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Function & Dysfunction > STI > Flashcards

STI Flashcards

1
Q

STI Risk Groups​

A

Men who have sex with men (MSM)​
Sexually active gay, bisexual and other men ​
Not using condoms​
Anal sex increases risk: “riskiest sexual behaviour” for exposure to HIV.​

Apps- Online​
Commercial Sex Workers (CSW) and their clients​
Multiple Partners who they don’t know the sexual history of​
Unprotected Oral Sex- transmission route for most STIs.​
People from countries with higher rates of STIs​
High-risk regions include: Sub-Saharan Africa South-East Asia Latin America/Caribbean​

People with multiple partners, or partners from other high risk group​
Increases the risk of STIs being passed on quickly.​

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2
Q

Consequences of Infection​

A

Women​
Infertility​
Pelvic Inflammatory Disease​
Cervical Cancer​
Adverse pregnancy outcomes​

Men​
Infertility ​
Narrowing of the Urethra​

Infants​
Eye Infections​
Blindness​
Death​

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3
Q

What are the main groups of sexually Transmitted Infections​

A

viral diseases
bacterial diseases
parasitic

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3
Q

Chlamydia

A

Chlamydia: Silent epidemic​
Pathogen - Chlamydia trachomatis​
Gram Negative​
Pelvic Inflammatory Disease, Eye Infections, urethritis​
nonmotile coccoid bacteria that are obligate intracellular parasites of eukaryotic cells.
Can be grown in tissue culture​
Reticular body​
Elementary body – infectious form of mucosal cells

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4
Q

Chlamydia Symptoms​

A

MEN​
Urethritis​
Proctitis​
Epididymitis​

WOMEN​
Urethritis​
Endocervicitis​
Proctitis​
PID​
Perihepatitis​

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5
Q

Chlamydia Diagnosis & Treatment​

A

Diagnosis- ​
What is the specimen site??​
Clinical examination​
Urine test- 1-2 hours after last expulsion​
Bacterial Culture​
Nucleic acid probes – PCR​

Treatment​
Patient and partner(s) should be treated​
Doxycycline​
Erythromycin​
AZITHROMYCIN​ (first choice)-however some bacteria are becoming resistant therefore we use a combination of antibiotics

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6
Q

Neisseria gonorrhoea​

A

Pathogen – Neisseria gonorrhoea​
Gram-negative diplococcus​
SYMPTOMLESS – then severe​

Can be cultured in selective media​
Sexual contact​
Perinatal​
Less common than Chlamydia​
Prevalence varies with population​

Can also get infections of the throat, rectum, eyes and conjunctiva.​​

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7
Q

Gonorrhoea: signs and symptoms??

A

Can be disseminated around the body:​
Arthritis​
Dermatitis​
Pericarditis and endocarditis​
Meningitis​- affect lining of brain
Infections in testicles​
PID​

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8
Q

Gonorrhoea Diagnosis & Treatment​

A

Diagnosis​
Clinical examination​
Men- urine, urethra​
Women- Vagina or Cervix​
Gram stain​
Culture​
Nucleic acid probes​

Treatment​
Patient and partner(s)should be treated​
Drugs of choice​
Ceftriaxone – 125 mg i.m.​
Azithromycin​

Unfortunately antibiotic resistance is increasing

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9
Q

“Super” Gonorrhoea ​

A

1st ever case of Super gonorrhoea in the UK March 2018​
Patient: unprotected sex in South East Asia​
Infection failed to respond to 1st line antibiotics​
Ceftriaxone and azithromycin​
Patient treated with ertapenem- after trial and error​

MDR Gonorrhoea prevalent in countries with sex tourism​
Where antibiotics can be purchased easily​
Infection has moved onto Australia​

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10
Q

Syphilis​

A

Pathogen: Treponema pallidum​
Spiral shaped, tend to be Gram negative​
Grows in cell co-cultures at low oxygen concentrations in brewer’s jar​
Sexual contact​
Can stay in the body without symptoms​
Increase in syphilis cases in MSM​

a large significant difference between men and women with a lot more cases affecting in men

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11
Q

Syphilis Infection​

A

Primary​
Secondary​
Latent (early and late) ​
Tertiary (late)​

Late stage Clinical Manifestation​
Destructive gummas (growth) in skin, bones and organs​
Aortic valve injury​
CNS manifestations​
Dementia​

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12
Q

Syphilis during pregnancy

A

Foetal death​
Growth restriction​
Multiple anomalies​
Immediately apparent at birth​
Delayed appearance​

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13
Q

Diagnosis and Treatment​

A

Diagnosis​
Clinical examination​
Serology – mainstay of diagnosis​ (antibodies to detect)
VDRL (venereal disease research laboratory)​
RPR (rapid plasma reagin) – screening test​
MHA (Microhemagglutination)​ (blood cells are used they have antigen if there is a reaction like clotting there serum is positive for syphilis)
FTA fluorescent treponemal antibody absorption using entire lysed bacterial cells ​

