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Reproduction > Sexually Transmitted Infections > Flashcards

Sexually Transmitted Infections Flashcards

1
Q

What organism causes Chlamydia?

A

Chlamydia Trachomatis

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2
Q

What type of bacteria is chlamydia trachomatis?

A

Gram negative

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3
Q

Give the male presentation of chlamydia

A

70% asymptomatic

Slight watery discharge

Dysuria

Conjunctivitis

Epididymo-orchitis

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4
Q

Give the female presentation of chlamydia

A

80% asymptomatic

Vaginal discharge

Dysuria

Dyspareunia

IMB and PCB

Conjunctivitis

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5
Q

What investigation is used in chlamydia diagnosis

A

Nucleic acid amplification test (NAAT)

  • Male, first pass urine
  • Female, vaginal swab
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6
Q

How is chlamydia managed?

A

Doxycycline 100mg twice daily for 1 week

Azithromycin if pregnant or breastfeeding

Test for cure only required if rectal or pregnancy

Partner notification

Abstain from sex for seven days of treatment

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7
Q

Give complications of chlamydia

A

Epididymo-orchitis

PID

Ectopic pregnancy

Infertility, due to damage to fallopian tubes

Reactive arthritis

Conjunctivitis

Preterm delivery and premature rupture of membranes

Neonatal infection

Lymphogranuloma venereum

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8
Q

What organism causes gonorrhoea?

A

Neisseria Gonorrhoeae

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9
Q

What type of bacteria is neisseria gonorrhoea?

A

Gram-negative diplococcus

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10
Q

What is the incubation period for gonorrhoea?

A

5-6 days average (range from 2 days-2 weeks)

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11
Q

Give the male presentation of gonorrhoea

A

10% asymptomatic

Thick profuse odourless yellow discharge

Dysuria

Epididymal-orchitis

Rectal or pharyngeal infection

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12
Q

Give the female presentation of gonorrhoea

A

50% asymptomatic

Odourless purulent yellow discharge

Dysuria

Pelvic pain

IMB and PCB

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13
Q

What investigation is used in gonorrhoea diagnosis?

A

Nucleic acid amplification test (NAAT)

  • Male, first pass urine
  • Female, vaginal swab

Charcoal swab for culture and sensitvities

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14
Q

How is gonorrhoea managed?

A

Single dose IM ceftriaxone

Test of cure at 2-6 weeks

Partner notification

Abstain from sexual activity for 1 week of treatment

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15
Q

Give complications of gonorrhoea

A

Epididymo-orchitis

PID

Infertility

Conjunctivitis

Disseminated gonococcal infection, spreading to skin and joints

Super Gonorrhoea, due to anti-microbial resistance

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16
Q

What organism causes trichomonas?

A

Trichomonas Vaginalis

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17
Q

What type of organism is trichomonas vaginalis?

A

Protozoan parasite with flagella

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18
Q

Give the male presentation of trichomonas

A

Usually asymptomatic, more difficult to identify in men

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19
Q

Give the female presentation of trichomonas

A

10-30% asymptomatic

Frothy yellow/green foul smelling discharge

Dyspareunia

Dysuria

Pruritis

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20
Q

What investigations are used in trichomonas diagnosis?

A

Charcoal vaginal/PCR swab, from posterior fornix

No test for men

Nucleic acid amplification test (NAAT), to rule out chlamydia and gonorrhoea

21
Q

What speculum sign is seen in trichomonas?

A

Strawberry cervix

22
Q

How is trichomonas managed?

A

Metronidazole for 5 days

Partner notification and treatment

23
Q

What is the incubation period for herpes simplex virus?

A

5 days-months

24
Q

How does herpes present?

A

80% asymptomatic

Recurring symptoms monthly/annually

Burning/itching

Blistering/ulceration

Tender inguinal lymphadenopathy

Flu-like symptoms

Dysuria

Neuralgic pain in back, pelvis and legs

25
Q

What investigation is used for herpes diagnosis?

A

NAAT on swab of ulcer

26
Q

What is the primary management of herpes?

