CC Jan 2017 Nongonococcal Urethritis

echoecho's version from 2017-05-08 04:54


Question Answer
What is seen in symptomatic patients?Urethral discharge (mucopurulent or purple to), dysuria, or urethral pruritus
In men, infectious urethritis has been subdivided by etiology, list these?1) gonococcal 2)nongonococcal (NGU)
What bacteria is the most common cause of NGU (15-40% of cases)?Chlamydia trachomatis
In most cases of NGU not caused by C. Trachomatis, it is NOT possible to identify an organism, although what are possible etiologic agents?1) mycoplasma genitalia. 2) Ureaplasma urealyticum. 3) Trichomonas vaginalis. 4) herpes simplex. 5) adenovirus
Mycoplasma genitalium is becoming more prevalent and is a rising concern due to what?Antibiotic resistance and its capacity to cause other genital tract disorders in men (chronic prostatic is and epididymitis) as well as cervicitis, PID, pregnancy complications and infertility in women
Why are urethral irritating symptoms (itching, dysuria) NOT sufficient to make a diagnosis of urethritis?because these complaints may also be present with stenosis and trauma
Providers should attempt to obtain objective evidence of inflammation by documenting the presence of what three things?1) mucopurulent or purulent discharge. 2) > 5 WBC per high power field on Gram stain of the discharge. 3) first-void urine testing with positive leukocyte esterase or > 10 WBC/HP
*** Any male presenting the above urethral symptoms should undergo testing for what two organisms using what type of tests?1) N. gonorrhoeae and C. Trachomatis. 2) NAATs (nuclei acid amplification tests)
While in research settings NAATs for the detection of Mycoplasma genitalium have shown a high level of sensitivity and specificity, has the FDA approved tests for current use?no
*** The CDC updated its recommendations in Aug 2012 and again in 2015. Which 2 mess are NO longer first-line agents due to resistance and decreased efficacy? What is the preferred drugs?1) oral cephalosporins and fluoroquinolones 2) Ceftriaxone (Rocephin) 250 mg IM plus a single oral dose of 1 gm azithromycin (Zithromax)
Whether gonorrhea and chlamydia tests are positive or negative, it is imperative to notify and evaluate all sexual partners in the preceding ____ days?60
If the index patient is positive for either gonorrhea or chlamydia, one of the recommended _____ regimens is given to the pattern?treatment
If the testing is negative, the partner should receive empiric treatment for _______?C. Trachomatis
Both _____ and axzithromycin treat chlamydia, although they are less effective against what organism?Mycoplasma genitalium