate of the rate of Neisseria gonorrhoeae antimicrobial resistance?

31% of isolates were resistant to ciprofloxacin Ceftriaxone is the preferred agent and widely used to treat gonorrhea. Fortunately, rates of resistance to ceftriaxone have remained less than 0.5%. In contrast, fluoroquinolone resistance with Neisseria gonorrhoeae is highly problematic and rates of ciprofloxacin are approximately 30%.

What is the rate of male-to-female transmission of Neisseria gonorrhoeae via semen per episode of vaginal intercourse?

50-70% The estimated rate of male-to-female transmission of Neisseria gonorrhoeae is 50-70% per episode of vaginal intercourse. Female-to-male genital transmission is estimated to be about 20% per episode. Rectal intercourse and fellatio have not been quantified, but are likely efficient modes of transmission. Cunnilingus appears to carry much lower risk, though transmission can occur.

What percentage of persons infected with HSV-2 are unaware of their serostatus? 25% 35% 55% 85%

85% Approximately 85% of persons infected with HSV-2 have not been diagnosed, and the proportion of persons who have knowledge of their HSV-2 status has not changed significantly in recent years.

A 43-year-old woman has a clinical diagnosis of secondary syphilis but has a negative nontreponemal Rapid Plasma Reagin (RPR) test with a titer of 1:1. A clinician suspects the nontreponemal test is negative due to the "prozone effect". What is the prozone effect? A false-negative nontreponemal syphilis test due to antigen excess from patients with autoimmune diseases. A false-negative nontreponemal syphilis test due to delayed antibody response with Treponema palladium infection. A false-negative nontreponemal syphilis test due to extremely high serum antibodies levels in response to infection with Treponema palladium. A false-negative nontreponemal syphilis test due to immunodeficiency.

A false-negative nontreponemal syphilis test due to extremely high serum antibodies levels in response to infection with Treponema palladium. The prozone effect occurs when very high serum antibodies supersaturate the antigens used in the nontreponemal assay; if this is suspected the laboratory should be informed and dilution of the sample can typically reveal the true positive test.

Which one of the following best describes a primary syphilis (chancre) lesion? Multiple painful shallow ulcers that have an erythematous base and persist for 3 to 4 days A large serpiginous ulcer that has a soft, beefy edge and persists for 2 to 4 days A painless, well-circumscribed ulcer that has a clean base and persists for 1 to 6 weeks A painful soft ulcer that persists for 2 to 4 days

A painless, well-circumscribed ulcer that has a clean base and persists for 1 to 6 weeks

Which one of the following would be an indication to perform a biopsy of an anogenital wart? A wart is larger than 3 cm A wart is larger than 5 cm A wart resolves with treatment but later returns at the same location A wart is persistently ulcerated or bleeding

A wart is persistently ulcerated or bleeding Although most anogenital warts may be diagnosed and treated based on a careful history and physical examination, biopsy confirmation may be indicated in any of the following situations: the patient is immunocompromised, warts are atypical (pigmented, indurated, or fixed), the lesions do not respond to standard treatment, or there is persistent ulceration or bleeding.

What is the normal vaginal pH in most healthy women? Acidic and less than 2.2 Acidic, between 3.8 and 4.5 Alkaline, between 5.8 and 6.2 Alkaline and greater than 6.2

Acidic, between 3.8 and 4.5 The normal bacterial flora is dominated by Lactobacillus species that convert glycogen to lactic acid, which helps to maintain a normal acidic vaginal pH of 3.8 to 4.5.

How is acute PID defined? Acute is less than or equal to 7 days in duration Acute is less than or equal to 14 days in duration Acute is less than or equal to 21 days in duration Acute is less than or equal to 30 days in duration

Acute is less than or equal to 30 days in duration Most experts have defined acute PID as a duration of less than or equal to 30 days. The pathogens associated with acute PID are typically different than those causing chronic PID.

What are the indications for the 9-valent human papillomavirus (HPV) vaccine? Administer for girls and boys anytime after age 16 when they become sexually active Administer routinely for girls and boys beginning at age 15 Administer for girls and boys anytime after age 18 when they become sexually active Administer routinely for girls and boys at ages 11-12 and it can be administered as early as 9 years of age

Administer routinely for girls and boys at ages 11-12 and it can be administered as early as 9 years of age

CDC recommendations for the management of sex partners of a patient diagnosed with urogenital chlamydia infection

All sex partners during the 60 days preceding the onset of symptoms should be referred for treatment All sex partners within the 60 days preceding the onset of symptoms or diagnosis of chlamydia should be referred for treatment. Partners with exposure greater than 60 days preceding the onset of symptoms or diagnosis of chlamydia do not need to be routinely screened or treated. Referral and treatment should occur for the most recent partner, even if this contact occurred more than 60 days prior. Similarly, all symptomatic contacts should be referred, regardless of time since diagnosis.

A 41-year-old man with chronic HIV infection presents with headaches and new hearing loss. He has a serum Venereal Disease Research Laboratory (VDRL) titer of 1:64. A lumbar puncture is performed and shows 32 white blood cells/mm3 and a cerebrospinal VDRL titer of 1:32. He does not have any antibiotic allergies. What treatment is recommended for this man? Aqueous crystalline penicillin G 18-24 million units per day, administered as 3-4 million units IV every 4 hours or continuous infusion, for 10-14 days Ceftriaxone 1 g IV daily for 3 days Benzathine penicillin G weekly doses of 2.4 million units for 3 weeks Ceftriaxone 1 g IV twice daily for 7 days

Aqueous crystalline penicillin G 18-24 million units per day, administered as 3-4 million units IV every 4 hours or continuous infusion, for 10-14 days

Which of the following is the most common cause of vaginitis in reproductive-aged women? Bacterial vaginosis Trichomoniasis Candidiasis Atrophic vaginitis

Bacterial vaginosis Bacterial vaginosis is the most common diagnosis among women with symptomatic vaginitis, followed by candidiasis and trichomoniasis. There are several less frequent causes for vaginal discharge and/or irritation, including normal physiologic variation, allergic reactions, atrophic vaginitis, and lichen simplex.

What is the most likely diagnosis based on the following criteria: (a) pH 5.0; (b) clue cells greater than 20% per high power field, (c) potassium hydroxide (KOH) "whiff test" positive with an fishy odor, and (c) homogenous discharge? Trichomoniasis Candidiasis Bacterial vaginosis Chlamydia

Bacterial vaginosis The most likely diagnosis is bacterial vaginosis since all of the Amsel's diagnostic criteria for bacterial vaginosis are present: (1) alkaline pH, (2) presence of clue cells, and (3) positive "whiff test, and (4) homogeneous discharge. The presence of three of the following four criteria provides sufficient evidence for a clinical diagnosis of bacterial vaginosis.

