Session 6

Question 1

Why has there been a large increase in the incidence of STIs?

Answer 1

Increased transmission
Increased GUM attendance
Increased awareness
Improved diagnostic methods
Increased use of screening programmes

Question 2

What are some of the morbidities associated with STIs?

Answer 2

Pelvic Inflammatory Disease
Impaired fertility
Reproductive tract cancers
Risk of Blood Borne Virus infection
Risk of congenital infection of neonate

Question 3

What are the specific risk groups for STIs?

Answer 3

Young
Minority
Low Socio-economic status
Poor education

Question 4

How can you treat STIs?

Answer 4

Antibiotics
Antivirals
Screen for other STIs as co-infections are common
Contact tracing
Advise abstinence

Question 5

What are some of the viruses that cause STIs?

Answer 5

HPV

BBV

Question 6

What are some of the bacteria that cause STIs?

Answer 6

Chlamydia trachomatis (Obligate intracellular bacterium)
Neisseria gonorrhoeae
Treponema pallidum (Syphillis)

Question 7

What are some of the fungi that cause STIs?

Answer 7

Candida species
Ureaplasma urealyticum
Myoplasma horminis

Question 8

What are some of the protozoa that cause STIs?

Answer 8

Trichomonas vaginalis (Underecognised in the UK)

Question 9

What are some of the arthropods that cause STIs?

Answer 9

Scabies mite

Public louse

Question 10

What are some examples of Genital tract infections?

Answer 10

Ulcers
Warts
Urethritis
Vulvo vaginalis
Prostatitis
Epididymitis

Question 11

What are the symptoms of Urethritis?

Answer 11

Discharge
Dysuria
Frequency

Question 12

What does the Human Papillomavirus cause?

Answer 12

Genital warts
Benign epithelial/mucosal outgrowths
Cervical/anogenital cancer

Question 13

What does the Herpes simplex virus cause?

Answer 13

Extensive painful genital ulceration

Question 14

How do you treat Herpes?

Answer 14

Smear and swab of vesicle fluid and/or ulcer base

Treat with aciclovir (Antiviral that is only activated by cells that have the virus)

Question 15

What does Chlamydia trachomatis cause?

Answer 15

Non specific genital chlamydial infections
Inflammation of areas of the tract
Conjuctivitis if inoculated into the eye

Question 16

How do you treat Chlamydia?

Answer 16

Doxycycline or azithromycin

Question 17

What is Neisseria gonorrhoeae?

Answer 17

A gram negative intracellular diplococcus

Question 18

What does Neisseria gonorrhoeae cause in males?

Answer 18

Urethritis
Proctitis
Prostatitis
Epidymitis

Question 19

What does Neisseria gonorrhoeae cause in females?

Answer 19

Endocervitis
Urethritis
PID
Asymptomatic
If disseminated can cause bacteraemia or skin/joint lesions

Question 20

How do you diagnose and treat Neusseria gonorrhoeae?

Answer 20

Smear & culture

Intramuscular injection of ceftriaxone (Ciprofloxacin used to be used, but now resistance is too common)

Question 21

What is Trichomonas vaginalis?

Answer 21

Flagellated protozoan whihc causes Trichomonas vaginitis

Question 22

What are the symptoms of Trichomonas vaginitis?

Answer 22

Thin, frothy offensive discharge
Irritation
Dysuria
Vaginal inflammation

Question 23

How do you diagnose Trichomonas vaginalis?

Answer 23

Vaginal wet preparation and or culture enhancement

Question 24

How do you treat Trichomonas vaginitis?

Answer 24

Metronidazole (Also treats c. diff and other anaerobes or protozoa)

Question 25

What are the 4 stages of Syphillis?

Answer 25

``` Caused by Treponema pallidum 1 = Indurated, painless ulcer 2 = 6-8 weeks later, fever rash mucosal lesions lymphadenopathy LATENT - Symptom free 3 = Chronic granulomatous lesions 4 = CVS & CNS pathology ```

Question 26

How do you diagnose and treat syphillis?

Answer 26

Serology, dark field microscopy | Treat with penicillin

Question 27

What are some examples of Non sexually transmitted GTIs?

Answer 27

``` Vulvo vaginal candidiasis (Younger people) Bacterial vaginosis (Middle aged people0 ```

Question 28

What causes Vulvo vaginal candidiasis?

Answer 28

Candida species such as albicans

Question 29

What are the risk factors for Vulvo vaginal candidiasis?

Answer 29

``` Antibiotics Oral contraceptives Pregnancy Obesity Diabetes ```

Question 30

How do you diagnose and treat Vulvo vaginal candidiasis?

Answer 30

Vaginal smear and culture Topical azoles or nystatin Oral fluconazole

Question 31

What causes Bacterial vaginosis?

Answer 31

Pertubed normal flora eg Gardnerella

Question 32

What is the symptoms of Bacterial vaginosis?

Answer 32

Offensive fishy discharge

Question 33

How do you diagnose and treat Bacterial vaginosis?

Answer 33

KOH whiff test Decreased lactobacilli pH >5 Treat with metronidazole