Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction > Sexually Transmitted Infections > Flashcards

Sexually Transmitted Infections Flashcards

1
Q

what is the most commonly reported bacterial STI in sexual health clinics?

A

chlamydia (CT)

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

what % of those with chlamydia are asymptomatic?

A

70-80% of women

50% of men

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

what type of bacteria is chlamydia?

A

gram negative obligate intracellular bacterium

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

what are the methods of transmission of chlamydia?

A

vaginal
oral
anal

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

in what age does the highest incidence of chlamydia occur?

A

20-40 years

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

what is a complication of chlamydia which increases the risk of ectopic pregnancy and tubal factor infertility?

A

pelvic inflammatory disease

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

how does chlamydia present in females if symptomatic?

A

post coital or intermenstrual bleeding
lower abdominal pain
dyspareunia
mucopurulent cervicitis

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

how does chlamydia present in males if symptomatic?

A 
urethral discharge 
dysuria 
urethritis 
epididymo-orchitis 
proctitis (LGV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

other than PID, what are another 2 complications of chlamydia (CT)?

A

conjunctivitis

reactive arthritis

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

what testing advice has been offered for CT?

A

stop testing for CT in women >25 with vaginal discharge

do test women who have had CT in past year
*one in five women with diagnosed and treated chlamydia are estimated to become reinfected within 10 months of initial treatment

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

what is LGV?

A

serovar of chlamydia trachomatis (L1-3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

who does LGV present in and what are the symptoms?

A

men who have sex with men (MSM)

rectal pain, discharge and bleeding

*high risk of concurrent STIs (67% HIV)

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

how is CT diagnosed?

A

test 14 days following exposure

NAAT - females (vulvovaginal swab), males (first void urine)

for MSM, add rectal swab if receptive anal intercourse

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

how is CT treated?

A

doxycycline 100mg BD x 1 week

or azithromycin 1G stat followed by 500mg daily for 2 days

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

what is mycoplasma genitalium?

A

emerging sexually transmitted pathogen which is associated with non gonococcal urethritis and PID

*1-2% population

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

mycoplasmic genitalium is asymptomatic - true or false?

A

true

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

how is mycoplasma genitalium diagnosed?

A

NAAT test (same sample sites as CT)

*test if first line treatment for PID and NGU failed

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

mycoplasma genitalium is associated with what resistance?

A

macrolide (estimated at 40%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what type of bacteria is gonorrhoea?

A

gram negative intracellular diplococcus

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

what are the primary sites of infection of gonorrhoea?

A

mucous membranes of urethra, endocervix, rectum and pharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the incubation time of gonorrhoea?

A

very short in men (2-5 days)

*20% risk from infection women to male, 50% from male to female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

in what age is the prevalence of gonorrhoea higher?

A

men - 20-24

women = <20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how does gonorrhoea present in men?

A

purulent urethral discharge
dysuria
pharyngeal / rectal infection (these are mostly asymptomatic)

*less than 10% asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how does gonorrhoea present in females?

A

increased/altered vaginal discharge
dysuria
pelvic pain
pharyngeal and rectal infection usually asymptomatic

*up to 50% asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what % of those with gonorrhoea get complications?

A 
females = 3%
males = <1%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are the lower genital tract complications of gonorrhoea?

A 
bartholinitis 
tysonitis 
periurethral abscess
rectal abscess
epididymitis 
urethral stricture
27
Q

what are the upper genital tract complications of gonorrhoea?

A 
endometritis 
PID
hydrosalpinx
infertility 
ectopic pregnancy 
prostatitis
28
Q

how is gonorrhoea diagnosed?

A

NAATs (screening)

microscopy (if symptomatic)

culture (if micro +ve or contract of GC)
*this will give antibiotic options

29
Q

how is gonorrhoea treated?

A

first line = ceftriaxone 1G IM

second line = cefixime 400mg oral (only if IM injection is contra-indicated or refused by patient)

*always get them back to do test of cure (at 2 weeks)

30
Q

what are the three types of genital herpes infection?

A

primary infection

non-primary first episode

recurrent infection

31
Q

what is the incubation and duration of primary genital herpes infection?

A 
incubation = 3-6 days 
duration = 14-21
32
Q

what are the symptoms of primary genital herpes infection?

A 
blistering and ulceration of external genitalia
pain 
external dysuria 
vaginal or urethral discharge 
local lymphadenopathy 
fever or myalgia (prodrome)
33
Q

recurrent episodes of HSV are more common in type 1 - true or false?

A

false - HSV-2 has more common recurrence

34
Q

what are the symptoms of a recurrent episode of HSV?