A 24-year-old man presents with a diffuse macular and papular rash on his chest, back, hands and feet. He had 2 new male sexual exposures approximately 6 weeks ago. He now has a positive Venereal Diseases Research Laboratory (VDRL) test with a titer of 1:256. He had a negative syphilis test about 3 months ago. He has no other symptoms and his neurologic examination is normal. He has no known antibiotic allergies. What treatment is indicated? Benzathine penicillin G 2.4 million units IM in a single dose Benzathine penicillin G 2.4 million units IM weekly for 3 total doses Ceftriaxone 250 mg IM in a single dose plus Azithromycin 1 g orally in a single dose Doxycycline 200 mg twice a day for 3 days

Benzathine penicillin G 2.4 million units IM in a single dose

A 29-year-old man develops a diffuse rash 5 weeks after having sexual contact with a new male partner. Testing for syphilis shows a positive Venereal Diseases Research Lab (VDRL) test of 1:256. He is diagnosed with secondary syphilis. He does not have any antibiotic allergies. What is the recommended treatment for this patient? Azithromycin 1 g orally as a single dose Ceftriaxone 1 g IV as a single dose Benzathine penicillin G 2.4 million units IM in a single dose Benzathine penicillin G 7.2 million units total, administered as 3 doses of 2.4 million units IM each at 1-week intervals

Benzathine penicillin G 2.4 million units IM in a single dose The recommended therapy for secondary syphilis is benzathine penicillin G, intramuscularly, 2.4 million units in a single dose. Three doses of benzathine penicillin G, spaced 1 week apart is appropriate for late latent therapy. The slow absorption of intramuscular benzathine penicillin G provides systemic levels of penicillin for at least 1 week.

Based on 2018 surveillance data in the United States, what is the correct order for gonorrhea rates by race/ethnicity, (in descending order)?

Blacks, American Indians/Alaskan Natives, Native Hawaiians/other Pacific Islanders, Hispanics Among race/ethnicity categories in the United States for 2017, blacks have the highest gonorrhea rate (548 cases per 100,000 population), followed sequentially by American Indians/Alaskan Natives, Native Hawaiians/Other Pacific Islanders, Hispanics, whites, and Asians The rate of gonorrhea in blacks was approximately 8.3 times higher than in whites.

Which one of the following is TRUE regarding the HPV vaccine dosing schedule for healthy boys and girls? Boys and girls younger than age 11 require 4 doses Boys and girls ages 9 through 14 require only 2 doses Boys and girls ages 15 and older require only 2 doses Boys and girls ages 17 and older require only 1 dose

Boys and girls ages 9 through 14 require only 2 doses In 2016, a new recommendation was issued so that boys and girls aged 9 through 14 require only 2 doses, with the second dose given 6 to 12 months after the first dose. For those aged 15 to 26, three doses of the vaccine is recommended. The 2-dose schedule applies only to healthy boys and girls. For examples, the 2-dose series should not be given to persons with secondary immunocompromising conditions that might reduce cell-mediated or humoral immunity, inclulding B lymphocyte antibody deficiencies, T lymphocyte complete or partial defects, HIV infection, malignant neoplasms, transplantation, autoimmune disease, or immunosuppressive therapy.

Which one of the following treatment regimens is considered a recommended parenteral option for the initial treatment of a woman with pelvic inflammatory disease? Levofloxacin 500 mg IV once daily plus Azithromycin 1 g single dose Cefoxitin 2 g IV every 6 hours plus Doxycycline 100 mg orally or IV every 12 hours Clindamycin 900 mg IV every 8 hours plus Azithromycin 1 g single dose Ertapenem 1 g IV once daily plus Doxycycline 100 mg orally or IV every 12 hours

Cefoxitin 2 g IV every 6 hours plus Doxycycline 100 mg orally or IV every 12 hours Prompt and effective therapy is essential to optimize good outcomes for women with PID. Three parenteral regimens are recommended for the treatment of PID: Cefotetan 2 g IV every 12 hours PLUS Doxycycline 100 mg orally or IV every 12 hours, or Cefoxitin 2 g IV every 6 hours PLUS Doxycycline 100 mg orally or IV every 12 hours, or Clindamycin 900 mg IV every 8 hours PLUS Gentamicin loading dose IV or IM (2 mg/kg), followed by a maintenance dose (1.5 mg/kg) every 8 hours. Single daily dosing (3-5 mg/kg) can be substituted.

A 23-year-old woman is diagnosed with gonococcal cervicitis based on purulent discharge and Gram's stain findings. Results for chlamydia are pending. Which one of the following regimens is recommended? Cefixime 400 mg orally in a single dose plus Doxycycline 100 mg twice daily for 7 days Ceftriaxone 125 mg IM in a single dose plus Doxycycline 100 mg twice daily for 7 days Ceftriaxone 250 mg IM in a single dose plus Azithromycin 1 g orally in a single dose Ciprofloxacin 500 mg orally in a single dose plus Azithromycin 1 g orally in a single dose

Ceftriaxone 250 mg IM in a single dose plus Azithromycin 1 g orally in a single dose

A 26-year-old woman is diagnosed with pelvic inflammatory disease. She has no antibiotic allergies. The decision is made to treat her as an out-patient. Which one of the following regimens is recommended? Ceftriaxone 250 mg IM in a single dose plus doxycycline 100 mg twice a day for 14 days plus metronidazole 500 mg orally twice a day for 14 days Moxifloxacin 400 mg orally in a single dose plus doxycycline 100 mg twice a day for 14 days Ceftriaxone 250 mg IM in a single dose plus azithromycin 1 g orally in a single dose Ceftriaxone 1 g IM in a single dose plus moxifloxacin 400 mg orally in a single dose plus doxycycline 100 mg twice a day for 14 days

Ceftriaxone 250 mg IM in a single dose plus doxycycline 100 mg twice a day for 14 days plus metronidazole 500 mg orally twice a day for 14 days

A 17-year-old male is diagnosed with an uncomplicated gonococcal urethritis based on a Gram's stain of a urethral discharge specimen that shows multiple gram-negative intracellular diplococci. No additional testing is performed. He denies any history of drug allergies. preferred regimen for treatment of this patient's urethritis?

Ceftriaxone 250 mg intramuscularly in a single dose plus Azithromycin 1 gram orally in a single dose Ceftriaxone 250 mg intramuscularly in a single dose plus azithromycin 1 gram orally in a single dose is the regimen recommended in the 2015 STD Treatment Guidelines for uncomplicated gonococcal urethritis. Cefixime is an acceptable substitution for ceftriaxone only when ceftriaxone is not available. Similarly, doxycycline is considered acceptable to use in place of azithromycin only in the context of azithromycin allergy.

