Gynae Flashcards
(24 cards)
What is the most prevalent STI in the UK?
Chlamydia (1/10 women in the UK)
What is the pathogen causing Chlamydia?
Chlamydia trachomatis
What is the incubation period for Chlamydia?
7-21 days
What proportion of patients with Chlamydia are asymptomatic?
- 70% women
- 50% men
What are the symptoms of Chlamydia in women?
- Cervicitis (yellow/ cloudy discharge, pv bleeding outside of periods)
- Dysuria
What are the symptoms of Chlamydia in men?
- Urethral discharge (white, cloudy or watery)
- Dysuria
What are the complications of Chlamydia?
- Epididymitis
- PID
- Endometritis
- Increased risk of ectopic pregnancy
- Infertility
- Reactive arthritis
- Perihepatitis
What are the investigations for chlamydia in women?
Vulvo-vaginal or endocervcal swab
If the woman is opposed to this, a first-catch urine (FCU) sample can be collected (first 20mL urine)
What testing is done on the chlamydia samples?
Nucleic acid amplification tests (NAATs)
What are the investigations for chlamydia in men?
- FCU specimen of choice
- Urethral swab is an alternative
In which patients with suspected chlamydia should rectal samples be taken?
- All HIV-positive men MSM
- All people with proctitis
Why are rectal samples in suspected chlamydia patients taken?
To test for lymphogranuloma venereum
What is the first line management for chlamydia?
Doxycycline 100mg BD for 7 days
What is given if doxycycline is contraindicated in a chlamydia patient?
Azithromycin 1g orally for one day, followed by 500mg orally once daily for two days
What should be given in patients with chlamydia if doxycycline and azithromycin are contraindicated?
Erythromycin 500mg BD for 10-14 days
What’s the management for chlamydia in pregnant patients?
- Azithromycin 1g orally for one day then 500mg orally BD for two days
Or
- Erythromycin 500mg 4x a day for 7 days
Or
- Amoxicillin 500mg 3x a day for 7 days
When should patients with chlamydia be urgently referred to a GUM clinic?
- No response to 1st line treatment
- Suspected PID
Which chlamydia patients are offered repeat testing?
Anyone under the age of 25 3-6 months after completion of treatment
When should chlamydia testing be carried out?
Two weeks after possible exposure
Who is the national chlamydia screening programme open to?
All men and women aged 15-24
Who should be contacted for men with chlamydia with urethral symptoms?
All contacts since and in the 4 weeks prior to the onset of symptoms
Who should be contacted for women and asymptomatic men with chlamydia?
All partners from the last six months or the most recent sexual partner
What should contacts of confirmed chlamydia cases be offered?
Treatment prior to the results of their investigation
What is common on histology for chlamydia?
Inclusion bodies
