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Reproduction Pathology > Sexually Transmitted Infections > Flashcards

Sexually Transmitted Infections Flashcards

(75 cards)

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1
Q

Definition of a sexually transmitted infection

A

An infection which is predominately sexually transmitted

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2
Q

STI vs STD

A

STI is the infection e.g. HPV

STD is the disease it causes e.g. warts

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3
Q

What is the activity of identification and informing sexual contacts of someone with an STI called?

A

‘partner notification’ or

‘contact tracing’

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4
Q

What is gonnorhoea caused by?

A

Neisseria Gonnorhoea

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5
Q

Which is more common, chlamydia or gonnorhoea?

A

Chlamydia

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6
Q

What gender is gonnorhoea more common in?

A

Men, often MSM

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7
Q

What does MSM mean?

A

Men who have sex with men

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8
Q

Incubation period of gonorrhoea

A

Average 5-6 days

Range 2 days - 2 weeks (if get symptoms at all)

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9
Q

Male symptoms of gonnorhoea

A

Thick, profuse yellow discharge
Dysuria
Rectal and pharyngeal infection often asymptomatic
10% with no symptoms

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10
Q

What % of males have no gonorrhoea symptoms?

A

10%

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11
Q

What % of women have no gonorrhoea symptoms?

A

> 50%

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12
Q

Women symptoms of gonnorhoea

A 
>50% asymptomatic
Vaginal discharge 
Dysuria
Intermenstrual bleeding
Post coital bleeding
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13
Q

Investigations for gonnorhoea

A

NAAT from urine or swab from exposed site (vagina, rectum, throat)
gram stain smear from urethra/cervix/rectum in symptomatic people
To confirm antibiotic sensitivity -> culture of swab obtained specimen from exposed site using highly selective lysed blood agar

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14
Q

NAAT means….

A

Nucleic acid amplification test

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15
Q

Treatment of gonnorhoea

A

Blind treatment with
- ceftriaxone 500mg IM once
PLUS
- Azithromycin 1g

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16
Q

Follow up after treatment for gonnorhoea infection

A

Test of cure at 2 weeks

Test of re infection at 3 months

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17
Q

Male complications of gonorrhoea

A

Epididymitis
Acute monoarthritis usually elbow or shoulder
Disseminated gonococcal infection; skin lesions - pustular with halo

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18
Q

Women complications of gonorrhoea

A

PID
Bartholin’s Abscess (gonococcal opthalmia neonatorum)
Acute monoarthritis (especially eblow or shoulder)
Disseminated gonococcal infection; skin lesions - pustular with halo

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19
Q

Causative organisms of chlamydia

A

Chlamydia trachomatis serovars D to K

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20
Q

Which type of causative organism of chlamydia is rare and causes lymphogranuloma and symptoms of severe proctitis?

A

Serovar Lb2

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21
Q

Who is chlamydia most commonly seen in?

A

mostly < 25 y/os

Especially in sexually active teenage women

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22
Q

Male symptoms of chlamydia

A

> 70% asymptomatic
Slightly watery discharge
Dysuria
Conjunctivitis

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23
Q

What % of males have asymptomatic chlamydia?

A

> 70%

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24
Q

What % of females have asymptomatic chlamydia?