The CDC 2015 STD Treatment Guidelines recommend presumptive PID treatment for sexually active young women and other women at risk for STDs if they are experiencing pelvic or lower abdominal pain, if no cause for the illness other than PID can be identified, and if one or more minimum clinical criteria are met. Which one of the following is included under "Minimal Clinical Criteria"? Cervical motion tenderness occurring in the absence of any other explanation Cervical petechiae without evidence of thrombocytopenia or cervical trauma Purulent discharge from the cervical os Erythema of the vaginal wall

Cervical motion tenderness occurring in the absence of any other explanation The clinical presentation for PID is highly variable and some women are asymptomatic. The Minimal Clinical Criteria include the following: Uterine or adnexal tenderness (bilateral or unilateral), Cervical motion tenderness occurring in the absence of any other explanation, or Acute adnexal tenderness, which may be the most sensitive sign of upper genital tract infection.

To make a presumptive diagnosis of pelvic inflammatory disease in sexually active young women and other women experiencing pelvic or lower abdominal pain, the CDC recommends one or more minimum clinical criteria are present on pelvic examination. What are the three minimum clinical criteria? Cervical petechiae or cervical motion tenderness or friability of the cervical os Cervical discharge or cervical petechiae or cervical motion tenderness Cervical motion tenderness or uterine tenderness or adnexal tenderness Palpable adnexal mass or cervical motion tenderness or cervical discharge

Cervical motion tenderness or uterine tenderness or adnexal tenderness

Which one of the following is TRUE regarding the organism Chlamydia trachomatis?

Chlamydia trachomatis has a gram-negative-like cell wall, but is not visible using a standard Gram's stain. This organism is an obligate intracellular pathogen. During the life cycle of C. trachomatis, the elementary body is the infectious form and the reticulate body is the replicative form.

What type of virus is human papillomavirus (HPV)? Double-stranded DNA virus that belongs the Papillomaviridae family RNA virus that belongs to the Poxviridae family RNA virus that belongs to the Herpesviridae family Single-stranded DNA virus that belongs to the Polymyxoviridae family

Double-stranded DNA virus that belongs the Papillomaviridae family

How is most genital HSV-2 transmitted? During a rebound viral activation phase that occurs following discontinuation of antiviral therapy for recurrent symptomatic infection During the initial 72 hours of a recurrent symptomatic infection During the wet ulcer phase of a recurrent symptomatic infection During asymptomatic viral shedding

During asymptomatic viral shedding

A 31-year-old woman had a negative screening syphilis test 9 months ago. Five months ago she developed a maculopapular rash that resolved on its own; she now has a Rapid Plasma Reagin (RPR) titer of 1:128. How would you classify the current stage of syphilis for this patient? Syphilis of unknown duration Early latent syphilis Late latent syphilis Very late latent syphilis

Early latent syphilis The patient fits the criteria for early latent syphilis because of the positive serologic test for syphilis, lack of current clinical manifestations, and a history of secondary syphilis symptoms within the prior 12 months. At the time she initially developed the rash she had secondary syphilis. Late latent reflects latent syphilis infection of at least 1 year in duration. There is no category of latent syphilis that is referred to as very late latent syphilis.

Which one of the following should be considered a factor in guiding the selection of anogenital wart treatment? Prior history of anogenital warts Human papillomavirus DNA type identified in wart tissue Experience of the health care provider in treating anogenital warts Age of patient

Experience of the health care provider in treating anogenital warts Treatment of anogenital warts should be guided by the preference of the patient, available resources, experience of the health care provider, location of the lesion, pregnancy status. In contrast, patient age, HPV type, and prior history of warts do not play a significant role in the decision of treatment method.

Based on United States STD surveillance data, which age group has the highest rates of infection with Chlamydia trachomatis?

Females aged 15-24 years Females 15-24 years of age are the age group with the highest rates of C. trachomatis infection. The high rates in this age group, in combination with the significant potential for long-term complications in women from unidentified C. trachomatis infection, underlies the USPSTF and CDC recommendation to perform routine screening in all sexually active females younger than 25 years of age.

A 26-year-old male has two new recent sexual partners and presents with urethral discharge. Which one of the following tests is preferred for detecting Chlamydia trachomatis? Urethral swab Gram's stain Urethral swab culture First catch urine nucleic acid amplification test First catch urine culture

First catch urine nucleic acid amplification test

Which one of the following is an appropriate plan regarding follow-up for a 19-year-old woman who is diagnosed with Chlamydia trachomatis cervicitis and treated with a recommended regimen? Follow-up visit and obtain NAAT for "test of cure" (at 2 weeks from initial visit) Follow-up visit and obtain NAAT to evaluate for reinfection (at 4 weeks from initial visit) Follow-up visit and obtain NAAT to evaluate reinfection (at 3 months from initial visit) No follow-up is needed as long as the patient remains asymptomatic

Follow-up visit and obtain NAAT to evaluate reinfection (at 3 months from initial visit) In most situations involving genitourinary chlamydial infection, patients do not require routine "test-of-cure" after appropriate therapy. Due to high rates of reinfection, patients should have a follow-up visit with additional testing even if asymptomatic; the testing for reinfection as well as additional education and counseling is recommended at 3 months after treatment.

A 19-year-old man is evaluated in the clinic with a purulent urethral discharge. A Gram's stain is performed on a sample of the discharge. Which one of the following is most consistent with a diagnosis of gonorrhea? Extracellular gram-negative rods in rows Gram-negative diplococci within white blood cells Extracellular gram-positive cocci in chains Abundant white blood cells with no visible organisms

Gram-negative diplococci within white blood cells

responsible for most cases of recurrent genital herpes in the United States?

Herpes simplex virus type 2 Most cases of recurrent genital and perirectal herpes in the United States are caused by herpes simplex virus type 2 (HSV-2). More recently, however, an increasing proportion of anogenital herpetic infections have been attributed to HSV-1, especially in young women, college students, men who have sex with men, and heterosexual African American men.

Which treatment is considered a recommended patient-applied treatment for external anogenital warts? Imiquimod 3.75% cream Cidofovir 1% gel Trichloroacetic acid (TCA) 80-90% solution Bichloroacetic acid (BCA) 10-20% solution

Imiquimod 3.75% cream The recommended options for patient-applied treatments for external anogenital warts consist of: Podofilox 0.5% solution or gel Imiquimod 3.75% cream Imiquimod 5% cream Sinecatechins 15% ointment

In which one of the following patients would it be reasonable to perform type-specific serologic testing for HSV? In an asymptomatic woman presenting for her first prenatal care visit In a symptomatic patient in whom very early HSV-2 infection is suspected In a symptomatic patient with a positive viral cell culture for HSV-2 In an asymptomatic patient with recurrent genital symptoms but negative HSV cultures

In an asymptomatic patient with recurrent genital symptoms but negative HSV cultures Type-specific serologic assays might be useful in patients with recurrent or atypical genital symptoms with negative cultures, a clinical diagnosis of genital herpes without laboratory confirmation, a sex partner with genital herpes, or as part of a comprehensive evaluation for STDs in persons with multiple sex partners, persons with HIV infection, and men who have sex with men (MSM) who have increased risk for HIV acquisition. Routine HSV type-specific serologic testing is not recommended in asymptomatic persons (including during pregnancy), in patients with culture-proven HSV-2, or in cases of early infection since HSV-specific antibodies can take from 2 weeks to 3 months to develop.

