General STIs Flashcards
(43 cards)
Which condition(s) present with genital warts?
Human papilloma virus
Which condition(s) present with genital ulcers?
Genital herpes - vesicles/papules around genitals
Syphilis - macule to papule to painless ulcer
Chlamydia - can present with a painless papule/ulcer
How does genital herpes present?
A flu-like prodrome, the vesicles/papules filled around genitals/anus. These burst forming painful shallow ulcers. Can also get urethral discharge, dysuria, urinary retention and proctitis.
How is genital herpes diagnosed?
Swab taken for PCR
How is genital herpes treated?
Topical analgesia (lipocaine) and antivirals (aciclovir)
What are the symptoms of the three stages of syphilis?
Primary - <90days after inoculation - macule to papule to painless ulcer (Chancre)
Central slough, defined rolled edge, highly contagious
Secondary (4-10 weeks after chancre) - maculopapular rash (50-75%), mucous patches, condyloma lata (raised pale plaques on extensor surfaces), fever headache, hepatitis
Tertiary - 20-40yrs after infection - Neurosyphilis - focal neurological deficits, seizures, psychiatric symptoms
How is syphilis diagnosed?
PCR and serology
How is syphilis treated?
Benzylpenicillin
What are the four main diseases that are swabbed for in individuals presenting with risk of sti?
Gonorrhea, chlamydia, HIV and syphilis
In a male presenting with discharge what would you swab for?
Gonorrhea and chlamydia
Which bacterial sti do you culture for?
Culture for gonorrhoea but not chlamydia
What kind of organism is syphilis?
Called treponema and in the bacterial subtype spirochaetes
What kind of organism is chlamydia?
Intracellular bacteria
What kind of organism is gonorrhea?
It is a gram negative (pink staining) diplococci
What routine blood tests are done for people who are worried they have been exposed to stis?
HIV, syphilis and hep B
How well do you know your syphilis serology? it might well come up
Learn it
How is syphilis diagnosed using serology?
There must be 2 positive specific results e.g. TPPA, TPHA, EIA and IgM
This window period for serology is only up to 3 months
What serology can be done for syphilis early on in the infection?
Specific results e.g. TPPA and IgM
VDRL or cardiolipin can be used to determine staging of syphilis but is not very specific
T. Pallidum can be isolated from chancres in early syphilis and identified by PCR
What does high titre VDRL or cardiolipin suggest?
Primary or secondary syphilis
What does low titre VDRL or cardiolipin suggest?
Tertiary syphilis
What does a negative VDRL or cardiolipin with positive syphilis serology suggest?
Suggests syphilis that has been treated
What is the presentation of chlamydia?
Usually asymptomatic and picked up on screening
Dysuria and discharge main symptoms
How is a diagnosis made for chlamydia?
Through nucleic acid amplification testing (NAAT) of:
- Swabs in women
- First pass urine in men
How is chlamydia treated?
Azithromycin 1g single dose or 100mg doxycycline BD for 7 days
Partner tracing, screening, treatment
Avoid sex until treated
