[2] Trichomoniasis Flashcards

1
Q

What is trichomoniasis?

A

A curable sexually transmitted infection caused by the protozoan trichomonas vaginalis (TV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How common is trichomoniasis?

A

The most common curable STI worldwide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is happening to the incidence and prevalence of trichomoniasis?

A

Decreasing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does the incidence of trichomoniasis in the UK compare to worldwide statistics?

A

Less common - 7000 cases in 2016

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What age group is trichomoniasis most common in?

A

Under 25s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which ethnic group is trichomoniasis most common in?

A

Black

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is trichomonas vaginalis transmitted?

A
  • Vaginal sexual intercourse

- Rarely vertical transmission at delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Is trichomonas vaginalis spread through oral or anal sex?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of organism is trichomonas vaginalis?

A

Anaerobic flagellated protozoan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Does trichomonas vaginalis affect males or females?

A

Both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where can trichomonas vaginalis infect in women?

A
  • Urethra
  • Vagina
  • Paraurethral glands
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where can trichomonas vaginalis affect in men?

A
  • Urethra

- Underneath foreskin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What site is most commonly affected by trichomonas vaginalis?

A

Urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How many sites are often affected by trichomonas vaginalis?

A

More than one

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does trichomonas vaginalis affect the site it colonises?

A

Replicates via binary fission whilst destroying epithelial cells through direct cell contact and by the release of cytotoxins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How can trichomonas vaginalis affect the immune system?

A

Binds to host plasma proteins preventing recognition by complement pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What can trichomonas vaginalis infection increase the risk of contracting?

A

HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the risk factors for trichomoniasis?

A
  • Multiple sexual partners
  • Unprotected sexual intercourse
  • History of other STIs
  • Older women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What proportion of trichomoniasis cases are symptomatic?

A

Many

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

In which gender is asymptomatic trichomoniasis more common?

21
Q

How do most men with trichomoniasis present?

A

As a partner of a symptomatic infected woman

22
Q

When do symptoms of trichomoniasis develop after infection?

A

Within 28 days

23
Q

What are the symptoms of trichomoniasis in women?

A
  • Offensive vaginal discharge
  • Abnormal vaginal discharge
  • Itchiness or soreness of the vulva
  • Dyspareunia
  • Dysuria
24
Q

What is the appearance of the discharge in trichomoniasis?

A

Can be thick or thin and frothy yellow-green colour

25
What are the symptoms of trichomoniasis in men?
- Urethral discharge - Dysuria - Urinary frequency - Pain or itching around foreskin
26
What are the signs of trichomoniasis in women?
- Abnormal vaginal discharge - Vulvitis - Vaginitis - Strawberry cervix
27
What is a strawberry cervix?
Punctate and papilliform appearance
28
What are the signs of trichomoniasis in men?
- Urethral discharge | - Balanoposthitis
29
What is balanoposthitis?
Inflammation of the glans penis
30
How common is balanoposphitis?
Rare
31
What are the differentials for trichomoniasis?
- Other vaginal infections - Other causes of vaginal discharge - Atrophic vaginitis - Post-surgery discharge - Other causes of prostatitis, cervicitis and cystitis
32
What are some other vaginal infections?
- Candidiasis - BV - Chlamydia - Gonorrhoea
33
What are some benign causes of vaginal discharge?
- Physiological - Chemical irritants - Pregnancy
34
What steps are important to attempt to diagnose trichomoniasis before investigations?
- History | - Examination
35
How is trichomoniasis investigated?
Culture and sensitivity testing
36
How are sample obtained for trichomoniasis culture testing in women?
- High vaginal swab from posterior fornix | - OR self administered vaginal swab
37
How are samples obtained for trichomoniasis culture testing in men?
- Urethral swab | - First void urine sample
38
What is required if a patient tests positive for trichomoniasis?
- Contact tracing | - Full STI screen
39
What type of medication is used to treat trichomoniasis?
Anti-protozoan
40
What is the drug of choice for trichomoniasis in men and non-pregnant/breast-feeding women?
Metronidazole
41
What are the treatment regimes for trichomoniasis with metronidazole?
- 2g orally as single dose | - OR 400-500mg BD for 5-7 days
42
What is an alternative single dose medication for trichomoniasis?
2g tinidazole
43
Which contacts should be tested for trichomoniasis?
Any current or previous sexual partners in the preceding 4 weeks
44
For how long should patients with trichomoniasis abstain from sex?
- Whilst being treated | - OR 1 week after single dose
45
When is a test of cure required for trichomoniasis?
- Patient is not responding to treatment | - Re-infected
46
What is the risk of trichomoniasis in pregnancy?
- Pre-term labour - Low birth weight - Maternal post-partum sepsis
47
How is trichomoniasis treated differently in pregnancy?
Avoid high (single) dose metronidazole
48
How is trichomoniasis treated when breast feeding?
- Avoid single dose | - OR avoid breast feeding for 12-24 hours after single dose