Based on data from the Gonococcal Isolate Surveillance Project (GISP), which one of the following statements is TRUE? In recent years, more than 10% of gonococcal isolates have been resistant to fluoroquinolones In recent years, the percentage of isolates with reduced susceptibility to ceftriaxone (defined as MIC ≥ 0.125 μg/mL) has been approximately 15% In recent years, more than 15% of gonococcal isolates have reduced susceptibility to azithromycin (defined as MIC≥2 μg/mL) In recent years, approximately 15% of gonococcal isolates have reduced susceptibility to cefixime (defined as MIC ≥0.25 μg/mL)

In recent years, more than 10% of gonococcal isolates have been resistant to fluoroquinolones

Which one of the following statements is TRUE regarding reported rates of primary and secondary syphilis in the United States? Since 2001, there has been a significant decrease in syphilis rates among men and women Since 2001, there has been a significant increase in syphilis rates among women but a decrease in the rate among men In recent years, the syphilis rate in women is higher than in men In recent years, syphilis rate in men has been higher than in women

In recent years, syphilis rate in men has been higher than in women The all-time low for incidence of reported cases of syphilis in the United States occurred in 2001. Since 2001, however, there has been a significant increase in cases and rate among men, with a disproportionate number of these cases involving men who have sex with men. The number of cases and rate in women has increased slightly since 2011. Overall, in recent years, syphilis cases in men markedly exceed those in women.

Which one of the following is considered a known chronic sequela following acute pelvic inflammatory disease (PID) in a young woman? Cervical incompetence Increased risk for ovarian cancer Infertility Uterine prolapse

Infertility Even after one episode of PID, a woman has significant risk of developing subsequent complications, including ectopic pregnancy, infertility, and chronic pelvic pain. The risk for development of these complications increases further with multiple episodes of PID.

In the United States, which one of the following is TRUE regarding the incidence of PID? It has increased due to rising rates of gonorrhea and chlamydia. It has increased due to the emergence of Mycoplasma genitalium It has decreased due to increased screening and treatment of gonorrhea and chlamydia It has decreased due to greater use of intrauterine devices for birth control

It has decreased due to increased screening and treatment of gonorrhea and chlamydia In the United States, the incidence of PID in both inpatient and office-based settings has decreased in recent years. This has been widely attributed to an increase in effective screening for infection with Neisseria gonorrhoeae and Chlamydia trachomatis in adolescents and young women.

What is the key component of the viral-like particles utilized in the HPV vaccine? E1 protein E2 protein L1 protein L2 protein

L1 protein The HPV vaccine is based on recombinant synthesis of the major L1 protein, which self-assemble into pentameric capsids. The self-assembly of the L1 proteins generates non-replicating viral-like particles that are highly immunogenic.

Which one of the following is TRUE regarding a definition of latent syphilis? Early latent refers to syphilis infection of less than 6 weeks in duration Early latent refers to syphilis infection of less than 12 weeks in duration Late latent refers to syphilis infection of at least 5 years in duration Late latent refers to syphilis infection of at least 1 year in duration

Late latent refers to syphilis infection of at least 1 year in duration

Which one of the following combinations of clinical and laboratory findings most accurately describes primary HSV-2 infection? No lesions or symptoms, HSV-1 antibodies may or may not be present, HSV-2 antibodies are present Lesions present, symptoms usually mild, HSV-1 antibodies may or may not be present, HSV-2 antibodies are present Lesions present, symptoms usually severe, HSV-1 and HSV-2 antibodies not present Lesions present, symptoms usually moderate, HSV-1 antibodies present, HSV-2 antibodies are not present

Lesions present, symptoms usually severe, HSV-1 and HSV-2 antibodies not present In primary HSV-2 infection, lesions and severe systemic symptoms are typically present, and there are no antibodies to either HSV-1 or HSV-2. In nonprimary HSV-2 infection, the patient already has antibodies to HSV-1, which typically mitigate the severity of HSV-2 symptoms. Patients with recurrent symptomatic HSV-2 infection will usually have milder symptoms in the setting of established HSV-2 antibodies.

risk factors for acquiring genital herpes?

Major risk factors identified for acquiring genital herpes include black race, female sex, hormonal contraception, high number of lifetime sex partners.

The most common pathogens associated with PID are? Group B streptococcus and Chlamydia trachomatis Group B streptococcus and Chlamydia trachomatis Neisseria gonorrhoeae and Ureaplasma urealyticum Neisseria gonorrhoeae and Chlamydia trachomatis

Neisseria gonorrhoeae and Chlamydia trachomatis The most common pathogens associated with PID are Neisseria gonorrhoeae and Chlamydia trachomatis. Other microbes associated with PID include gram-negative rods, anaerobes, Mycoplasma genitalium, and Ureaplasma urealyticum.

Which one of the following statements is TRUE regarding neurosyphilis? Neurosyphilis occurs only in patients with late latent syphilis. Neurosyphilis occurs only in patients with early latent syphilis. Neurosyphilis can occur in patients with early or late latent syphilis, but not with secondary syphilis. Neurosyphilis can occur in patients with secondary, early latent, or late latent syphilis

Neurosyphilis can occur in patients with secondary, early latent, or late latent syphilis. Patients can develop syphilis early or late in the course of illness. Early neurosyphilis can develop in patients with secondary syphilis and patients may present with meningitis, cranial neuropathy, and occasionally stroke-like symptoms. Clinical manifestations of late neurosyphilis include general paresis and tabes dorsalis but can present with a wide variety of neurologic symptoms. Ocular involvement can occur in early or late neurosyphilis. Patients can develop neurosyphilis during secondary, early latent, or late latent syphilis.

Which one of the following groups has the highest rates of diagnosis of trichomoniasis? Non-Hispanic black women Black men who have sex with men (MSM) White women younger than age 21 White women older than age 35

Non-Hispanic black women The prevalence of Trichomonas vaginalis infection among reproductive-age women in the United States is estimated at 3.1%, but rates are at least four times higher among non-Hispanic black women. In addition, trichomoniasis prevalence increases with age. Despite high rates of STDs (especially HIV and syphilis) among men who have sex with men, trichomoniasis remains uncommon in this subgroup.

preferred method to diagnose chlamydial urethritis in men?

Nucleic acid (DNA, RNA) amplification technique on a urine or urethral swab sample The nucleic acid amplification test (NAAT) has emerged as the preferred method to diagnose chlamydial infection, primarily because of improved sensitivity; this test is FDA approved for use on urine specimens from men and women, urethral swabs in men, and endocervical swabs in women. Cell culture techniques remain an acceptable method for the diagnosis of chlamydial infection, but they are no longer preferred because of the test complexity and lower sensitivity when compared with NAAT.

Which one of the following tests has the highest sensitivity for detecting Neisseria gonorrhoeae from a sample of purulent cervical discharge?

