Sexually Transmitted Infections Flashcards

(36 cards)

1
Q

What is the most commonly reported STI in BC?

A

Chlamydia

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2
Q

What types of bacteria is Chlamydia?

A

gram negative, obligate intracellular bacteria

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3
Q

How is Chlamydia transmitted?

A
  • oral, vaginal, anal sexual contact.
  • conjunctival mucosal infection
  • vertical
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4
Q

Who is predominantly infected with chlamydia? Men or women?

A

women 2:1 to men

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5
Q

What is the most common clinical presentation of chlamydia?

A

asymptomatic!!

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6
Q

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

A

PID

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7
Q

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

A

men: NAAT with initial stream urine sample
women: NAAT with either vaginal or cervical swab

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8
Q

What are the 2 treatment options for chlamydia infection?

A
  1. azythromycin 1g PO in a single dose

2. doxycycline 100mg PO BID for 7 days

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9
Q

What is the estimated lifetime risk of infection with HPV?

A

75%

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10
Q

What is the mode of transmission of HPV?

A

skin to skin and vertical

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11
Q

What are some of the possible clinical manifestations of HPV?

A
  • asymptomatic
  • ano-genital warts
  • HPV related pre-cancers and cancers
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12
Q

What type of bacteria is Neisseria gonorrhoea ?

A

small, intracellular, gram negative diplococci

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13
Q

How is Neisseria gonorrhoea transmitted?

A
  • oral, vaginal, anal sexual contact
  • conjunctival mucosal infection
  • vertical
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14
Q

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

A

Men 2:1 to women

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15
Q

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

A

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

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16
Q

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

17
Q

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

A

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
Q

How is Neisseria gonorrhoea infection diagnosed in men and women?

A

men: NAAT from initial stream urine sample
women: NAAT from vaginal or cervical swab

19
Q

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

A
  • 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
Q

What are the two treatment options for gonorrhoea?

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

plus

  1. doxycycline 100mg PO BID for 7 days OR azithromycin 1m PO (single dose)
21
Q

What is PID?

A

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
Q

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

A

doing a bimanual examination looking for cervical motion tenderness

23
Q

What the the 3 minimum diagnostic criteria for PID?

A
  1. lower abdo tednerness
  2. adnexal tenderness
  3. cervical motion tenderness
24
Q

what are the 2 outpatient treatment options for PID?

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

plus

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

plus/minus

  1. 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
31
What will the whiff test be for BV, candidiasis, and trichomoniasis?
BV: positive candidiasis: negative trichomoniasis: negative
32
what is the treatment for BV?
metronidazole (oral or topical) or clindamycin (topical)
33
what is the treatment for candidiasis ?
antifungals - fluconazole oral - clotrimazole or miconazole topical
34
What is the treatment for trichomoniasis
metronidazole 2g PO (single dose) or 500mg PO PID for 7 days
35
Who is disproportionately affected by syphilis infections?
MSM | - 83% of cases
36
What is an important risk factor for acquiring syphilis?
HIV positive status