A

unilateral, small blisters and ulcers
minimal systemic symptoms (resolves within 5-7 days)

*often overlooked / misdiagnosed

35
Q

how are genital herpes diagnosed?

A

swab base of ulcer for HSV PCR

36
Q

how are genital herpes treated?

A

give oral antiviral treatment (aciclovir 400mg TDS x 5/7)

consider topical lidocaine 5% ointment if very painful

saline bathing

analgesia

37
Q

viral shedding is more common in what type of HSV?

A

viral shedding following HSV 2 is consistently higher than for HSV 1

  • more frequent in first year of infection
  • more in individuals with frequent recurrences
  • reduced by suppressive therapy (if more than 6 in a year - 400mg aciclovir and assess again after a year)
  • type 1 - less attacks also
38
Q

what should you do if genital herpes presents in pregnancy?

A

inform O+G (review birth plan)

  • if first episode in 3rd trimester within 6 weeks of EDD
  • if not a primary episode this is good as will have passed antibodies onto baby
39
Q

what is the most common viral STI in the UK?

A

HPV

40
Q

what is the lifetime risk of acquiring HPV?

A

80%

41
Q

how many types of HPV are described and how many of these infect anogenital epithelium?

A

> 200 HPV described

>40 HPV types infect anogenital epithelium

42
Q

what are the low and high risk types of HPV?

A

low = 6,11, 42, 43, 44

high = 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68

43
Q

what are the different clinical sequelae of HPV which are associated with different genotypes?

A

latent infection
anogenital warts (6 and 11)
palmar and plantar warts (1 and 2)
cellular dysplasia / intraepithelial neoplasia (16 and 18)

44
Q

what strains of HPV are covered in HPV vaccines?

A

6, 11 (genital warts)

16 and 18 (cancer)

45
Q

what % of population is exposed to HPV and what % develop anogenital warts?

A

80% exposed
10% probably harbour infection
1% develop anogenital warts

46
Q

what is the incubation period of HPV transmission?

A

3 weeks to 9 months

*likely to have got it from asymptomatic partner

47
Q

you can only transfer one type of HPV at a time - true?

A

FALSE

transmission of more than one HPV type is common

48
Q

what are the success rates of treatment of HPV?

A

spontaneous clearance = 20-34%

clearance with treatment = 60%

persistence despite treatment = 20%
*smoking makes it harder to clear

49
Q

what are the four treatment options for HPV?

A

podophyllotoxin (warticon)

  • cytotoxic
  • not licensed for extra genital warts (but widely used)

imiquimod (aldara)

  • immune modifier
  • can be used on all anogenital warts (1st line when anogenital)

cryotherapy

  • cytolytic, can require repeat treatments
  • tend to use in combo with one of above or if warts tiny

electrocautery

50
Q

what groups of people are now included in HPV vaccine?

A

MSM

adolescent boys

51
Q

what bacterium causes syphilis?

A

treponema pallium

52
Q

how can syphilis be transmitted?

A

sexual contact
trans-placental / during birth
blood transfusions
non-sexual contact (healthcare workers)

53
Q

what are the two classifications of syphilis?

A

congenital

acquired

54
Q

what types of acquired syphilis causes early infectious syphilis (within first 2 years)?

A

primary
secondary
early latent

55
Q

what types of acquires syphilis causes late non-infectious syphilis?

A

late latent

tertiary

56
Q

what is the incubation period of primary syphilis?

A

9-90 days (mean of 21 days)

57
Q

what is the lesion of primary syphilis normally known as?

A

chancre (painless), appears at site of inoculation

  • genital (90%) or extra genital (10%)
  • also get non-tender local lymphadenopathy
58
Q

what is the incubation period of secondary syphilis?

A

6 weeks to 6 months

59
Q

what are the symptoms of secondary syphilis (known as great imitator)?

A

skin (macular, follicular or pustular rash on palms + soles)

lesions of mucous membranes

generalised lymphadenopathy

patchy alopecia

condylomata lata (most highly infectious lesion in syphilis, exudates a serum teeming with treponemes)

60
Q

how is syphilis diagnosed?

A

demonstration of treponema pallidum (from lesions or infected lymph nodes)

  • dark field microscopy
  • PCR

serological testing = detects antibody to pathogenic treponemes

61
Q

what is the screening serological test for syphillis?

A

ELISA / EIA (enzyme immunoassay)

when this is positive, then do definitive test

62
Q

how is syphilis treated?

A

early = 2.4 MU benzathine penicillin x1

late = 2.4 MU benzathine penicillin x3

63
Q

how is syphilis followed up?

A

followed up until PCR is negative or serofast

  • titres should decrease fourfold by 3-6 months in early syphilis
  • there is serological relapse / reinfection if titres increase by fourfold

Reproduction (45 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions