STIs

Swab/Urine

Chlamydia: usually asymptomatic. Screen routinely. Can cause infertility/PID and Fitz-hugh-curtis. Treat with Azithro x1
Gonorrhea: often asymptomatic. Screen routinely. Can cause infertility/PID. Treat with Ceftriaxone and Azithromycin
Trich: frothy/watery discharge. “Strawberry cervix” Can see trich moving on wet mount. Treat Flagyl 2g PO once.
HPV: Cervical dysplasia/cancer and Genital warts. Topical treatments as needed.

Serum

Syphilis: Painless chancre followed by latent, then secondary with palmar/plantar rash. If unsure stage, treat as if latent, PCN IM x3
HIV: Universal screening. PREP if high risk. Referral to ID and counseling if positive.
Hep B: Treatable, not curable. Routine serum screening.

No Routine Screening, diagnose if lesion

HSV: Antivirals as needed for outbreaks, can prophylax if frequent outbreaks/immunosuppressed. Valacyclovir or acyclovir are most common.