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Flashcards in Session 9 Deck (26):
1

Factors effecting STI transmission 

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2

Burden of STI/problems with having STIs

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3

How can STIs present? 

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4

Give examples of bacteria, viruses, parasites, fungi & Protozoa causing STIs 

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5

What investigations can you perform for STI in men?

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6

What investigations would you perform in women?

How would you manage STIs 

- Treatment

- co infections

- contact tracing 

- STI prevention 

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7

Chylamydia trachomatis 

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8

Niesseria gonorrhoea 

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9

Symphilis

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10

HSV presentation 

 

Ulcer base specific type serology 

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11

Trichomonas vaginalis

 

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12

How to treat scabies and pubic lice 

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13

What is this image showing 

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 HPV - anogential warts 

6 11 non harmful

16 18 harmful - cervical cancer 

 

 

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14

Bacterial vaginosis 

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15

Vulvovaginal candidiasis 

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16

State some less complicated UTIS

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17

Systemic complications of STIs

The result of infection ascending
from the endocervix, causing
endometritis, salpingitis,
parametritis, oophoritis, tubo-
ovarian abscess and/or pelvic
peritonitis”

 

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18

1. What is PID?

2. Pathophysiology?

 

1. The result of infection ascending from the endocervix, causing endometritis, salpingitis,
parametritis, oophoritis, tubo- ovarian abscess and/or pelvic peritonitis

ESPOAP

parametritis inflammation of CT of uterus/parametrium

oophoritis - ovary 

2.  Ascending infection from the endocervix and vagina

 Infection causes inflammation

 Inflammation causes damage:

Thus damaged tubal epithelium

Thus adhesions form

 Some recovery of tubal epithelium does occur

 

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19

1. Aetiology

2. Risk factors 

 

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1. Sexually transmitted infections:
- Chlamydia trachomatis D-K
- Neiserria gonorrhoea

Others
- Gardnerella vaginalis
- Mycoplasma hominis

- Anaerobes
- Actinomycosis

Often polymicrobial

2. As for STIs:
- Young age
- Lack of use of barrier contraception
- Multiple sexual partners
- Low socioeconomic class

IUCD

 

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20

Clinical features to check for PID 

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21

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22

1. Investigations

2. Clinical findings for PID 

 

Urinary and/or serum pregnancy test 

Endocervical and High vaginal swabs

- Presence of NG/CT supports diagnosis

- Absence of NG/CT does not exclude diagnosis

Blood tests

- WBC and CRP 

Screening for other STIs including HIV 

Diagnostic laparoscopy is gold standard

- Can also perform adhesiolysis and drain abscesses

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23

1. Findings at laparoscopy in women with suspected PID

2. Management

 

 

1. IMAGE 

fibre-optic instrument is inserted through the abdominal wall to view the organs in the abdomen or permit small-scale surgery

2.  Low threshold for empirical treatment
- Delayed treatment increases longterm sequelae

 Symptomatic management with analgesia and rest

Management of sepsis

 Severe disease requires IV antibiotics and admission for observation and possible surgical intervention

- Pyrexia >38, signs of tubo-ovarian abscess, signs of pelvic peritonitis

- No response to oral therapy

- Increased risk of longterm sequelae

Contact tracing essential for partners, and full screen for woman

- GUM best able to do this

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24

Antiobiotics treatment regime for PID

When might laparoscopy be considered?

 

Surgical management - Laparoscopy/laparotomy may be considered if:

- no response to therapy 

- Clinically severe disease

- Presence of a tubo-ovarian abscess

 

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25

Complications of laparoscopy? 

Ectopic pregnancy

Infertility

Chronic pelvic pain  

Fitz-Hugh-Curtis Syndrome -> RUQ pain and peri-hepatitis following Chlamydial PID (10- 15%)

Reiter syndrome -> Disseminated Chlamydial infection

 

add on note: describe the causation and consequences of pelvic inflammatory
disease in women

 

26

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