A

> 80%

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25
Female Symptoms of chlamydia
``` >80% asymptomatic Vaginal discharge Dysuria Intermenstrual bleeding Post coital bleeding Conjunctivitis ```
26
Investigations of chlamydia
First void urine in men Self taken or clincial taken swab from cervix, urethra, rectum as appropriate All tested using NAAT
27
Treatment of chlamydia
Azithromycin 1g po once OR | Doxycycline 7 days
28
Follow up after chlamydia treatment
Test for reinfection 3-12 months | Earlier test of cure not needed unless symptoms present
29
Male complications of chlamydia
Epididymitis Reactive arthritis Reiter's syndrome - urethritis/cervicitis + conjunctivitis + arthritis
30
Women complications of chlamydia
PID ->hence ectopic pregnancy, pelvic pain and infertility Reactive arthritis Reiter's syndrome - urethritis/cervicitis + conjunctivis + arthritis
31
What % of women who get chlamydia will develop a problem with their fertility?
1%
32
What is herpes caused by?
Herpes simplex virus types 1 and 2
33
What is HSV2 an important co factor for?
HIV transmission
34
Approx. what % of the UK population has herpes?
15-20% - very common
35
Which strain of herpes is more common in genital infection?
Both strains equally common
36
Which gender is herpes most common in?
Roughly equal in both sexes
37
Incubation period of herpes
5 days to months
38
what % of people have no symptoms of herpes?
80%
39
Herpes symptoms
80% asymptomatic Rest have recurring symptoms (monthly/annually) Burning/itching then blistering then tender ulceration flu like symptoms dysuria neuralgic pain in back, pelvis and legs
40
Investigations of herpes
Clinical impression | Swab from lesion tested using PCR
41
Treatment of herpes
``` Primary outbreak - aciclovir e.g. for 5 days, 400mg td - Lidocaine ointment Infrequent recurrences - Lidocaine ointment - aciclovir 1.2 g once daily until symptoms gone (1-3 days) Frequent recurrences - acyclovir 400bd long term suppression ```
42
Complications of herpes
Autonomic neuropathy (urine retention) neonatal infection secondary infection
43
What does trichomonas vaginalis cause?
Trichomoniasis
44
Who usually gets trichomoniasis?
Middle aged women
45
Male symptoms of trichomoniasis
Usually asymptomatic
46
Female symptoms of trichomoniasis
10-30% asymptomatic Profuse thin vaginal discharge - greenish, frothy and foul smelling. vulvitis
47
What % of women are asymptomatic for trichomoniasis?
10-30%
48
Investigations for trichomoniasis
PCR on vaginal swab Not on urine so no test for men Microscopy of wet preparation of vaginal discharge
49
Treatment of trichomoniasis
Metronidazole 400mg po bd for 5 days or 2g single dose
50
Complications of trichomoniasis
Miscarriage and preterm labour
51
Causative organisms of anogenital warts
Human papilloma virus types 6 and 11 (occasionally type 1)
52
What % of the population has a HPV infection and warts
>90% of UK population have a genital HPV infection at somepoint in their life only 20% of those infected with a wart causing strain of HPV get warts
53
Symptoms of anogenital warts
Lumps with a surface texture of a small cauliflower | Occasionally itching or bleeding especially if perianal or intraurethral
54
Investigations of anogenital warts
Appearance | Biopsy unusual
55
When is a biopsy used to investigate anogenital warts?
To exclude intraepithelial neoplasia but this is rarely needed
56
Treatment of anogenital warts
``` Hormonal - podophyllotoxin - Imiquimod Cryotherapy Diathermy, scissor removal for bulky warts ```
57
Complications of anogenital warts
None common | Neonatal laryngeal papillomatosis
58
What is syphilis caused by?
Treponema pallidum subspecies pallidum
59
Common risk factor for syphilis
MSM
60
Incubation period of syphilis
9 to 90 until appearance of chancre but can be asymptomatic
61
Symptoms in the stages of syphilis
``` Often asymptomatic or mild symptoms Primary - local ulcer (chancre) Secondary - rash - mucosal ulceration - neuro symptoms - patchy alopecia - other symptoms Tertiary (all very rare) - neurological - Cardiovascular - gummatous - Skin lesions ```
62
Definition of early latent syphilis
No symptoms but < 2 years since caught
63
Definition of late latent syphilis
No symptoms but > 2 years since caught
64
Investigations for syphilis
Clincial signs Serology for TP IgGEIA, TPPA, RPR PCR sample from an ulcer
65
Treatment for syphilis
early (<2 years) and no neurological involvement - Benzathine penicillin 2.4 MU IM once OR - doxycycline 100mg bd po 2 weeks Late (> 2 years) and no neurological involvement - benzathine penicillin 2.4 MU IM weekly for 3 doses - doxycycline 100mg bd po 28 days
66
Complications of syphilis
Neurosyphilis (cranial nerve palsies common) Cardiac or aortal involvement Congenital syphilis
67
What is the equation to do with STIs?
B x C x D B = the probability of transmission C = contact (number of sexual contacts in a year) D = Duration
68
How can we reduce STIs?
``` Condoms/barrier methods Vaccines (HPV, HBV) PrEP (pre exposure prophylaxis) /ARVs (HIV) PEP (post exposure prophylaxis) Types of sex; education ```
69
How can we reduce the number of sexual contacts in a certain period of time?
Education Cultural influences/role models/advertising Alcohol
70
How can we reduce the duration of STIs?
``` Education of symptoms Accessibility of testing (stigma, appeal) Screening programmes - Cervical - HPV - Antenatal - HIV, Hep B, syphilis Resistance ```
71
Which STIs have a resistance problem?
HIV | Gonnorhoea
72
Investigation specifics for gonorrhoea
Due to resistance every swab has to be tested for drug resistance
73
If having gonnorhoea Tx, what must be done?
Abstain from sex for 2 weeks
74
Most common cause of PID
Chlamydia
75
Management of the baby if the mum is Hep B +ve
Hep B vaccine | 0.5ml of HBIG within 12 hours of birth with a further vaccine at 1 - 2 months then another at 6 months

Reproduction Pathology (28 decks)

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