Sexually Transmitted Infections Flashcards Preview

Med 2 - Week 42 > Sexually Transmitted Infections > Flashcards

Flashcards in Sexually Transmitted Infections Deck (36)
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1

What is the most commonly reported STI in BC?

Chlamydia

2

What types of bacteria is Chlamydia?

gram negative, obligate intracellular bacteria

3

How is Chlamydia transmitted?

- oral, vaginal, anal sexual contact.
- conjunctival mucosal infection
- vertical

4

Who is predominantly infected with chlamydia? Men or women?

women 2:1 to men

5

What is the most common clinical presentation of chlamydia?

asymptomatic!!

6

What is the most common complication of chlamydia infection in women?

PID

7

What is the preferred method of lab diagnosis of chlamydia for men and for women ?

men: NAAT with initial stream urine sample

women: NAAT with either vaginal or cervical swab

8

What are the 2 treatment options for chlamydia infection?

1. azythromycin 1g PO in a single dose

2. doxycycline 100mg PO BID for 7 days

9

What is the estimated lifetime risk of infection with HPV?

75%

10

What is the mode of transmission of HPV?

skin to skin and vertical

11

What are some of the possible clinical manifestations of HPV?

- asymptomatic
- ano-genital warts
- HPV related pre-cancers and cancers

12

What type of bacteria is Neisseria gonorrhoea ?

small, intracellular, gram negative diplococci

13

How is Neisseria gonorrhoea transmitted?

- oral, vaginal, anal sexual contact
- conjunctival mucosal infection
- vertical

14

Who is more likely to be infected with Neisseria gonorrhoea, men or women?

Men 2:1 to women

15

What is the typical clinical presentation of Neisseria gonorrhoea? For women and men

women: vaginal discharge, dysuria, abnormal bleeding, lower abdo pain, deep dyspareunia, rectal pain and discharge with proctitis

men: urethral discharge, dysuria, urethral itch, testicular pain and or swelling. symptoms of epididymititis, rectal pain and discharge with proctitis

16

What is the most common complication of Neisseria gonorrhoea in women?

PID

17

What are other possible complications of Neisseria gonorrhoea infection in women and men?

women: PID, infertility (from PID), ectopic pregnancy, chronic pelvic pain, reactive arthritis, disseminated gonococcal infection

Men: epididymo-orchitis, reactive arthritis, infertility (rare), disseminated gonococcal infection

18

How is Neisseria gonorrhoea infection diagnosed in men and women?

men: NAAT from initial stream urine sample

women: NAAT from vaginal or cervical swab

19

When would you use culture to detect either gonorrhoea or chlamydia?

- antimicrobial sensitivities
- test of cure
- symptomatic MSM
- sexual abuse/sexual assault cases
- evaluation of causative agent of PID
- in areas with high local antimicrobial resistance rates

20

What are the two treatment options for gonorrhoea?

1. cefixime 800mg PO (one dose) OR ceftriaxone 250mg IM (single dose)

plus

2. doxycycline 100mg PO BID for 7 days OR azithromycin 1m PO (single dose)

21

What is PID?

polymicrobial infection of the upper female genital tract
- involving any combination of endometrium, fallopian tubes, pelvic peritoneum, and contiguous structures
- can be caused by STIs, endogenous organisms, anaerobic bacteria, facultative bacteria

22

What key PE test will help you determine whether a patient has PID?

doing a bimanual examination looking for cervical motion tenderness

23

What the the 3 minimum diagnostic criteria for PID?

1. lower abdo tednerness
2. adnexal tenderness
3. cervical motion tenderness

24

what are the 2 outpatient treatment options for PID?

1. cefixime 800mg PO (one dose) OR ceftriaxone 250mg IM (single dose)

plus

2. doxycycline 100mg PO BID for 10-14 days OR azithromycin 1m PO (single dose) once a week for 2 weeks

plus/minus

3. metronidazole 500mg BID for 14 days

25

25% of women will experience sequelae after a single episode of PID such as ...

ectopic pregnancy, infertility, or chronic pelvic pain

26

tubal infertility occurs in what % of women who have had 1, 2, and 3 episodes of PID?

8%, 20%, 50%

27

Differentiate between the discharge seen in BV, candidiasis, and trichomoniasis

BV: white or grey, thin, copious, fishy smell

Candidiasis: white, clumpy, curdy

Trichomoniasis: off-white, yellow, frothy

28

What are the typical presentations of BV, candidiasis, and trichomoniasis?

BV: fishy odour and vaginal discharge, 50% can be asymptomatic

Candidiasis: itchy, external dysuria, erythema and edema of vagina and vulva, vaginal discharge

Trichomoniasis: itch, dysuria, and discharge. 10-50% can be asymptomatic. "strawberry cervix"

29

What does a wet mount look like for BV, candidiasis, and trichomoniasis?

BV: PMNs and clue cells

candidiasis: budding yeast and pseudohyphae

trichomoniasis: motile flagellated protozoa

30

What does a gram stain look like for BV, candidiasis, and trichomoniasis?

BV: clue cells, decreased normal flora, predominant gram negative curved bacilli and coccobaciilli

candidiasis: PMNs, budding yeast, pseudohyphae

trichomoniasis: PMNs, trichomonads