Treatment​
Patient and sexual partner(s) should be treated​
Antibiotic therapy​
Penicillin – preferred in pregnancy​
Doxycycline​
Tetracycline​

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14
Q

Bacterial STI’s

A

Chlamydia, gonorrhoea and syphilis

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15
Q

Viral STI’s​

A

Herpes

16
Q

Herpes Simplex Virus​

A

Genital Herpes!​
alphaherpesvirus subfamily of herpesviruses​
dsDNA enveloped virus, genome of ~150 kb​
HSV-1 and HSV-2 share 50 - 70% genetic homology​
antigenic cross-reaction with VZV (chickenpox)​
Genital lesions may be primary or recurrent ​

17
Q

Herpes Simplex Virus Symptoms​

A

Pain, itching, scarring, scabs, open sores​
Red bumps, tiny white bumps/ulcers/blisters, take weeks to heal​
Dangerous in premature infants​
Dissemination; where the brain is involved, the prognosis is severe.​
Residual disabilities.​
Treated with Acyclovir​=antiviral
Prevention is to offer Caesarean​

18
Q

Human Papilloma Virus (HPV)​

A

Causes Genital Warts, often symptomless ​
Papillomavirus family​
dsDNA virus, genome of ~150 kb​
Genital warts and laryngeal papilloma​
HPV Vaccines prevention, safe sex​
Can cause cancer (oncogenic)​
Cervical Cancer screening​

19
Q

Human Papilloma Virus Vaccine​

A

Gardasil 9 ​
90% Efficacy!​
Vaccine can eliminate disease​
Fewer Cervical Smears​

20
Q

HPV Symptoms & Treatment​

A

HPV can affect the mouth, throat or genital area​
Penetrative sex is not essential​

Transmission routes:​
any skin-to-skin contact of the genital area​
vaginal, anal or oral sex​
sharing sex toys​

Diagnosis:​
Cervical Smear​
If HPV is linked to cancer (abnormal changes) then appropriate cancer diagnosis and treatment routes are established.​

Cancer types include:​
Cervical cancer​
Anal cancer​
Penile cancer​
Vulval Cancer​
Vaginal Cancer ​

21
Q

HIV/AIDs​

A

Acquired Immune Deficiency Syndrome​
Death usually results from an opportunistic Infection​
HIV discovered in 1984 by Luc Montagneir​

In 2019, a total of 98,552 people (30,388 females and 68,088 males) were seen for HIV care in the UK​

HIV is transmitted via Four body fluids​

  1. Blood (needles, contact blood-blood)​
  2. Semen (sex- high risk sex)​
  3. Vaginal Secretions (Sex, birth- mother to child)​
  4. Breast Milk (mother to child)​
22
Q

HIV/AIDs: Diagnosis and Treatment​

A

Diagnosis​
Enzyme Linked Immunosorbent Assay tests for HIV Antibodies​
If ELISA is positive, same sample is tested again​
If ELISA is positive again, then a Western Blot Test is done (proteins for virus are detected highly specific).​
Western Blot - test for Viral antigens​
Prophylaxis- PreP -preexposure prophylaxis​

Treatment​
AZT: azidothymidine (inhibits viral RT, analogue of dGTP)​
3TC ( 2’-deoxy-3’-thiacytidine – cytosine analogue)​
Protease Inhibitor (HIV-1 protease essential for virulence)​

23
Q

Parasitic STI’s​

A

Phthirus pubis​

Found in​ underarm and leg hair​
hair on the chest, abdomen and back​
facial hair, such as beards and moustaches​
eyelashes and eyebrows (very occasionally)​

Biology​
Adults are small (2mm). Yellow-grey/red​
6 legs​
Look like small crab- hold onto hair base​
Eggs laid in sac that sticks onto hair​
Visible in hair​

24
Q

Phthirus pubis​

A

Sexually transmitted​
Bodily contact​
Condoms do not prevent this!​

Treatment​
Treated at home ​
Insecticidal creams, lotions, shampoos​
3-7 days​
Lice can become resistant​
To prevent re-infection all sexual partners should be treated​

25
Q

Trichomonas vaginalis​

A

Trichomoniasis​
Common in women​
Lower genital tract infection​
70% cases are Symptomless​

Diagnosis​
-Symptoms​
-Antigen tests​
-PCR​

Complications​
-Perinatal​
-Co-occurrence with other STIs​

26
Q

Trichomonas vaginalis​

A

Symptoms in Men​
Itching or irritation inside the penis;​
Burning after urination or ejaculation;​
Discharge from the penis.​

Symptoms in Women​
Itching, burning, redness or soreness of the genitals;​
Discomfort with urination;​
A change in their vaginal discharge -unusual fishy smell.​
Metronidazole​

27
Q

STI Prevention​

A

Safe Sex​

Abstinence: The only sure way to prevent contracting an STI is not to have oral, anal or vaginal sexual contact.​

Condoms -only protect the skin they cover, any sores/warts found on the genital region not covered by the condom can still spread to another person’s skin.​

Get tested and have regular check ups​
Kits!​

Function & Dysfunction (19 decks)

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