Sexually Transmitted Infections Flashcards
(111 cards)
1
Q
what are reportable STIs?
A
chlamydia, syphilis, gonorrhoea
2
Q
what are non reportable STIs?
A
herpes simplex virus (HSV) and human papillomavirus (HPV)
3
Q
what percentage of people have HPV in their life?
A
75
4
Q
are rates of syph, gonorrhoea and chlamydia increasing or decreasing?
A
increasing
5
Q
what is the sequele for STIs?
A
sterility, miscarriage, ectopic pregnancy, congenital defects, cancer, chronic pain an psychiatric disorders
6
Q
what is the most common bacterial STI in Canada?
A
chlamydia
7
Q
are men or women more prone to getting chlamydia?
A
women
8
Q
is chlamydia trachomatis gram neg or pos and what type of bacteria is it?
A
gram neg, obligate intracellular bacteria
9
Q
how is chlamydia trachomatis transmitted?
A
vaginal, oral or anal
10
Q
how does chlamydia trachomatis enter the body?
A
enters body through microscopic brakes in mucosal membranes and infects mucosal epithelial cells of pharynx, urethra, cervix, uterus, Fallopian tubes, anus or rectum
11
Q
what may occur as a complication of chlamydia trachomatis?
A
autoinculation
- may occur when infected genital site to conjunctiva or rectum
12
Q
what are symptoms of autoinculation?
A
headache, fever, muscle aches
13
Q
what are symptoms of chlamydia?
A
dysuria, proctitis (inflamed rectal lining), conjunctivitis (tearing, discharge, inflammation, swelling)
14
Q
is chlamydia usually asymptomatic or symptomatic?
A
asymptomatic
15
Q
symptoms in women for chlamydia?
A
vaginal discharge, vaginal bleeding, dyspareunia (painful intercourse), cervicitis
16
Q
symptoms in men for chlamydia?
A
urethral discharge, urethritis, urethral itch and testicular pain
17
Q
what people should be annually screened?
A
all sexually active people younger than 30 and gay, bisexual and transgender people
18
Q
when should targeted screening be done?
A
sexually active people over 30 (drug use, sex work, sex w out protection, sdoh)
19
Q
how can you determine which specimens should be collected and type of test used?
A
clinical picture and sexual history
20
Q
how should asymptomatic people be tested for chlaymida?
A
- naats
- first void urine (person should not void for at least 2 hours prior to specimen collection)
- vaginal swab (conjunctival, pharyngeal and rectal swabs
- physical exam when STI is suspected
21
Q
how should symptomatic people be tested for chlaymida?
A
naats, first void urine, vaginal/cervical swab, urethral swab, conjunctival, rectal and pharyngeal swabs, swab of any visible lesions
22
Q
who should be treated for chlamydia?
A
pos lab results, suspected chlamydia or ppl with symptoms, or pos lab results for neisseria gonorrhoea, or Dx of sexual partners
23
Q
what pharmalogical Tx is required? (Chlamydia)
A
doxycycline (2x/day), azithromycin (single dose)
24
Q
what is pelvic inflammatory disease (PID)?
A
infection and inflammation of upper genital tract
25
symptoms of PID?
fever upper abdominal pain or tenderness, adnexal and cervical motion tenderness
26
what is the sequele for PID?
chronic pelvic pain, ectopic pregnancy and infertility
27
how to diagnose PID?
abdominal or pelvic exam and microbiology (gram stain)
28
once PID is treated, when should symptoms resolve?
48-72 hours post Tx
29
what pharmacological Tx is required for PID?
ceftriaxone, doxycycline (2x/day), metronidazole (2x/day)
30
can PID be managed?
no, must be Tx
31
what is the second most reported bacterial STI in Canada?
gonorrhoea
32
what is the sequele for gonorrhoea?
PID, ectopic preg, infertility, chronic pelvic pain. Reiters syndrome, dissimenated infection, transmission to new borns
33
is niesseria gonorrhoea gram neg or pos and what type of bacteria?
gram neg diplococci, faucultative intracellular bacteria
- develops antimicrobial resistance
34
how is gonorrhoea transmitted?
via vaginal, anal or oral
35
how does gonorrhoea enter the body?
adheres via fimbriae and capsules to mucosal epithelial cells of pharynx, urethra, cervix, uterus, Fallopian tubes, anus and rectum
- fimbriae allow N. gonorrhoea to attach to sperm cells
36
what happens if phagocytized bacteria survives?
multiply in neutrophils traveling to distal sites in body such as joints, meningitis and heart
37
how long does gonorrhoea last for?
