Sexually Transmitted Infections Flashcards by Shauneen Kiernan

What organism causes Chlamydia?

Chlamydia Trachomatis

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What type of bacteria is chlamydia trachomatis?

Gram negative

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Give the male presentation of chlamydia

70% asymptomatic

Slight watery discharge

Dysuria

Conjunctivitis

Epididymo-orchitis

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Give the female presentation of chlamydia

80% asymptomatic

Vaginal discharge

Dysuria

Dyspareunia

IMB and PCB

Conjunctivitis

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What investigation is used in chlamydia diagnosis

Nucleic acid amplification test (NAAT)

Male, first pass urine
Female, vaginal swab

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How is chlamydia managed?

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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Give complications of chlamydia

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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What organism causes gonorrhoea?

Neisseria Gonorrhoeae

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What type of bacteria is neisseria gonorrhoea?

Gram-negative diplococcus

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What is the incubation period for gonorrhoea?

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

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Give the male presentation of gonorrhoea

10% asymptomatic

Thick profuse odourless yellow discharge

Dysuria

Epididymal-orchitis

Rectal or pharyngeal infection

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Give the female presentation of gonorrhoea

50% asymptomatic

Odourless purulent yellow discharge

Dysuria

Pelvic pain

IMB and PCB

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What investigation is used in gonorrhoea diagnosis?

Nucleic acid amplification test (NAAT)

Male, first pass urine
Female, vaginal swab

Charcoal swab for culture and sensitvities

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How is gonorrhoea managed?

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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Give complications of gonorrhoea

Epididymo-orchitis

PID

Infertility

Conjunctivitis

Disseminated gonococcal infection, spreading to skin and joints

Super Gonorrhoea, due to anti-microbial resistance

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What organism causes trichomonas?

Trichomonas Vaginalis

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What type of organism is trichomonas vaginalis?

Protozoan parasite with flagella

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Give the male presentation of trichomonas

Usually asymptomatic, more difficult to identify in men

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Give the female presentation of trichomonas

10-30% asymptomatic

Frothy yellow/green foul smelling discharge

Dyspareunia

Dysuria

Pruritis

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What investigations are used in trichomonas diagnosis?

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Charcoal vaginal/PCR swab, from posterior fornix

No test for men

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

What speculum sign is seen in trichomonas?

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Strawberry cervix

How is trichomonas managed?

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Metronidazole for 5 days

Partner notification and treatment

What is the incubation period for herpes simplex virus?

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5 days-months

How does herpes present?

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80% asymptomatic

Recurring symptoms monthly/annually

Burning/itching

Blistering/ulceration

Tender inguinal lymphadenopathy

Flu-like symptoms

Dysuria

Neuralgic pain in back, pelvis and legs

What investigation is used for herpes diagnosis?

NAAT on swab of ulcer

What is the primary management of herpes?

Aciclovir for 5 days Lidocaine ointment Salt water baths, passing urine in bath

How is herpes managed?

Lidocaine ointment Oral aciclovir once daily until symptoms gone (1-3 days) Longterm aciclovir if recurrences

How is herpes managed in pregnancy?

Oral aciclovir until delivery, and then delivery by c section

What points are important to cover in herpes counselling?

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

Give complications of herpes

Autonomic neuropathy/urinary retention Neonatal infection Secondary infection Herpes Encephalitis HSV2 important co-factor in HIV transmission

What is the difference between HS1 and HS2?

HS1 * Associated more with oral herpes HS2 * Associated more with genital herpes

What is herpes zoster ophthalmicus (HZO)?

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

Give features of herpes zoster ophthalmicus (HZO)

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

How is herpes simplex keratitis managed?

Topical aciclovir

What organism causes genital warts?

Human Papilloma Virus types 6 and 11

How are genital warts managed?

Podophyllotoxin Imiquimod

What organism causes syphilis?

Treponema pallidum

What type of bacteria is treponema pallidum?

Spirochete

What is the incubation period for syphilis?

9-90 days until appearance of chancre

How can syphilis be transmitted?

Sexually transmitted Vertical transmission from mother to baby during pregnancy IV drug use Blood transfusions and other transplants

How does syphilis present?

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

How does neurosyphilis present?

Headache Altered behaviour Dementia Tabes dorsalis (demyelination affecting the spinal cord posterior columns) Ocular syphilis (affecting the eyes) Paralysis Sensory impairment

What investigations are used in syphilis diagnosis?

Antibody screening Blood serology PCR on ulcer sample

How is syphilis managed?

IM benzathine penicillin

What organisms can cause PID?

Chlamydia trachomatis Neisseria gonorrhoeae Mycoplasma genitalium

Give risk factors for PID

Existing STI Multiple sexual partners and not using barrier contraception IUD

How does PID present?

Constant lower abdominal/pelvic pain Purulent vaginal discharge Deep dyspareunia Dysuria Fever Cervical excitation/cervical motion tenderness IMB and PCB Increased inflammatory markers

What is the management of PID?

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

Give complications of PID

Tubal factor infertility Sepsis Tubo-ovarian abscess formation Ectopic pregnancy Chronic pelvic pain Fitz-Hugh-Curtis syndrome, inflammation of liver capsule

Sexually Transmitted Infections Flashcards

(49 cards)