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MD3002 post MSA > STDs > Flashcards

STDs Flashcards

1
Q

what are the most common STIs

A 
HPV
chlamydia
(candida)
trichomonas vaginalis 
herpes
gonorrhoea 
syphylis 
hep b
chancroid (haemophilus)
lymphogranuloma venereum
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2
Q

describe the epidemiology

A

young people

have many more partners

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3
Q

what are the risk factors for STIs

A 
young 
failure to use a barrier
sex with people of the same sex
IV drug use
african origin
social deprivation
prostitution and paying for sex
poor access to advice and treatment
non regular relationships
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4
Q

what are the determinants of risky sexual behaviours

A

individual factors
external influences- peer pressure, attitudes and prejudices and stigma
service provision

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5
Q

what are the causes of genital discharge disease

A

chlamydia trachomatis

gonorrhoea

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6
Q

what are the features of chlamydia

A

obligate intracellular gram negative

can cause trachoma( eye disease)
or causes genital infection
or causes lymphogranuloma venereum
may cause eye infections in neonates

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7
Q

what are the symptoms of chlamydia

A 
vaginal/ anal/ urethral discharge
post coital bleeding 
epididymal tenderness
abdo tenderness
pelvic tenderness
reiter's syndrome
(arthritis, urethritis and conjunctivitis) 
proctitis
pharyngitis
perihepatitis 
skin lesions 
watery discharge
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8
Q

what chlamydia investigations are there

A

urine (nucleic acid amplification test)
endocervical swab
antigen detection
cell culture

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9
Q

what is chlamydia treated with

A

azithromycin and tetracycline

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10
Q

what are the features of gonorrhoea

A

gram negative
intracellular diplococcus
humans only
infects epithelial cells of mucous membrane
localised infection and production of pus
can be assymptomatic

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11
Q

what are the symptoms of gonorrhoea

A 
inflammation and discharge
cervical discharge 
rectal infection 
oral pharyngitis 
disseminated infection 
septic infection 
dysuria
salpingitis (PID)
post coital bleeding 
epididymal tenderness 
can be transmitted orogenitally 
PAIN AND PUSS - men
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12
Q

what is opthalmia neonatorum

A

conjunctivitis contracted by new borns during delivery
mother infected wiht N gonorrhoea or C trachomatis
can cause blindness

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13
Q

how is gonorrhoea diagnoses

A

microscopy
NAAT
culture

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14
Q

how is gonorrhoea treated

A

cetriaxone
cefixime
ciprofloxacin

increasing resistance

may have a concommitant chlamydia infection - doxycycline

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15
Q

what are the features of thrush

A

itchy vaginitis
may present as a UTI
microscopy/ culture used to diagnose

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16
Q

how is thrush treated

A

oral fluconozole

or topical/ pessary triazole

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17
Q

what are the features of trichomonas vaginalis

A 
anaerobic, flagellated protozoa 
infects vagina/ urethra
causes trichomoniasis 
common in men, uncommen in woman 
yellowish vaginal discharge
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18
Q

what is trichomonas vaginalis treated with

A

metronidazole

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19
Q

where are genital warts found

A

shaft of penis

vagina, vulva and cervix

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20
Q

what are the features of HPV

A

hyperplastic epithelial lesions

incubation for 1- 6 months

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21
Q

what symptoms can HPV cause

A 
cervical carcinoma
anal carcinoma 
urogenital warts 
laryngeal papillomas
common, flat and plantar warts
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22
Q

what are the treatments of HPV

A

podophyllum
cryo
laser
surgery

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23
Q

what does gardasil protect against

A

most types of cervical cancer

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24
Q

what are the features of hepes

A

both types can infect the mouth and genitals

25
Q

what are the features of neonatal herpes

A

spread during birth

may result in a disseminated infection

26
Q

what are the features of herpes

A 
febrile flu like prodrome
neuropathic pain 
bilateral crops of painful blisters 
tender lymph nodes
local oedema 
dysuria
vaginal or urethral discharge
27
Q

what is genital herpes treated with

A

aciclovir

28
Q

what are the features of a reccurent herpes infection

A

virus becomes latent in sensory ganglia
periodic reactivation
with lesions or viral shedding
episodes are usually shorter

HSV2 will have 4 attacks in first year
hsv1 wil have 1 attach in the first twelve months

attacks become less frequent over time

29
Q

what are the features of HSV diagnosis

A

appearance
swab from ulcer
viral culture
serology

30
Q

what organism causes syphylis

A

treponema pallidum

gram negative spirochete

31
Q

what are the stages of syphylis

A

primary - genital or oral ulcer at site of infection

secondary- red maculopapular rash plus pale moist papules in urogenital region and mouth (condylomas)

tertiary- degeneration of NS, aneurysms, granulomas in liver, skin and bones

32
Q

what is congenital syphylis

A

placental transfer
can cause spontaneous abortion
babies develop secondary syphylis

33
Q

how is syphylis diagnosed

A

from lesions or infected lymph nodes

dark field microscopy
naat
immunoglobulin

34
Q

what is chancroid

A 
caused by gram negs
painful genital ulcers
microscopy
treated with a macrolide
eg erythromycin
35
Q

how can HIV be transmitted

A

blood
sex
perinatally

36
Q

what are the two types of HIV

A

HIV 1 most common
HIV2 less virulent

retroviridae lentivirus

37
Q

what does retrovirus mean

A

uses reverse transcriptase to make dna copy from viral rna

38
Q

describe progression from HIV to AIDS

A 
seroconversion 
asymptomatic
persistant generalised lymphadenopathy 
AIDS related clinical features
AIDS

greater viral load means quicker progression

39
Q

how is HIV treated

A

nucleoside reverse transcriptase inhibitors

non nucleoside reverse transcriptase

protease inhibitors

40
Q

what is highly anti retroviral therapy

A

combinations of drugs

e.g. 1 NRTI + 1 PI
or 2 NRTIs and 1 NNRTIs

41
Q

how is HIV diagnosed

A 
diagnosis of HIV antibodies
NAAT 
viral RNA detected 
viral load measured 
follow up a negative result
42
Q

what virus is hep B

A

hepadnivirus

double stranded DNA

43
Q

how is Hep B transmitted

A 
blood 
needles 
sex
birth 
haemodialysis
44
Q

what are the stages of infection of HBV

A

long incubation period
acute hepatitis
fulminant disease 1% mortality
50% of patients develop chronic active hepatitis leading to cirrhosis and hepatocellular carcinoma

pre icteric stage and icteric stage

45
Q

what are the features of the pre icteric stage in hep b

A

malaise
anorexia
nausea
pain in RuQ

46
Q

how is HBV treated

A

pegylated interferon

nucleoside analogues

47
Q

how is HBV prevented

A

vaccine
immunoglobulin
blood screening
needle exchange

48
Q

can HCV be sexually transmitted

A

rarely

49
Q

where does HCV replicate

A

liver cells

rarely progresses to cirrhosis

50
Q

how is HCV treated

A

interferon

ribavirin

51
Q

what is seroconversion

A

the point at which hiv antibodies become detectable

usually accompanied by flu like symptoms

52
Q

reiter’s

A

chlamydia

53
Q

macrolide

A

chancroid

54
Q

aciclivor

A

herpes

55
Q

azithromycine and tetracycline

A

chlamydia

56
Q

ceftriaxone cefixime ciproflaxin

A

gonorrhoea

57
Q

doxycycline

A

gonorrhoea and chlamydia

58
Q

fluconazole and triazole

A

thrush

59
Q

benzyl penicillin

A

syphylis

MD3002 post MSA (66 decks)

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