Notes on Treatment of Sexually Transmitted Diseases (STDs) and MCQ for GPAT, NEETPG, Nursing, Pharmacy exams

Notes on Treatment of Sexually Transmitted Diseases (STDs) and MCQ for GPAT, NEETPG, Nursing, Pharmacy exams

🦠 1. Chlamydia trachomatis

🔹 Treatment:

  • First-line:

    • Doxycycline 100 mg PO BID × 7 days

  • Alternative (e.g., pregnancy):

    • Azithromycin 1 g PO single dose

🔹 Notes:


🦠 2. Neisseria gonorrhoeae

🔹 Treatment:

  • First-line:

    • Ceftriaxone 500 mg IM single dose

    • (If chlamydia not ruled out: add Doxycycline 100 mg PO BID × 7 days)

🔹 Notes:

  • Dual therapy to prevent resistance

  • Test for co-infections (chlamydia, HIV, syphilis)


🦠 3. Treponema pallidum (Syphilis)

🔹 Early Syphilis (Primary, Secondary, Early Latent <1 year):

  • Benzathine Penicillin G 2.4 million units IM single dose

🔹 Late Latent or Unknown Duration:

  • Benzathine Penicillin G 2.4 million units IM weekly × 3 weeks

🔹 Neurosyphilis:

  • Aqueous Penicillin G IV 3–4 million units q4h × 10–14 days

🔹 Notes:

  • Penicillin allergy: Doxycycline or Desensitization (preferred in pregnancy)


🦠 4. Trichomoniasis (Trichomonas vaginalis)

🔹 Treatment:

  • Metronidazole 2 g PO single dose

  • OR Tinidazole 2 g PO single dose

🔹 Notes:

  • Treat partners

  • Avoid alcohol for 24–72 hours after dose (disulfiram reaction)


🦠 5. Genital Herpes (HSV-1, HSV-2)

🔹 First Episode:

  • Acyclovir 400 mg TID × 7–10 days

  • OR Valacyclovir 1 g BID × 7–10 days

🔹 Recurrent Episodes:

  • Acyclovir 400 mg TID × 5 days

  • OR Valacyclovir 500 mg BID × 3 days

🔹 Suppressive Therapy:

  • Acyclovir 400 mg BID

  • OR Valacyclovir 500–1000 mg daily


🦠 6. Human Papillomavirus (HPV)

🔹 Treatment:

  • Genital Warts (external):

    • Podophyllotoxin, Imiquimod, Cryotherapy, or Surgical removal

  • Prevention:

    • HPV vaccine (e.g., Gardasil-9)

🔹 Notes:

  • Vaccine recommended for males and females aged 9–26 years (up to 45 in some cases)


🦠 7. Pelvic Inflammatory Disease (PID)

🔹 Outpatient:

  • Ceftriaxone 500 mg IM single dose

  • PLUS Doxycycline 100 mg BID × 14 days

  • ± Metronidazole 500 mg BID × 14 days

🔹 Inpatient:

  • Cefotetan IV + Doxycycline

  • OR Clindamycin + Gentamicin


🦠 8. HIV Post-Exposure Prophylaxis (PEP)

🔹 Start within 72 hours:

  • Tenofovir + Emtricitabine (Truvada) + Raltegravir or Dolutegravir × 28 days


⚠️ General Principles of STD Management

Principle Description
Partner Notification Sexual partners should be tested/treated
Abstinence Avoid sex until treatment complete and symptoms resolved
Retesting Retest after 3 months for chlamydia/gonorrhea
Counseling Educate about safe sex, condom use, and risk reduction
Vaccination HPV and hepatitis B vaccination recommended for prevention

MCQs on STD Treatment

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1. A 24-year-old woman is diagnosed with uncomplicated Chlamydia trachomatis infection. Which is the preferred first-line treatment?

A. Azithromycin 1 g PO single dose
B. Doxycycline 100 mg PO BID for 7 days
C. Ciprofloxacin 500 mg BID for 7 days
D. Ceftriaxone 250 mg IM single dose

✅ Answer: B. Doxycycline 100 mg PO BID for 7 days


2. Which antibiotic is used as a single-dose intramuscular injection for treating gonorrhea?

A. Doxycycline
B. Azithromycin
C. Ceftriaxone
D. Metronidazole

✅ Answer: C. Ceftriaxone


3. What is the drug of choice for primary syphilis?

A. Benzathine Penicillin G IM single dose
B. Ceftriaxone IM single dose
C. Doxycycline PO for 3 days
D. Azithromycin PO single dose

✅ Answer: A. Benzathine Penicillin G IM single dose


4. Which of the following is contraindicated with alcohol due to a disulfiram-like reaction?

A. Acyclovir
B. Ceftriaxone
C. Metronidazole
D. Doxycycline

✅ Answer: C. Metronidazole


5. A sexually active woman presents with a frothy green vaginal discharge and is diagnosed with Trichomoniasis. Which of the following is appropriate treatment?

A. Acyclovir 400 mg BID for 5 days
B. Metronidazole 2 g PO single dose
C. Doxycycline 100 mg BID for 7 days
D. Valacyclovir 1 g BID

✅ Answer: B. Metronidazole 2 g PO single dose


6. Which antiviral is commonly used for suppressive therapy in recurrent genital herpes?

A. Metronidazole
B. Valacyclovir
C. Amoxicillin
D. Doxycycline

✅ Answer: B. Valacyclovir


7. A 30-year-old man with genital warts asks about prevention. What is the best option?

A. Doxycycline
B. Benzathine Penicillin G
C. HPV Vaccine (Gardasil 9)
D. Metronidazole

✅ Answer: C. HPV Vaccine (Gardasil 9)


8. Which of the following drug combinations is appropriate for Pelvic Inflammatory Disease (PID) outpatient treatment?

A. Ceftriaxone + Doxycycline
B. Acyclovir + Valacyclovir
C. Azithromycin + Metronidazole
D. Penicillin G + Gentamicin

✅ Answer: A. Ceftriaxone + Doxycycline


9. Post-exposure prophylaxis (PEP) for HIV should ideally be started within how many hours of exposure?

A. 12 hours
B. 24 hours
C. 48 hours
D. 72 hours

✅ Answer: D. 72 hours


10. What is the treatment of choice for neurosyphilis?

A. Benzathine Penicillin G IM
B. Oral Doxycycline
C. IV Aqueous Penicillin G
D. Azithromycin

✅ Answer: C. IV Aqueous Penicillin G

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