2-7 days but can last up to 1-14 days
38
what are symptoms of gonorrhoea?
dysuria, proctitis
39
is gonorrhoea symptomatic or asymptomatic in men and women?
asymptomatic in women
symptomatic in men
40
symptoms of women for gonorrhoea?
cervicitis, vag discharge, lower abdominal pain, vagina bleeding, painful intercourse and bartholinitis
41
symptoms of men for gonorrhoea?
urethral discharge, itch, testicular pain, epididymo orchitis
42
when being screened for gonorrhoea, what else should you be screened for?
chlamydia, syph, HIV
43
what people should be annually screened for gonorrhoea?
sexually active ppl <30, gay, bisexual and trans
44
what people should have targeted screening in gonorrhoea?
sexually active ppl >30, all preg ppl at first prenatal visit - rescreen at 3rd trimester for who tested pos, screen at delivery for those who haven't been tested , neonates born to ppl with gonorrhoea
45
what lab tests should be done for gonorrhoea?
cultures, NAAT and microscopy (gram stain)
46
how should asymptomatic be tested for gonorrhoea?
- first void urine (person should not void for at least 2 hours prior to specimen collection)
- urethral swabs for men, vaginal/cervical swabs for women (vaginal preferred)
47
how should symptomatic be tested for gonorrhoea?
pharyngeal and rectal swabs
- men need urethral swab for gram stain an culture and urine specimen for NAAT
- women need cervical swab for NAAT and culture
48
what is a culture strongly recommended for in gonorrhoea?
- as a test of cure for suspected Tx failure
- if infection was acquired in countries w high rates of antimicrobial resistance
AS WELL AS..
symptomatic pt, PID, preg women, sexual abuse
49
who should be treated for gonorrhoea?
- pos lab results for N. gonorrhoea
- sexually active and symptomatic
- Dx of gonorrhoea in sex partner
50
what is the pharmalogical treatment for gonorrhoea?
ceftriaxone IM, doxycycline 2x/day over 7 days
51
what should be obstained from until treated for gonorrhoea?
unprotected sex
52
antimicrobial resistance - gonorrhoea
Tx complicated by worldwide spread of gonococcal strains resistant to many antibiotics
53
how can people be infected multiple times?
high variability in surface antigens across strains
54
what is the third most reported bacterial STI in Canada?
Syphilis
55
can congenital syphilis be transmitted to fetus during pregnancy or delivery?
yes
56
what type of bacteria is treponema pallidum?
helical shaped bacteria
57
how is syphilis transmitted?
vaginal, oral and anal
58
how does syphilis enter the body?
enters host through breaches in mucosal membranes
59
what phases of syphilis are infectious?
primary, secondary and early latent stages
60
how is syphilis transmitted in pregnancy?
through vertical transmission
- can also occur through contact with genital lesion
61
what characterizes PRIMARY syphilis?
(infectious)
- small, hard, painless ulcers occurring at site
- cervix, vulva wall, penis, mouth and anus
- manifests 3 weeks post infection
- symptoms resolve w out Tx
62
what characterizes SECONDARY syphilis?
(infectious)
- systemic symptoms
- rash, fever, malaise, headaches, mucosal lesions, lymphadenopathy, alopecia, candylomata late, meningitis, retinitis
63
what characterizes the early latent phase?
- asymptomatic phase
- less then 1 year post secondary stage
64
what characterizes the late latent phase?
- asymptomatic phase
- over 1 year post secondary stage
- pt may never develop any long term complications
65
what characterizes the Tertiary phase?
- can occur decades after initial infection
- CV syphilis, neurosyphilis, gumma
66
what characterizes neurosyphilis?
- can occur at any stage of syphilis (untreated primary infection, up to 20 years or more after infection)
- headaches, ataxia, vertigo, dementia, personality changes
67
what people should be screened for syphilis?
gay, bisexual, trans
- screen pregnant ppl in first trimester, then again at 28-32 weeks an again at delivery
68
people being screened for syphilis should also be screened for?
chlamydia, gonorrhoea and HIV
69
diagnostic testing for syphilis may include?
blood specimens, lesion, sampling and or samples of CSF
70
should serologic testing be done for syphilis?
yes, to detect antibodies
71
what is lesion sampling for in syphilis?