Nucleic acid amplification testing (NAAT) Nucleic acid amplification tests (NAATs) have increasingly become the primary test used to diagnose Neisseria gonorrhoeae genital infections. Multiple studies have shown that NAATs have greater sensitivity for detecting N. gonorrhoeaethan Gram's stain, culture, or DNA probe testing. These tests are FDA-cleared for diagnosis of N. gonorrhoeae in endocervical specimens from women, urethral specimens from men, and urine specimens from men and women. In addition, some laboratories have validated N. gonorrhoeae for use with rectal or oropharyngeal specimens.

Which one of the following options is a preferred therapy for both episodic and suppressive treatment of recurrent genital herpes infections? Oral acyclovir Oral valganciclovir Topical cidofovir Topical imiquimod

Oral acyclovir HSV antiviral therapy for episodic therapy of recurrent HSV includes three preferred oral medications, all with similar efficacy: acyclovir, valacyclovir, and famciclovir. Intravenous acyclovir should be reserved for patients with severe HSV disease or complications requiring hospitalization (e.g. disseminated infection, pneumonitis, or hepatitis) or complications of the central nervous system (e.g. meningitis or encephalitis). Intravenous cidofovir, topical cidofovir, and topical imiquimod have been used to treat acyclovir-resistant HSV, but these therapies are not recommended for routine treatment of HSV.

Which one of the following changes in the normal vaginal environment is associated with bacterial vaginosis? Decreased cervical mucus production Overgrowth of lactobacilli Overgrowth of Gardnerella vaginalis and Prevotella bivia Overgrowth of pathogenic urogenital strains of Escherichia coli

Overgrowth of Gardnerella vaginalis and Prevotella bivia Although the etiologic agent in bacterial vaginosis is not known, symptomatic infection is characterized by a relative decrease in lactobacilli and an overgrowth of bacterial vaginosis-associated organisms, which are typically gram-negative rods and cocci. The organisms that appear to play the most significant role in the overgrowth are Gardnerella vaginalis and Prevotella bivia.

Which one of the following statements is TRUE regarding appropriate follow-up for PID? All women treated for PID should have a one-time visit with a reproductive health specialist All women treated for PID should receive antimicrobial prophylaxis for major dental work All women treated for PID should undergo yearly pelvic ultrasound every 5 years until age 45 to monitor for possible long-term sequelae Patients should be re-examined within 72 hours after initiation of therapy

Patients should be re-examined within 72 hours after initiation of therapy All women who receive treatment for PID should be re-examined within 72 hours after initiation of therapy; this follow-up evaluation should demonstrate substantial clinical improvement. Retesting for chlamydial or gonococcal infection is recommend at 3 to 6 months after treatment. There are no specific recommendations to monitor for long-term sequelae after PID.

What are known potential complications of genitourinary gonococcal infection in women?

Pelvic inflammatory disease, accessory gland infection, and perihepatitis (Fitz-Hugh-Curtis Syndrome) Well-described complications of genitourinary infection with Neisseria gonorrhoeae include pelvic inflammatory disease, accessory gland infection, and perihepatitis (Fitz-Hugh-Curtis Syndrome). Acute renal failure, neurologic symptoms, and severe vaginal hemorrhage do not have a clear association with gonococcal infections and an alternative diagnosis should be sought for these symptoms.

Which one of the following most accurately describes recommendations for chlamydia screening in asymptomatic females? Perform one time screening in all women aged 25-30 years Perform one time screening in all women aged 21-25 years Perform annual screening in sexually active females 15-21 years of age and in older women who have a prior history of a sexually transmitted disease Perform annual screening in sexually active females 24 years or younger and in older women who are at increased risk for infection

Perform annual screening in sexually active females 24 years or younger and in older women who are at increased risk for infection

In the United States, most common clinical condition caused by chlamydial infection among neonates (younger than 1 month of age)?

Perinatal eye infection causing inclusion conjunctivitis The most common clinical condition caused by chlamydial infection in neonates and infants in the United States is inclusion conjunctivitis (ophthalmia neonatorum). Cases of infant inclusion conjunctivitis are almost always perinatally-acquired infections. In contrast, the trachoma-forming chlamydial serotypes are most often transmitted by flies. Pneumonia and urogenital infections do occur in neonates and infants, but less often than inclusion conjunctivitis.

Which of the following is considered one the criteria for hospitalization in a woman with acute pelvic inflammatory disease. Pregnancy A serum white blood cell count greater than 9,500 cells/mm3 Diabetes mellitus A serum creatinine greater than 1.3 mg/dL

Pregnancy The decision whether to admit a woman to the hospital with acute PID can be difficult. Among the choices listed, only pregnancy is considered one of the CDC criteria for admission.

Which one of the following adverse clinical outcomes is associated with Trichomonas vaginalis infection in women? Ectopic pregnancy Infertility Ovarian cancer Premature rupture of membranes and preterm labor

Premature rupture of membranes and preterm labor Infection with Trichomonas vaginalis in pregnant women is associated with obstetrical adverse outcomes, including premature rupture of membranes, preterm labor, and preterm birth. Trichomoniasis does not increase the risk of ectopic pregnancy, infertility, or ovarian cancer.

Based on data from the National Health and Nutrition Examination Survey (NHANES) conducted 2007-2010, which one of the following is TRUE regarding the seroprevalence of herpes simplex virus-2 in whites and blacks? Rates are higher in whites than in blacks for both males and females Rates are higher in blacks than in whites for both males and females In females, rates are higher in whites than blacks whereas in males rates are higher in Blacks than in Whites In females, rates are higher in blacks than whites whereas in males rates are higher in Whites than in Blacks

Rates are higher in blacks than in whites for both males and females

Which one of the following statements is TRUE regarding the epidemiology of gonorrhea in the United States? Rates of reported cases are higher in women than in men Rates of reported cases are higher in the South than in the West, Midwest, or Northeast California is the state with the highest rate of reported cases Rates of reported cases are higher in Hispanics than in blacks

Rates of reported cases are higher in the South than in the West, Midwest, or Northeast

reporting requirements for a person diagnosed with Chlamydia trachomatis infection in the United States?

Reporting is required in all states Laws and regulations in all states require reporting of all persons diagnosed with Chlamydia trachomatis infection to public health authorities by clinicians, laboratories, or both.

most consistent with current CDC recommendation for screening for chlamydial infection?

Routine annual screening for all sexually active females younger than 25 years of age The CDC recommends routine screening for chlamydial infection every 12 months for all sexually active females under the age of 25. More frequent screening may be considered in higher risk populations. There is no recommendation for routine screening for chlamydial infection in males, although it is reasonable in male populations who have a higher risk of acquiring chlamydial infection.

