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