Repro 6

Question 1

What is the difference between an STI and an STD?

Answer 1

STIs can be symptomatic or asymptomatic

STDs are only symptomatic cases

Question 2

Give an example of an intestinal pathogen that can be sexually transmitted

Answer 2

Salmonella
Shigella
Giardia

Question 3

Give some examples of the common STDs and their associated organism

Answer 3

Genital warts - Papillomaviruses
Urethritis - Chlamydia
Genital Herpes - Herpes Simplex

Question 4

Describe a specific group that is at risk of STIs

Answer 4

Young people

Low socio-economic status groups

Question 5

List some risk factors associated with STIs

Answer 5

Young age at first sexual encounter
High number of sexual partners
Sexual Orientation
Unsafe sexual activity

Question 6

Describe some causes of the increase in incidence of STIs

Answer 6

Changing sexual/social behaviours 
Increasing density & mobility of population 
INcrease in visits to GUM clinics 
Greater awareness
Imporved screening

Question 7

Why are STIs a burden to sufferers?

Answer 7

Can be chronic/relapsing
Stigma
Can lead to further pathology
Possible transmission to foetus

Question 8

What do patients STIs with STIs commonly present with?

Answer 8

Ulcers
Vesicles
Warts
Urethral discharge/pain

Question 9

How is HPV diagnosed?

Answer 9

BIopsy + genome analysis, “hybrid capture”

Question 10

How is HPV treated?

Answer 10

No intervention - 90% spontaneosu resolution within 2yrs

Otherwise surgery

Question 11

How is HPV screened?

Answer 11

Cervical Pap smear

Cervical swab

Question 12

How is Chlamydia trachomatis diagnosed?

Answer 12

Endocervical and urethral swabs

Conjunctival swab in neonates

Question 13

How is Chlamydia trachomatis treated?

Answer 13

Doxycycline or azithromycin

Erythromycin in children

Question 14

What are the symptoms of Primary genital herpes?

Answer 14

Extensive, painful genital ulceration
Dysuria
Ingunal lymphadenopathy
Fever

Question 15

How is Herpes diagnosed?

Answer 15

PCR or vesivelfluid and/or ulcer base

Question 16

How is Herpes treated?

Answer 16

Aciclovir

Question 17

Herpes preventative measures?

Answer 17

Aciclovir prophylaxis for recurrent infections or barrier contraception

Question 18

What is Neisseria gonorrhoeae?

Answer 18

Gram negative intracellular diplococcus

Question 19

What are the male symptoms of Gonorrhoea?

Answer 19

Urethritis, epididymitis, prostatitis, pharyngitis

Question 20

What are the symptoms of Gonorrhoea?

Answer 20

Can be asymptomatic
Endocervicitis
Urethritis
PID (subsequent infertility)

Question 21

How is Gonorrhoea diagnosed?

Answer 21

Swab - urethra, cervix, throat or urine

Gram stain

Question 22

How is Gonorrhoea treated?

Answer 22

Ceftriaxone

Question 23

What is Treponema pallidum?

Answer 23

Spirochaete, aetiological agent of syphilis (most cases men and MSM)

Question 24

What are the symtpms, in order of development, of shyphilis?

Answer 24

Painless ulcer
Fever, rash, lymphadenopathy
Neurosyphilis (insanity)

Question 25

Treatment of Treponema pallidum (syphilis)?

Answer 25

Penicillin

Question 26

What is Pelvic Inflammatory disease (PID)?

Answer 26

The result of infection ascending from the endocervix to cause inflammation

Question 27

What areas are inflamed in PID?

Answer 27

``` Endometrium Fallopian tubes (salpingitis) Ovaries (oophoritis) Pelvic peritoneum ```

Question 28

Other than inflammation, what can PID cause?

Answer 28

Tubo-ovarian abscess

Question 29

What is the epidemiology of PID?

Answer 29

Sexually active women Peaks 20-30y/o Incidence in primary care ~280 per 100,000py

Question 30

What are the risk factors for PID?

Answer 30

``` Young age Unsafe sex Multiple partners low socio-economic class IUCD ```

Question 31

What are the clinical features of PID?

Answer 31

Fever Lower abdo pain Vaginal/carvical discharge

Question 32

List some differential diagnoses for PID

Answer 32

Ectopic pregnancy Endometriosis UTI IBS/Appendicitis

Question 33

Describe the management of PID

Answer 33

Analgesia, rest, manage sepsis | Severe cases use IV antibiotics, surgery if no response

Question 34

Describe the antibiotic treatment therapy for PID

Answer 34

Ceftriaxone, doxycycline, metronidazole

Question 35

What is involved in surgical management of PID?

Answer 35

Laparoscopy/laparotomy

Question 36

List some possible complications of PID

Answer 36

Ectopic pregnancy Infertility Chronic pelvic pain Reiter syndrome (disseminated chlamydia)