Which one of the following statements best reflects the 2012 U.S. Preventive Services Task Force (USPSTF) recommendations regarding cervical cancer screening to prevent invasive cervical cancer? Routine cervical screening should be performed starting at age 15 with cytology (Pap smear) and continue through age 50 Routine cervical screening should be performed starting at age 30 with cytology (Pap smear) and continue through age 50 Routine cervical screening should be performed starting at age 35 with cytology (Pap smear) and continue through age 70 Routine cervical screening should be performed starting at age 21 with cytology (Pap smear) and continue through age 65

Routine cervical screening should be performed starting at age 21 with cytology (Pap smear) and continue through age 65

Which one of the following statements best describes the 2016 U.S. Preventive Task Force Service Recommendation regarding serologic screening for genital herpes infection in asymptomatic adolescents and adults? It is recommended for all sexually active men ages 18 to 30 It is recommended for all sexually active women ages 18 to 30 It is recommended for all pregnant women Routine screening is not recommended

Routine screening is not recommended

Which one of the following statements regarding anogenital human papillomavirus transmission is TRUE? Transmission occurs predominantly via sexual activity and only in persons with visible genital lesions. Transmission via fomites accounts for up to 25% of cases. Approximately 50% of mothers with genital HPV at the time of delivery transmit HPV to their newborn. Use of condoms reduces, but does not eliminate the risk of sexual transmission of HPV.

Use of condoms reduces, but does not eliminate the risk of sexual transmission of HPV. Human papillomavirus (HPV) is predominately transmitted sexually and often involves persons who are asymptomatic or have subclinical HPV infection. Use of condoms reduces, but does not eliminate the risk of sexual transmission of HPV. Although HPV has been found in fomites, there are no clear documented cases of fomite-related HPV transmission. Mother-to-child transmission of HPV can infrequently occur and it can result in juvenile-onset respiratory papillomatosis.

Which one of the following regimens has been shown to reduce transmission of HSV in heterosexual HSV-2 discordant heterosexual couples? Famciclovir 250 mg orally once daily taken by the HSV-seropositive partner Famciclovir 500 mg orally once daily taken by the HSV-seronegative partner Valacyclovir 500 mg orally once daily taken by the HSV-seropositive partner Acyclovir 800 mg orally once daily taken by the HSV-seronegative partner

Valacyclovir 500 mg orally once daily taken by the HSV-seropositive partner

A 38-year-old man is seen with an episode of recurrent genital herpes. Which one of the following treatment options would be considered a recommended regimen for this man in this situation? Valacyclovir 1000 mg orally as a single dose Valacyclovir 500 mg orally twice a day for 3 days Acyclovir 400 mg orally once a day for 3 days Acyclovir 800 mg orally as a single dose

Valacyclovir 500 mg orally twice a day for 3 days

Which one of the following statements is TRUE regarding clinical presentations of anogenital warts? Anogenital warts always cause significant clinical symptoms Vulvovaginal warts may cause dyspareunia, pruritus, or burning discomfort Bleeding is not a known symptom associated with anal warts Anogenital warts rarely regress without treatment

Vulvovaginal warts may cause dyspareunia, pruritus, or burning discomfort Anogenital warts may present with a variety of symptoms and clinical appearances. They are frequently asymptomatic, but patients may describe dyspareunia, pruritus, and burning discomfort. Less common manifestations include impairment of urination, bleeding, and pain may be described. Studies suggest a spontaneous regression rate of 10% to 30%.

In 2018, which region of the United States had the highest rate of reported primary and secondary cases of syphilis in the United States? Midwest West Northeast South

West

In which one of the following groups is screening for bacterial vaginosis indicated? Women with HIV infection Pregnant women with a history of preterm birth Sex partners of persons diagnosed with bacterial vaginosis Women undergoing surgical abortion or hysterectomy

Women undergoing surgical abortion or hysterectomy Screening of asymptomatic women for bacterial vaginosis is generally not indicated, except in women undergoing surgical abortion or hysterectomy; treating bacterial vaginosis in these women has been shown to decrease rates of post-surgical infections. There is no evidence to support routine screening for bacterial vaginosis in women with HIV infection, pregnant women (at high or low risk for preterm delivery), or sex partners of women diagnosed with bacterial vaginosis.

Herpes simplex virus type 2 is a DNA virus that causes

chronic infection Herpes simplex virus (HSV) type 1 and type 2 have a single, linear molecule of double-stranded DNA that encodes approximately 74 genes. Following initial genital infection, HSV is transported from the infected epithelial cells along the peripheral nerve axons to the sacral ganglia and paraspinous ganglia. At this point, HSV establishes chronic infection and enters a latent phase.

Which one of the following statements about suppressive antiviral therapy for HSV-2 is TRUE? Suppressive antiviral therapy reduces the frequency of genital herpes recurrences by 25% Suppressive antiviral therapy with daily valacyclovir decreases the rate of HSV-2 transmission to susceptible heterosexual partners Suppressive acyclovir therapy will cause acyclovir resistance in about 30% of patients therapy Suppressive acyclovir therapy cannot be used in patients with renal impairment

Suppressive antiviral therapy with daily valacyclovir decreases the rate of HSV-2 transmission to susceptible heterosexual partners Suppressive therapy delays the time to first genital herpes recurrence and reduces the frequency of recurrences by approximately 75% in patients who have frequent recurrences. Furthermore, treatment with valacyclovir 500 mg daily has been shown to decrease the rate of HSV-2 transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection. There is no evidence that suppressive therapy leads to antiviral resistance, and all the anti-HSV antiviral agents can be dose-adjusted for patients with renal impairment.

In the life cycle of Chlamydia trachomatis, which particle is considered infectious and first infects the host cell? The elongation body The elementary body The rectangular body The reticulate body

The elementary body

Which one of the following statements is TRUE regarding the risk pelvic inflammatory disease (PID) associated with use of an intrauterine contraceptive device? The increased risk of PID is primarily confined to the first 3 weeks after insertion of the intrauterine contraceptive device The risk of PID decreases during the first 18 months after insertion of the intrauterine contraceptive device The increased risk of PID is primarily confined to persons who maintain the same intrauterine contraceptive device for more than 2 years There is no correlation of PID with use of an intrauterine contraceptive device

The increased risk of PID is primarily confined to the first 3 weeks after insertion of the intrauterine contraceptive device

Which one of the following is considered a preferred regimen for the treatment of trichomoniasis in a 28-year-old woman who is not pregnant and has not antimicrobial allergies? Metronidazole 500 mg orally in a single dose Tinidazole 2 grams orally in a single dose Amoxicillin 500 mg three times a day for 5 days plus metronidazole 500 mg twice a day for 5 days Doxycycline 100 mg twice a day for 3 days plus metronidazole 500 mg twice a day for 3 days

Tinidazole 2 grams orally in a single dose The preferred treatment for trichomoniasis is single-dose therapy with either metronidazole (2 grams orally) or tinidazole (2 grams orally). Patients need to be instructed that alcohol consumption should be avoided during treatment with metronidazole or tinidazole. To reduce the possibility of a disulfiram-like reaction, abstinence from alcohol use should continue for 24 hours after completion of metronidazole or tinidazole.

