Sexually transmitted diseases Flashcards
(25 cards)
What are risk factors for STIs
Unprotected sexual intercourse multiple sexual partners 15-24 year olds illicit drug use and alcohol use men who have sex with men sex workers urban areas
What organism causes chlamydia
Chlamydia trachomatis
How can chlamydia be transmitted
Sexual contact
perinatal transmission during vaginal delivery which can lead to neonatal conjunctivitis and pneumonia
How does chlamydia present in men and women
Asymptomatic in 80% of cases
Males: mucopurulent urethral discharge, dysuria, scrotal pain, proctitis
Females: mucopurulent vaginal discharge, cervicitis, cervical bleeding upon contact, proctitis, post-coital bleeding, intermenstrual bleeding
How would you diagnose chlamydia
Nucleic acid amplification test (NAAT)
urethral swab and first pass urine in Males
endocervical, urethral and vulvovaginal swabs in females for testing.
Also consider oropharyngeal and rectal sites
How is Chlamydia treated
Doxycycline
OR
azithromycin/erythromycin in pregnancy
What are possible complications for chlamydia
Pelvic inflammatory disease (PID)- increases the risk of ectopic pregnancy and infertility
Epididymitis
Prostatitis
Reactive arthritis
What organism causes gonorrhoea
Neisseria gonorrhoeae
How is gonorrhoea transmitted
sexual contact
vertical transmission during childbirth can cause ophthalmia neonatorum
How does gonorrhoea present
Male: mucopurulent urethral discharge, dysuria, orchitis
Female: mucopurulent cervical discharge with cervicitis, cervical bleeding upon contact, dyspareunia, pelvic pain
Rectal infection: rectal bleeding, rectal discharge, tenesmus, proctitis
oropharyngeal infection: pharyngitis, anterior cervical lymphadenopathy
How is gonorrhoea diagnosed
Nucleic Acid Amplification Test (NAAT)- First pass urine in males and vulvovaginal, endocervical and urethral swabs in females are used for testing.
If oropharyngeal or rectal symptoms are present these sites can also be swabbed for NAAT.
In addition, cultures (urethral, cervical, anal or oropharyngeal) are taken prior to administering antibiotics to assess antibiotic susceptibility.
How is gonorrhoea treated
ceftriaxone IM injection and Azithromycin
What are the complications of gonorrhea
Pelvic inflammatory disease (PID)- increases the risk of ectopic pregnancy and infertility
Fitz-Hugh-Curtis syndrome- secondary to PID there is inflammation of the hepatic capsule leading to perihepatic adhesions
Chronic pelvic pain in females
Infertility in males secondary to epididymitis
Prostatitis
Bartholinitis
What organism causes syphilis
Treponema pallidum
How is syphilis transmitted
direct sexual contact with a lesion on the skin or mucosa
congenital syphilis from trans placental transmission which increases the chance of stillbirth and miscarriage
What are the 5 stages of syphilis
Primary: Development of an indurated painless ulcer called a chancre forms most often on the genitals. This can form from 9-90 days.
Secondary: 6 weeks to 6 months following the primary infection a widespread non-pruritic maculopapular rash involving the palms and soles develops accompanied by alopecia, condylomata lata, generalised lymphadenopathy, oral snail-track lesions and constitutional symptoms (pyrexia, fatigue, malaise).
Early latent: Asymptomatic infection plus positive diagnostic serology obtained within two years of infection.
Late latent: Asymptomatic infection plus positive diagnostic serology obtained after two years of infection.
Tertiary: Untreated syphilis over many years can develop into:
Neurosyphilis – Tabes dorsalis, general paresis, strokes
Cardiovascular syphilis – Aortitis, aortic aneurysms
Gummatous syphilis – Formation of granulomas on bone, skin and mucosa
How is syphilis diagnosed
Serological test for syphilis (STS)
What are the signs of a trichomonas vaginalis infection
offensive, yellow/green frothy discharge.
vulval itching, inflammation and ulceration.
cervicitis - examination finding of the ‘strawberry cervix’
How is trichomonas vaginalis detected
posterior fornix swab and NAAT
How is trichomonas vaginalis treated
metronidazole
What are the signs of a BV infection
offensive, thin grey discharge. presence of clue cells
How is BV diagnosed
high vaginal swab for microscopy and culture
How is BV treated
metronidazole or topical clindamycin
What do vulval/high vaginal swabs detect
candida albicans and trichomonas vaginalis
