Sexual infection Flashcards
(21 cards)
List the different types of triple swabs and what infections they look for
Vagina
High cervical swab
Chlamydia
Gonorrhoea
Bacterial vaginosis
Candida
Risk factors of STD’s
Multiple or new partner(s) No barrier contraceptives used Previous or current STI Partner has an STI 25 or younger Sex worker
Discuss the causes, features and treatment of thrush
Causes
- C.Albicans
- C.Glabrata
Features
- Red
- Fissured
- Sore ( especially in allergic component)
- Discharge ( white, non offensive )
Treatment
- Clotrimazole 500mg pessary + cream
- Fluconazole 150mg
Risk factors for thrush
Pregnancy Contraception Steriods Immunodeficiencies Antibiotics Diabetes (check glucose)
Clinical features of chlamydia
TRIAD
- Cervical excitation
- Lower ado pain
- Adnexal tenderness
Asymptomatic
- Dysuria
- Vaginal discharge
- Intremenstural bleeding
- Post coital bleeding
Diagnosis: high end cervical swab, nucleic acid amplification test (NAAT)
What is the national chlamydia screening programme
Screening for chlamydia in all sexual activity people especially under the age of 25
Resulted in <20% drop in the prevalence in <25yrs
Complications of chlamydia
Pelvic inflammatory disease
Perihepatitis (Fitz-Hugh-Curtis syndrome)
Reiter’s syndrome
Treatment of chlamydia
Azithromycin 1g (single dose) Doxycycline 100mg BD ( 7 days)
Pregnancy
-Erythromycin 500mg BD 10-14 days
Clinical features and diagnosis of bacterial vaginosis
Fishy odour discharge
Vaginal pH >4.5
Epithelial cells clue cells are seen on microscopy
Altered bacterial flora ( too many bacteroides not enough lactobacilli)
Risks associated with BV
Preterm labour
Intra-amniotic infection during pregnancy
Post termination sepsis
Treatment of BV
Metronidazole 2g PO Balance Activ ( pH balancer for a more natural approach)
Discuss the causes, clinical and microscopic features of trichomoniasis
Cause
- Trichomonas vaginalis
Clinical features
- Vaginitis
- Bubbly thin fishy diacharge ( FISHY AND FROTHY)
Microscopic
- Cervix will have a strawberry appearance
- Must exclude gonorrhoea ( can co-exist)
- Motile flagellates exist on films
Treatment of trichomoniasis
Must treat partner too
Metronidazole 2g (STAT)
Pregnancy 400mg/12hr 5 days
Discuss the causes and the clinical features of gonorrhoea
Neisseria gonorrhoeae ( Gram -ve diplococcus)
Clinical features - Asymptomatic - Lower ado pain - Vaginal discharge - Intermenstural/ post coital bleeding -
Complications of Gonorrhoea
PID
Bartholin’s/ Skenes abscess
Tubal infertility
Increased risk of ectopic pregnancy
Disseminated gonorrhoea
- Fever
- Pustular rash
- Polyarthralgia
- Septic arthritis
Treatment of gonorrhoea
Ceftriaxone 500mg IM STAT + Azithromycin 1g PO STAT
Pregnancy Same treatment as above If untreated - PROM - Preterm delivery - Chorioamnionitis - Ophthalmia neonatarum
Clinical features of herpes simplex
Recurrent genital or perioral infection
Preceeded by feelings of burning and itching
Signs
- Grouped painful vesicles on erythematous base heal without scarring
- Fever
- Myalgia
- Lymphoedema
Treatment of herpes simplex
Oral infections: allow to resolve alone
Genital
- Oral aciclovir (200mg 5 days)
- Hygiene measures
- Abstain from sex until the lesions are cleared
Clinical features of genital warts
Sexually transmitted infections
WARTS ON GENITALS
Treatment of genital warts
Significant treatment failure and high relapse rate
Self applied imiquimod cream
Cryotherapy
Screen for other STD’s
Clinical features of syphillis
Single painful lesion which erodes deeper into an ulcer
1 infection
- Chancre
- Lymphoedema
-
