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Disease Facts! Flashcards

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1
Q

What can cause overgrowth of Grrdnerella vaginalis or other anaerobes in the vagina causing Bacterial Vaginalis?

A

Douching
Multiple Sexual Partners
Intrauterine contraceptive devices

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2
Q

How is BV diagnosed?

A

Vaginal discharge, decreased lactobacilli, wiff test, pH>4.5 (not acidic enough!), clue cells

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3
Q

Which diseases increase the risk of HIV?

A

BV
Thrush
Syphilis

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4
Q

Which diseases cause PID

A

Chlamydia
Gonorrhoea
BV

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5
Q

What is the treatment for BV?

A

Not recommend - unless pregnant, or undergoing insertion of intrauterine device

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6
Q

Is chancroid common in Australia?

A

No - mainly in developing countries

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7
Q

How is chancroid transmitted?

A

Direct contact with ulcer
Discharge during sexual activity
Auto-inoculation

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8
Q

What have ulcers / lesions?

A

Donovanosis, Chancroid
Genital herpes, Genital warts
LGV, Molluscum contagious (waxy)
Syphilis

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9
Q

If you had to say the defining feature of Donanvonis, what would it be?

A

Genital lesions (painful to touch, friable, ragged edges)

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10
Q

What must we first ‘rule out’ before we diagnose thrush?

A

HSV (herpes simplex virus)

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11
Q 
Which of the following diseases has a causative organism that is normal flora?
A) Bacterial vaginosis
B) Candidasis
C) Genital herpes
D) Trichomoniasis
A

B - causative agent is candida albicans

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12
Q

Classify causative agent of thrush, BV and trichomoniasis based on the TYPE of organism (e.g., bacterial, viral etc)

A 
Thrush = yeast
BV = bacterial
Trichomoniasis = protozoa
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13
Q

What defines a recurrent thrush infection? (how many in how long)

A

4 in 12 months

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14
Q 
Which of the following has an intracellular parasite as the causative organism:
A) Candidiasis
B) Trichomoniasis
C) Donovanosis
D) Chlamydia
What is the consequence of this?
A

Donovanosis and Chlmaydia

cannot culture it artificially

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15
Q

What is the main clinical feature of donovanosis?

A

Lesions (highly vascular, friable, bleed easily)

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16
Q

Which of the three (BV, trichomoniasis, thrush) have inflammation

A

Trush

Trichomoniasis

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17
Q

What is NAAT? Complete the sentence: It is the only __________ for Chlamydia.

A

Nucleic acid amplification test

It is the only EASILY ACCESSIBLE TEST for Chlamydia.

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18
Q

The highest notifications for Chalmydia is in what age groups? What ethnic group in Australia?

A

15-29 yo

Aboriginal/Torres Straight Islanders

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19
Q

Is trichomoniasis in male / female?

A

BOTH!
Male - urethrea
Female - vagina and urethra

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20
Q

What is the main symptom in MALES for any STI?

A

Urethritis

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21
Q

In trichomoniasis:
What % of males are asymptomatic?
What about females?

A 
Males = 90%
Females = 50%
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22
Q

What is the most common cause of GUD?

A

Herpes Simplex Virus

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23
Q

What are the two types of HSV? Which is which? Can they ‘interchange’ / be transmitted to other areas?

A

HSV 1 - orolabial
HSV 2 - genital herpes
Can be transmitted to other sites (i.e., HSV1 can infected HSV2 sites etc)

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24
Q

True or false?
Fomite spread is common mode of transmission for HSV.

What are some other methods?

A

False - it is rare

Perinatal (mother to child, 3rd trimester)
Self inoculation
Skin-skin (symptomatic or asymotpmatic)