NAAT to detect T. pallidum in mucosa and skin from lesions of suspected cases of primary and secondary syphilis
72
when is CSF used in cases of syph?
used in suspected cases to neurosyphilis
73
what pharmalogical Tx is used for primary, secondary and early latent syphilis?
Benzathine Penicillin G-LA (IM, single dose)
74
what pharmalogical Tx is used for late latent syphilis, cardiovascular syphilis and gumma?
Benzathine Penicillin G-LA (IM weekly for 3 doses)
75
is genital herpes a reportable infection?
no
76
what is genital herpes caused by?
HSV 1 an 2
77
how is genital herpes transmitted?
oral, anal and vaginal
78
is shedding of genital herpes asymptomatic?
yes
79
HSV 1 an 2 can lead to what?
transmitted vertically and lead to neonatal disease
80
what is the incubation period for genital herpes?
1-26 days (6-8)
81
how does HSV enter the body?
enters the mucocutaneous tissues and replicates
- after initial replication, HSV enters a latent phase where it may remain dormant for years
81
how does HSV enter the body?
enters the mucocutaneous tissues and replicates
- after initial replication, HSV enters a latent phase where it may remain dormant for years
82
what does genital herpes look like?
clear, straw coloured fluid filled vesicles appear first then develop into painful, burning ulcers as they rupture
83
symptoms of genital herpes?
systemic symptoms of fever, malaise, myalgia
84
how long does herpes last without Tx?
17-20
85
complications of primary infection (genital herpes)?
extragenital lesions, meningitis/encephalitis
86
what are prodromal symptoms of genital herpes?
pain, tingling, burning, itching and skin sensitivity where new vesicles form (unilateral, localized small erythematous patch, painful genital vesicles an ulcers along distribution of sacral nerves)
87
when is screening for HSV not recommended?
ppl with no hx of anogenital lesions
88
ppl being screened for HSV should also be screened for?
syph, gonorrhoea, chlamydia and HIV
89
what treatment is needed in first episode of genital herpes in pregnancy?
oral antiviral therapy
90
when should c section be considered when pregnant with genital herpes?
if first episode occurs in the 3rd trimester of pregnancy
91
how is genital herpes diagnosed?
NAAT or viral culture of fresh lesions (viral culture could fail to detect HSV)
92
what does a viral culture allow for in genital herpes?
typing and sensitivity testing
93
how is genital herpes managed?
psychological support an counselling to help them understand and cope with chronic infection
94
what is the pharmalogical Tx for genital herpes?
antiviral medications - reduce viral shedding, time of crusting and healing of lesions and duration of pain
95
what is the medication for (Antiviral Therapies- First episode, Non pregnant Adult)
acyclovir 400 mg 3 times/day for 7-10 days
96
what is the medication for (Antiviral Therapies- Recurrent Episodes, Non pregnant Adult)
acyclovir 800 mg 2 times/day for 5 days
97
is human papillomavirus (HPV) a reportable virus?
no
98
which two strains of human papillomavirus (HPV) cause 70% of angiogenital cancers?
16, 18
99
which strains of human papillomavirus (HPV) cause 14% of angiogenital cancers?
31, 33, 45, 52 and 58
100
which two strains of human papillomavirus (HPV) cause 90% of angiogenital warts?
6 & 11
101
what are genital warts?
painful lesions that present 3-4 months post exposure
102
what is the Gardasil-9 immunization?
consists of VLPs assembled from recombinant HPV proteins
- antibodies protect and prevent infection caused by viral strains covered in the vaccine
103
Gardasil-9 targets which HPV genotypes?
16, 18, 6, 11, 31, 33, 45, 52 and 58
104
what ages is Gardasil-9 vaccine for?
9-45
105
Gardasil-9 is provincially funded for which grade?
gade 7
106
in what intervals should Gardasil-9 be given?
two doses at least 6 months apart
- 15 an older: 3 doses
107
what are the symptoms of a uti?
dysuria, urgency, frequency, abdominal pain, fever and incontinence
108
how to diagnose a UTI?
- midstream urine first thing in the morning
- positive culture identifies organism
109
what shows in a urinalysis?
leukocyte esterase, enzyme produced by neutrophils, indicative of an active infection, WBCs, nitrites, protein levels
110
what are complications of UTI?
pyelonephritis, ascending infection, severe abdominal flank and back pain, fever for >3days, chills, nausea/vomiting, fatigue, pyuria, kidney damage sepsis