Which one of the following statements is TRUE regarding transmission of Treponema pallidum? Transmission occurs only via direct genital-to-genital sexual contact. Transmission can occur via sexual contact, fomites (contaminated objects), and with gastrointestinal secretions. Transmission can occur via sexual contact, from human bites, across the placenta, or through transfusion of blood products. Transmission can occur via sexual contact, human bites, respiratory droplets, and with gastrointestinal secretions.

Transmission can occur via sexual contact, from human bites, across the placenta, or through transfusion of blood products. Treponema pallidum is known to be transmitted via sexual contact, human bites, from mother-to-child across the placenta, or through transfusion of blood products. The transmission of T. pallidum has not been described with respiratory secretions, fomites, or gastrointestinal secretions.

best describes the transmission efficiency of herpes simplex virus (HSV)?

Transmission is most efficient from infected male to susceptible female partner The efficiency of sexual transmission is greater from males to females compared with females to males. Analysis of data from a randomized, double-blind, placebo-controlled trial found that on a per sex act basis, the rate of HSV-2 acquisition was nearly 6 times higher for women than for men.

Which one of the following statements is TRUE regarding the biology of Treponema pallidum? Treponema pallidum can be cultured in most microbiology labs if special culture media is used Treponema pallidum can be visualized via standard light microscopy with a modified Gram's stain Treponema pallidum is a motile spirochete bacterium that is approximately 6 to 20 micrometers in length Treponema pallidum is an atypical gram-negative bacterium that lacks lipopolysaccharide and is approximately 5 by 2 micrometers in size

Treponema pallidum is a motile spirochete bacterium that is approximately 6 to 20 micrometers in length

A pregnant women has multiple vulvar warts that she wants to have treated. Which one of the following choices is considered an acceptable option for this woman? Imiquimod Podofilox Trichloroacetic acid Topical cidofovir

Trichloroacetic acid For pregnant women with anogenital warts, watchful waiting is an acceptable option with smaller lesions, but there are several acceptable options available for treating external anogenital warts are available during pregnancy: cryotherapy, trichloroacetic acid, bichloroacetic acid, and surgical removal may be used. Women who are pregnant should not receive cytotoxic agents, including podophyllin, podofilox, and imiquimod.

What is the risk of developing tubal infertility following pelvic inflammatory disease (PID)? Tubal infertility occurs in approximately 35% of women after one episode of PID Tubal infertility occurs in approximately 8% of women after one episode of PID There is no evidence that PID increases the risk of tubal infertility Tubal infertility occurs in approximately 52% of women after one episode of PID

Tubal infertility occurs in approximately 8% of women after one episode of PID

What are the two human papillomavirus (HPV) types that play the most important role in causing cervical cancer in women? Types 3 and 5 Types 15 and 22 Types 6 and 11 Types 16 and 18

Types 16 and 18

Which one of the following is TRUE regarding the relationship between trichomoniasis and HIV infection? Women with trichomoniasis are 2 to 3 times more likely to acquire HIV infection Women with HIV infection are more likely to have recurrent trichomoniasis Women with HIV and trichomoniasis are more likely to have antibiotic-resistant trichomoniasis Women with HIV infection and Trichomonas vaginalis coinfection are more likely to deliver an infant that has neonatal trichomoniasis

Women with trichomoniasis are 2 to 3 times more likely to acquire HIV infection Trichomoniasis confers a two- to three-fold risk of acquiring HIV infection. Among women living with HIV, more than half are coinfected with Trichomonas vaginalis and are at an increased risk for pelvic inflammatory disease and for shedding of HIV in the genital tract. Women with HIV do not have higher risk of recurrent or resistant trichomoniasis, and there are no data to support a higher rate of neonatal trichomoniasis in infants born to HIV-infected women.

A 32-year-old HIV-negative man presents is diagnosed with secondary syphilis and neurosyphilis. He does not have any antibiotic allergies. Which one of the following regimens would you recommend for treatment? Benzathine penicillin G 4.8 million units total, administered as 2 doses of 2.4 million units IM each at 1-week intervals Benzathine penicillin G 7.2 million units total, administered as 3 doses of 2.4 million units IM each at 1-week intervals Aqueous crystalline penicillin G 18-24 million units per day, administered as 3-4 million units IV every 4 hours or continuous infusion, for 10-14 days Ceftriaxone 1 g IV daily for 3 days

Aqueous crystalline penicillin G 18-24 million units per day, administered as 3-4 million units IV every 4 hours or continuous infusion, for 10-14 days The recommended regimen for neurosyphilis is aqueous crystalline penicillin G 18-24 million units per day, given as 3-4 million units intravenous every 4 hours (or as continuous infusion), for a total of 10 to 14 days. An acceptable alternative regiment is procaine penicillin G 2.4 million units intramuscular once daily with probenecid 500 mg orally four times a day for 10 to 14 days. Benzathine penicillin, 2.4 million units IM once per week for up to 3 weeks, can be considered after completion of the neurosyphilis regimen.

Which one of the following best describes the most common clinical presentation of chlamydial urethral infection in males? Yellow urethral discharge Dysuria Scrotal pain Asymptomatic

Asymptomatic Although men with chlamydia infection may present with inflammatory signs and symptoms, most chlamydial urethral infections are asymptomatic. When discharge is present, it is usually mucopurulent, mucoid, or clear. Some patients will also have dysuria as a possible presentation, but this is less common. Scrotal pain is not commonly found in cases of urethritis, but is common in patients who develop epididymitis.

most common clinical presentation of chlamydial cervicitis in women?

Asymptomatic Women with cervical chlamydia infection most often are asymptomatic. When symptoms do appear they are typically non-specific and include vague pelvic discomfort and spotting. Women with chlamydial cervicitis can develop urethritis, pelvic inflammatory disease, and perihepatitis (Fitz-Hugh-Curtis syndrome). Chronic complications include fallopian tube scarring and infertility.

Which one of the following best describes the signs and symptoms of trichomoniasis in women? Foul, fishy odor and thick, clumpy white vaginal discharge Asymptomatic, or frothy gray or yellow-green vaginal discharge Dysuria, itching, and thin milky white vaginal discharge Mucosal ulcerations associated with pain and radicular symptoms

Asymptomatic, or frothy gray or yellow-green vaginal discharge Women with vaginitis caused by acute infection with Trichomonas vaginalis characteristically present with a frothy gray or yellow-green vaginal discharge and pruritus. Pelvic examination may show cervical petechiae ("strawberry cervix"). Many women, however, have no symptoms or minimal symptoms with trichomoniasis. Foul, fishy odor is characteristic of bacterial vaginosis whereas dysuria and milky white vaginal discharge best describes the presentation of candidiasis. Mucosal ulcerations generally do not result from any of the organisms that cause vaginitis.