A

Aciclovir for 5 days

Lidocaine ointment

Salt water baths, passing urine in bath

27
Q

How is herpes managed?

A

Lidocaine ointment

Oral aciclovir once daily until symptoms gone (1-3 days)

Longterm aciclovir if recurrences

28
Q

How is herpes managed in pregnancy?

A

Oral aciclovir until delivery, and then delivery by c section

29
Q

What points are important to cover in herpes counselling?

A

Typically first episode is most severe

May get recurrence, more severe and frequent if HSV 2

Most contagious when have symptoms but can cause asymptomatic shedding

Oral to genital spread is possible if one partner gets cold sores

30
Q

Give complications of herpes

A

Autonomic neuropathy/urinary retention

Neonatal infection

Secondary infection

Herpes Encephalitis

HSV2 important co-factor in HIV transmission

31
Q

What is the difference between HS1 and HS2?

A

HS1

  • Associated more with oral herpes

HS2

  • Associated more with genital herpes
32
Q

What is herpes zoster ophthalmicus (HZO)?

A

Describes the reactivation of the varicella-zoster virus in the area supplied by the ophthalmic division of the trigeminal nerve

33
Q

Give features of herpes zoster ophthalmicus (HZO)

A

Vesicular rash around the eye, which may or may not involve the actual eye itself

Hutchinson’s sign, rash on the tip or side of the nose, suggests future eye involvement

Anterior uveitis, conjunctivitis,

Ptosis

34
Q

How is herpes simplex keratitis managed?

A

Topical aciclovir

35
Q

What organism causes genital warts?

A

Human Papilloma Virus types 6 and 11

36
Q

How are genital warts managed?

A

Podophyllotoxin

Imiquimod

37
Q

What organism causes syphilis?

A

Treponema pallidum

38
Q

What type of bacteria is treponema pallidum?

A

Spirochete

39
Q

What is the incubation period for syphilis?

A

9-90 days until appearance of chancre

40
Q

How can syphilis be transmitted?

A

Sexually transmitted

Vertical transmission from mother to baby during pregnancy

IV drug use

Blood transfusions and other transplants

41
Q

How does syphilis present?

A

Often asymptomatic

Primary

  • Painless chancre at site of infection

Secondary, resolves in 3-12 weeks

  • Maculopapular rash
  • Mucosal ulceration
  • Lymphadenopathy

Tertiary, occuring years after infection

  • Neurosyphilis
  • Aortic aneurysms
  • Gummatous lesions
42
Q

How does neurosyphilis present?

A

Headache

Altered behaviour

Dementia

Tabes dorsalis (demyelination affecting the spinal cord posterior columns)

Ocular syphilis (affecting the eyes)

Paralysis

Sensory impairment

43
Q

What investigations are used in syphilis diagnosis?

A

Antibody screening

Blood serology

PCR on ulcer sample

44
Q

How is syphilis managed?

A

IM benzathine penicillin

45
Q

What organisms can cause PID?

A

Chlamydia trachomatis

Neisseria gonorrhoeae

Mycoplasma genitalium

46
Q

Give risk factors for PID

A

Existing STI

Multiple sexual partners and not using barrier contraception

IUD

47
Q

How does PID present?

A

Constant lower abdominal/pelvic pain

Purulent vaginal discharge

Deep dyspareunia

Dysuria

Fever

Cervical excitation/cervical motion tenderness

IMB and PCB

Increased inflammatory markers

48
Q

What is the management of PID?

A

1g IM ceftriaxone single dose, to cover gonorrhoea

100mg oral doxycycline + metronidazole for 14 days, to cover chlamydia and mycoplasma genitalium

400mg metronidazole for 14 days, to cover anaerobes

Severe cases require IV antibiotics

49
Q

Give complications of PID

A

Tubal factor infertility

Sepsis

Tubo-ovarian abscess formation

Ectopic pregnancy

Chronic pelvic pain

Fitz-Hugh-Curtis syndrome, inflammation of liver capsule

Reproduction (18 decks)

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