1. Step 9
1.1. Review session 2
1.2. mechanism flow chart
1.3. 20 minutes
2. Step 10
2.1. Management
2.1.1. goals
2.1.2. antibiotics
2.1.2.1. doxycyclin
2.1.2.1.1. one week to three weeks
2.1.2.1.2. 1st line therapy
2.1.2.1.3. was shown as more effective than azithromycin
2.1.2.1.4. 100 mg
2.1.2.1.5. inhibits the protein synthesis of the bacteria
2.1.2.1.6. cheeper than azythromycin and has multiple doses
2.1.2.1.7. better in complicated cases
2.1.2.1.8. palpitatio
2.1.2.2. azithromycin
2.1.2.2.1. one single dose
2.1.2.2.2. 1st line therapy
2.1.2.2.3. recommended in pregnants
2.1.2.2.4. higher cost
2.1.2.2.5. palpitation is one of the side effects
2.1.2.3. erythromycin and penicilin
2.1.2.3.1. in pregnancy
2.1.2.3.2. more side effects
2.1.2.4. there is some interaction with alcoho
2.1.2.5. if noncompliance is a concern so the dose van be as single and admission can be done
2.1.2.6. adding ofloxacin if gonorrhea is a co-infection
2.1.2.6.1. not recommended in children and pregnants because of side effects
2.1.2.7. only if symptoms persist, infection tests can should be done, and in pregnancy
2.1.2.8. gonorrhea treatment and testing is highly indicated in hih risk people (infected parter and endemic areas)
2.1.2.9. shouldnt have intercorse during treatment period
2.1.2.9.1. safe sex counseling including condoms can be done as protection
2.1.2.10. contact tracing is very important to prevent infections
2.1.2.10.1. it is not perfectly well in many areas
2.1.2.10.2. empirical treatment can be administered
2.1.2.11. HIV and pregnancy tests
2.1.2.12. vaccination for HBV and HPV
2.1.3. follow-up
2.1.3.1. re-testing
2.1.3.1.1. after 3 months of tratment
2.1.3.2. test of cure
2.1.3.2.1. after 3 weeks of treatment
2.2. Prevention
2.2.1. primary
2.2.1.1. education about safe sex
2.2.1.1.1. condoms and OCP for pregnancy
2.2.1.2. vaccinations for HBV and HPV
2.2.1.3. education about all types of sex especially in some people like truck drivers
2.2.2. secondary
2.2.2.1. screening annualy for chlamydia and gonorrhea for high risk people like infected partners and homosexual (man having sex with man) people, even if theres asymptomatic
2.2.3. tertiary
2.2.3.1. regular pap-smear is crucial especially in high risk patients for cervical cancer