In adults in the United States, Chlamydia trachomatis conjunctivitis occurs most often as a result of which one of the following: Genital-ocular sexual practices Autoinoculation from an individual's genital infection Extension from oropharyngeal infection Reactivation of congenitally-acquired infection

Autoinoculation from an individual's genital infection In adults, accidental autoinoculation from an individual's genital infection is the most common cause of chlamydial inclusion conjunctivitis; genital-ocular sexual practices are relatively rare and not a common route of inoculation in adults. Congenitally-acquired C. trachomatis conjunctivitis can occur from exposure of the neonate to infected secretions from the mother's genital tract during birth. Trachoma, a follicular conjunctivitis caused by C. trachomatis, can result in blindness, but the C. trachomatis serotypes associated with this infection are rare in the United States.

A 19-year-old woman has Chlamydia trachomatis detected on a screening test of a self-collected vaginal swab. She has a pregnancy test, which is negative. Which one of the following medications is recommended for treatment in this case? Doxycline 200 mg orally in a single dose Ciprofloxacin 500 mg orally twice daily for 5 days Levofloxacin 250 mg orally once a day for 5 days Azithromycin 1 g orally in a single dose

Azithromycin 1 g orally in a single dose

appropriate first-line therapy for urogenital infection due to Chlamydia trachomatis in an adult?

Azithromycin 1 gram orally in a single dose The 2015 STD Treatment Guidelines recommend treating urogenital Chlamydia trachomatis infection in adults with either azithromycin 1 gram orally in a single dose or doxycycline 100 mg orally twice a day for 7 days. For rectal chlamydial infections, some experts prefer using doxycycline rather than azithromycin. Erythromycin ethylsuccinate and levofloxacin are considered acceptable alternative agents for the treatment of urogenital C. trachomatis infection.

Management of sex partners of women with pelvic inflammatory disease (PID) includes which of the following strategies? There are no recommendations for partner management of women with PID Male partners should be tested and empirically treated for gonorrhea and chlamydia if they had sexual contact during the 60 days preceding onset of the patient's symptoms Male partners should be tested and empirically treated for trichomoniasis if they had sexual contact during the 30 days preceding onset of the patient's symptoms Female partners should be tested and empirically treated for bacterial vaginosis if they had sexual contact during the 30 days preceding onset of the patient's symptoms

Male partners should be tested and empirically treated for gonorrhea and chlamydia if they had sexual contact during the 60 days preceding onset of the patient's symptoms All male sex partners who have had contact with a woman with PID during the 60 days preceding onset of the woman's symptoms should be examined, tested, and receive presumptive treatment for gonorrhea and chlamydia. If a patient's last sexual intercourse was longer than 60 days before onset of symptoms or diagnosis, the patient's most recent sex partner should be treated.

Which one of the following is a recommended treatment regimen for non-pregnant women with symptomatic bacterial vaginosis? Metronidazole 2 grams orally in a single dose Tinidazole gel 0.75%, 5 grams intravaginally as a single application Metronidazole 500 mg orally twice a day for 7 days Clindamycin 300 mg orally twice a day for 14 days

Metronidazole 500 mg orally twice a day for 7 days The 2015 STD Treatment Guidelines recommend any of the following regimens as first-line therapy for bacterial vaginosis in non-pregnant women: (1) metronidazole 500 mg orally twice a day for 7 days, 2) metronidazole gel 0.75%, one full applicator (5 grams) intravaginally once daily for 5 days, or 3) clindamycin cream 2%, one full applicator (5 grams) intravaginally at bedtime for 7 days. Alternative options include oral tinidazole, oral clindamycin, and intravaginal clindamycin ovules. Single-dose metronidazole should not be used to treat bacterial vaginosis.

A 22-year-old man is diagnosed with syphilis and condylomata lata. What is condylomata lata? A term used to describe patients with large, irregular chancres in patients with primary syphilis. Moist, wart-like papular lesions that develop in 10-20% of patients with secondary syphilis. Multiple cauliflower-like warts that emerge in secondary syphilis as a result of Treponema pallidum upregulation of human papillomavirus in genital epithelial cells. A rare cutaneous disorder manifested as growths on the scalp in patients with tertiary syphilis

Moist, wart-like papular lesions that develop in 10-20% of patients with secondary syphilis. Patients with secondary syphilis can have protean manifestations, including condylomata lata. Approximately 10 to 20% of patients with secondary syphilis will develop condylomata lata, which manifests as moist, papular lesions in warm intertriginous areas. These lesions are not the same as human papillomavirus-related condyloma acuminata.

Which one of the following statements is TRUE regarding the natural history of HPV infection? More than 90% of HPV infections are cleared within 2 years. Persistent HPV infection consistently leads to development of HPV-related cancer within 10 years. Clearance of HPV infection only slightly reduces a person's risk of developing HPV-related cancer. The average time from infection with HPV until the development of HPV-related cancer is 6.5 years.

More than 90% of HPV infections are cleared within 2 years. The natural history of infection with HPV is a dynamic process, with more than 90% of persons clearing the infections within 2 years. In a small minority of persons, persistent infection with HPV can result in the eventual development of cancer, but this typically does not occur until decades after the initial acquisition of HPV.

Which one of the following statements most accurately describes the natural history of human papillomavirus (HPV) infection? More than 90% of individuals with genital HPV infections are asymptomatic and more than 90% clear the infection within 2 years Approximately 60% of individuals with genital HPV infections are symptomatic and 50% clear the infection within 3 years Approximately 90% of individuals with genital HPV infections are symptomatic and 20% clear the infection within 5 years Approximately 60% of individuals with genital HPV infections are asymptomatic and 60% clear the infection within 2 years

More than 90% of individuals with genital HPV infections are asymptomatic and more than 90% clear the infection within 2 years

Which one of the following statements is TRUE regarding the microbiology of pelvic inflammatory disease? Most cases are caused by Lactobacillus crispatus Most cases are caused by Mycoplasma genitalium Most cases are polymicrobial Most cases are caused by Ureaplasma urealyticum

Most cases are polymicrobial

best describes the clinical sign and symptoms of urethritis caused by infection with Neisseria gonorrhoeae in men?

Most men complain of urethral discharge In contrast to chlamydial urethritis, which is more frequently asymptomatic, most men with urethritis due to Neisseria gonorrhoeae infection complain of urethral discharge and/or urethral discomfort. Epididymitis is a possible complication of genitourinary gonococcal infection, but most men with gonorrhea do not develop epididymitis. Coinfection with Chlamydia trachomatis does not significantly alter the clinical presentation of urethritis caused by N. gonorrhoeae.

Which one of the following is described as a risk factor associated with PID? Use of female condom with spermicide Multiple sexual partners Diabetes mellitus Use of a diaphragm

Multiple sexual partners Multiple sexual partners, age younger than 20 years, and current or prior infection with gonorrhea or chlamydia have consistently been demonstrated to be significant risk factors for PID. Other possible risk factors include history of PID, male partners with gonorrhea or chlamydia, current douching, insertion of IUD, bacterial vaginosis, and oral contraceptive use.