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25
During what trimester of pregnancy can HSV be transmitted from mother to child?
Trimester 3
26
What diseases are NOT involved in community screening?
HSV and genital warts
27
What are some diseases that ARE screened?
HIV Chlamydia Gonorrhoea Syphilis Remember: He Couldn't Get Sick (thanks Dakota!)
28
True or false? A primary HSV infection presents with no antibodies.
True Primary: NO pre-existing Ab Secondary: pre-existing Ab
29
Where does HSV become latent? How is this relevant in a clinical scenario?
Dorsal root ganglion It can reemerge
30
Which HSV type reemerges more often?
HSV2
31
Is primary or recurrent HSV infection more severe? Which lasts longer? What causes recurrence?
PRIMARY - more severe, more painful, longer Recurrence - stress, menstruation, sexual intercourse
32
Can we contact trace HSV?
No! We cannot! There is also NO prophylactic treatment :)
33
How long does it take for symptoms to appear after Trichomoniasis infection?
4-28 days
34
How long do the eggs in pubic lice take to hatch?
6-10 days
35
Are Pubic lice are more severe at day or night?
Night
36
How is pubic lice transmitted?
``` Direct close contact Fomite spread (survive 0-1 days here) ```
37
What is a complication of pubic lice?
Dermatitis
38
Diagnosis of pubic lice
Visualisation of lice | Microscopy of eggs/mite
39
In pubic lice, who should be contact traced?
Recent sexual contacts | Household members
40
How long does scabies take to show symptoms?
4-6 weeks
41
True or false? | One can catch scabies through handshakes?
FALSE = must be prolonged contact
42
You have a patient who comes in complaining of a genital itch? What should you check for?
Pubic lice and scabies
43
Pubic or scabies? Which has burrows?
Scabies
44
What % of women and men are asymptomatic for chlamydia?
``` Women = 80% Men = 5-20% ```
45
Which age group has highest rate of notifications for chlamydia?
15-29 yo
46
What is the most common cause of non-gonococcal urethritis?
Chlamydia
47
What is the most frequently reported STI?
Chlamydia
48
What are the symptoms of neonatal chlamydia infection?
Conjunctivitis | Chlamydial pneumonia
49
What is Reiter's syndrome
May occur after chlamydia (mainly in men - 50:1 m:f ratio) Arthritis, conjunctivitis, urethritis
50
You have a patient who you diagnose with chalmydia. How did you likely diagnose HER (how did you do this?). She tells you that she has an IDU device (do you leave this in or remove it before treatment?). She also tells you she has had 2 sexual partners in the last 5 months (discuss contact tracing). When do we begin treatment?
NAAT (only easily accessible test for chlamydia) IUD - leave it in Last 6 months Begin treatment immediately, BEFORE receiving lab results
51
Is lymphogranuloma venereum (LGV) common in Australia?
Negative
52
How does LGV travel through the body?
Lymphatics
53
How is LGV transmitted?
Skin to skin contact with lesion (or exudate from lesion) during sexual contact
54
Classify the following stages of LGV as primary, secondary, tertiary: - painful inguinal lymphadenitis - anogenitorectal syndrome - painless ulcers at site of inoculation
primary - painless ulcers at site of inoculation secondary - painful inguinal lymphadenitis tertiary - anogenitorectal syndrome (years after)
55
How do we diagnose LGV?
Clinical presentation Isolate bacteria from lesion - Titres > 1:64 - diagnosis likely - Titres
56
What are the diseases causing urethritis
NSU/NSGI, chalmydia, gonorrhoea
57
What disease can the destruction of lymph glands occur?
LGV
58
What is difference between NSU and NSGI?
``` NSU = male (non specific urethritis) NSGU = female (non specific genital infection) ```
59
What is the cause of NSU and NSGI?
Not gonorrhoea or chlamydia
60
What is complication of NSU/NSGI?
Reinfection
61
What presents with waxy lesions? How wide?
Molluscum contagiosum | 1-10mm
62
What causes molluscs contagiosum? Can we culture it?
Molluscum contagiosum | NO - virus
63
What is treatment for molluscs contagiousum?
Self limiting | BUT treated with topical for cosmetic reasons
64
What are stages of syphilis? and symptoms of each
EARLY - primary: chancre (painless lesion) RESOLVES in 3 wks - secondary (rash, lesion, systemic organ involvement) - early latent (spontaneous resolution) LATE (non-infectious) - late latent (asymptomatic) - late symptomatic / tertiary (CVD, CNS, skin lesions)
65
When is syphilis infectious?
EARLY (primary, secondary, early latent) Not in LATE
66
Can syphilis spread across the placenta?
YES
67
When should syphilis be screened in pregnancy?
Initial visit If high risk, also: - 28 weeks - Birth
68
What is the difference between where gonorrhoea and chlamydia grow?
``` Gonorrhoea = grows on epithelial surface Chlamydia = grows in cells ```
69
What is the difference between treatment for gonorrhoea and chlamydia?
Antibiotics - Gonorrhoea = resistance - Chlamydia = no resistance
70
Is gonorrhoea more common in males or females
MALES
71
Most notifications for gonorrhoea in which age group. What about chlamydia?
15-24 yo (gonorrhoea) | 15-29 yo (chlamydia)
72
Is there such thing as neonatal gonorrhoea?
Yes
73
Is NAAT a culture technique?
No
74
Of the ____ types of HPV, how many affect the genitals?
Of 100, 20 affects genitals
75
Of the strains of HPV, which common ones affect genitals? Which causes common skin warts?
GENITALS: HPV (6, 11, 16, 18, 31, 33, 35) SKIN WARTS: 1, 2, 3, 4
76
Do all genital warts develop cancer
NO
77
HPV type ___ and ___ account for ____ %of genital warts. If you've studied you'll know :P
16 and 18 | 70% of cervical cancer
78
How long after exposure to HPV does it take to develop genital warts?
2 weeks to 8 months
79
What are the stages of genital warts?
Clinical Sub clinical Latent
80
True or false? Genital warts / HPV can be transmitted by fluid/blood
FALSE ONLY by skin to skin contact CAN BE
81
What fraction of HPV patients also have at least one other STI?
1 in 3 people with HPV have another STI
82
True or false... | Penetrative sex is required for transmission of genital warts.
False - not needed
83
True or false? | Condoms are not 100% effective in preventing transmission of HPV.
True - they may not cover the entire region of affected skin
84
True or false? | Genital wart diagnosis should be confirmed by culture and serological diagnosis
False - it cannot be cultured
85
True or false? | All sexually active women over the age of 18 should receive a pap smear every 2 years.
False - not needed in some scenarios. Once over 70 - if had two normal in past 5 years (unless symptoms developed) If have full hysterectomy (usually can stop)
86
What does the vaccine gardasil protect against?
HPV
87
What is incubation period of HSV?
2-12 days after infection symptoms can develop

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