Repro 6 STIs and PID Flashcards Preview

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Flashcards in Repro 6 STIs and PID Deck (105)
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1

Why is the term STI instead of STD used?

STI - symptomatic and asymtomatic infection - still potential problems and potential to spread it
STD - symptomatic infection only

2

Where is the national data for STIs collected from?

GUM clinics - Gentio Urinary Medicine, which notify STDs centrally

3

Why is there a gradual and sustained increase in STI prevalence from 1995 to 99?

Increased transmission
Acceptability of GUM services
Greater public awareness
Development in diagnostic methods

Behavioural, socio-economic, healthcare provision and biological factors all contribute

4

What is the suspected reason for the fall in STI diagnosis prior to 95?

Thought to reflect changes in behaviour in response to the HIV epidemic

5

Why is data from GUM clinics an underestimation of the true incidence of STIs?

Patients may be seen in other settings e.g. GP or family planning clinics
Many infections are asymptomatic and only approx 10% of cases attend GUM

6

Who are the at risk groups in society of contracting STIs?

Young people
Ethnic minority (stigma)
Poverty/social exclusion
Low socio-economic status
Poorly educated
Unemployed
Teenage mothers (at risk behaviour)

7

What factors contribute to the risk of contracting STIs?

Age at first intercourse
Total number of sexual partners
Frequency of change of partners
Concurrent partners
Sexual orientation (with other factors)
Practice of unsafe sex
Lack of skills ad confidence to negotiate safe sex

8

What STIs might cause genital ulcers?

HSV (herpes simplex virus)
Syphilis
Chanchroid (Haemophilus ducreyi)

9

What STIs might cause vesicles of bullae?

HSV

10

When might an STI cause genital papules? Give some examples.

Transient manifestation of STIs - condylomata acuminata (anogenital warts), umbilicated lesions of Molluscum contagiosum virus

11

What should aspects of genital ulcers should be assessed?

Number
Size
Tenderness
Base
Edges

12

What are the various types of urethritis and what might cause them?

Gonococcal urethritis
NGU (nongonococcal urethritis) - chlamidia trachomatis, ureaplasma, mycoplasma, trichomonas HSV
Post-gonococcal urethritis
Non-specific urethritis
Non-infectious urethritis

13

What is vulvovaginitis and what might cause it?

Vaginal infection - candidias, trichomoniasis, staphylococcal, foreign body, HSV

14

What might cause cervicitis?

C. trachomatis, N. gonorrhoeae, HSV, HPV

15

What is bartholinitis and what might cause it?

Inflammation of one or both of the bartholin glands. Caused by polymicrobial infections with endogenous flora or rarely STIs

16

What are the symptoms of bacterial vaginosis?

Discharge
Odour
Itch
Dyspareunia
Soreness

17

How is bacterial vaginosis diagnosed?

Vaginal pH >4.5
Pungent odour with KOH (whiff test)
Presence of clue cells on a wet mount lacking many PNMs

18

What is the cause of bacterial vaginalis?

Thought to be the result of a synergistic infection involving the overgrowth of normal flora including gardnerella vaginalis

19

What are the potential pregnancy related causes of infections of the female pelvis?

Chorioamnionitis
Post-partum
Endometriosis
Episiotomy infections
Peurperal ovarian vein thrombophlebitis
Osteomyelitis pubis

20

What are the different types of prostatitis?

Acute bacterial
Chronic bacterial
Chronic pelvic pain syndrome

21

What are the different types of epididymitis?

Non-specific bacterial
Sexually transmitted

22

What are the causes of orhchitis?

(inflammation of the testes)
Viral (mumps, coxsackie B)
Pyogenic bacterial

23

Why do chlamydia trachomatis not grow on routine lab media?

They are obligate intracellular bacteria

24

What is the infective form of chlamydia trachomatis?

Elementary body which develops within the host cell into the reticulate body

25

What does the reticulate body of chlamydia trachomatis do?

Replicates eventually reverting back to elementary bodies which leave the cell to infect other cells

26

Where in the female reproductive tract does chlamydia replicate?

Epithelium of the cervix and urethra

27

What are the consequences of an infection of C. trachomatis?

An ascending infection with involvement of the upper genital tract occurs and can result in clinical or subclinical PID presenting as endometritis or salpingitis. Perihepatitis is a rare complication (more likely from gonorrhoea)

28

What results from a cervical infection of C. trachomatis?

The majority of infections are symptomatic but it is an important cause of muopurulent cervicitis

29

What are the manifestations of a urethral infection of chlamydia?

Acute urethral syndrome - dysuria and frequency (most common in young sexually active women)

30

What are the common symptoms of chlamydia infection in males?

Urethritis
Prostatitis
Proctitis