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STI Flashcards

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1
Q

what is the most common bacterial STI

A

chlamydia

70-80% of women are asymptomatic, 50% of men are asymptomatic

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2
Q

what are the characteristics of chlamydia bacteria

A

gram negative obligate intracellular bacterium

stain poorly with gram stains

cell walls lack peptidoglycan

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3
Q

how is chlamydia transmitted

A

vaginal, oral or anal sex

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4
Q

who is most likely to get chlamydia

A

20-24 year olds

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5
Q

what percentage of women with chlamydia go on to develop pelvic inflammatory disease

A

9%

an episode of PID increases the risk of an ectopic pregnancy x10

also carries risk of tubal factor infertility (15-20%)

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6
Q

how does chlamydia present in a female

A

post coital (after sex) or intermenstrual bleeding

lower abdominal pain

dyspareuria (painful sex)

mucopururlent cervicitis

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7
Q

how does chlamydia present in males

A

urethral discharge

dysuria

urethritis

epidididymo-orchitis (inflammation of epididymus and testes)

proctitis

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8
Q

what are the complications of chlamydia

A 
Pelvic inflammatory disease 
Ectopic pregnancy 
Reactive arthritis (reiter's syndrome)
Conjunctivitis 
Transmission to neonate (conjunctivitis and pneumonia)
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9
Q

what is some testing advice for chlamydia

A

dont test women >25 with vaginal discharge

do test women who have had CT in past year

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10
Q

what is LGV (lymphogranuloma veneereum)

A

a server of chlamydia trachoma’s

diagnosed in men who have sex with men

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11
Q

how does LGV present

A

Rectal pain
Discharge
Bleeding

high risk of concurrent STI

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12
Q

how do you diagnose chlamydia

A

test 14 days following exposure

Nucleic acid amplification test (NAAT) - females (vulvovaginal swab)

males - urine sample (avoid first urine)

Add a rectal swab id reciprocal anal intercourse

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13
Q

how do you treat chlamydia

A

doxycycline 100mg 2x daily for 1 week

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14
Q

what is mycoplasma genitalium

A

emerging sexually transmitted pathogen

associated with non-gonococcal urethritis

prevalence in 1-2% of the population

asymptomatic carriage

need NAAT test to diagnose

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15
Q

what bacteria is Gonorrhoea

A

gram negative intracellular diplococcus

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16
Q

where does gonorrhoea infect

A

mucus membranes of the urethra, endocervix, rectum and pharynx

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17
Q

how is gonorrhoea transmitted /incubated

A

incubation period or urethral infection in men is 2-5 days

20% risk from infected women to male partner

50-90% risk from infected man to female partner

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18
Q

how does gonorrhoea present in males

A

Asymptomatic <10%

urethral discharge >80%

Dysuria

Pharyngeal/rectal infections (Mostly asymptomatic)

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19
Q

how does gonorrhoea present in females

A

Asymptomatic (up 50 50%)

Increased/altered vaginal discharge

Dysuria

Pelvic pain

Pharyngeal and rectal infection (asymptomatic)

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20
Q

what are some complications of gonorrhoea

A

Lower genital tract:

  • bartholinitis (glands at either side of vagina)
  • tysonitis (Tyson gland infection)
  • periurethral abscess
  • rectal abscess
  • epididymitis
  • urethral stricture

upper genital tract:

  • endometritis
  • PID
  • hydrosalpinx
  • Infertility
  • Ectopic pregnancy
  • Prostatitis
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21
Q

how do you diagnose gonorrhoea

Study These Flashcards
A

NAAT - nucleic acid amplification test (screening test)

microscopy (for symptomatic)

culture (if microscopy +ve or contact of GC)

22
Q

treatment for gonorrhoea

Study These Flashcards
A

1st line - Ceftriaxone 500mg IM

2nd line - Cefixime 400mg oil (if IM is contraindicated)

23
Q

what are the characteristics of genital herpes

Study These Flashcards
A

first a primary infection

then a non-primary first episode of herpes

then recurrent infection

24
Q

how long does a first episode of herpes tend to last

Study These Flashcards
A

14-21 days

incubation 3-6 days

25
how does herpes present
``` Blistering and ulceration of external genetalia Pain External dysuria Vaginal or urethral discharge Local lymphadenopathy Fever and myalgia ```
26
how do recurrent episodes of herpes tend to present
unilateral, small blisters and ulcers minimal systemic symtpoms resolves within 5-7 days
27
what investigations are done for herpes
swab base of ulcer for HSV PCR
28
herpes treatment
Oral antiviral treatment (acyclovir 400mg 3x daily for 5-7 days) if v painful lidocaine 5% ointment can be used saline bathing analgesia
29
what to do if first episode of herpes happens in the 3rd trimester of preganancy
inform O+G to review birth plan 50% risk of transmission to neonate is primary HSV
30
what is the most common viral STI in the uk
HPV | 80% life time risk of getting infection
31
how many HPV genotypes infect the anogenital epithelium
>40
32
what serotypes are associated with different clinical problems
anogenital warts - 6/11 palmar and plantar warts - 1/2 cellular dysplasia - 16/18
33
what is the incubation period for HPV
3 weeks - 9 months
34
HPV immunology
spontaneous clearance of wards - 20-24% clearance with treatment - 60% persistence despite treatment - 20%
35
treatment for HPV
Podophyllotoxin (warticon) - cytotoxic - not licensed for extra genital warts Imiquidmod (alder) - immune modifier - used on all anogenital warts Cryotherapy - cyctolytic - needs repeat treatments Electrocautery
36
what bacteria causes syphilis
treponema pallidum
37
how is syphylis transmitted
sexual contact trans-placental/during birth blood transfusions non-sexual contact (health care workers)
38
what are the 2 main classifications of syphilis
congenital acquired
39
what are the stages of acquired syphilis
Early infectious: - primary - secondary - early latent late non-infectious: - late latent - tertiary
40
what is the incubation period for primary syphilis
9-90 days
41
how does primary syphilis present
Primary chancre (painless ulcer) lesion appears at site of inoculation genital (90%) extra-genital (10%) non-tender local lymphadenopathy
42
when does secondary syphilis start
6 weeks to 6 months
43
how does secondary syphilis present
``` Rash on palms and soles Lesions of mucous membranes Generalised lymphadenopathy Pathcy alopecia Condylomata lata (v infectious lesions exuding a serum teeming with treponems) ```
44
how do you diagnose sylphilis
Dark field microscopy PCR from lesions or infected lymph nodes Serological testing to detect antibodies
45
what non-treponemal serological tests are done for syphilis
Non-treponemal (look at biomarkers released in cellular damage) VDRL - venereal disease research lab RPR -rapid plasma reagin
46
what treponemal serological tests are done for syphilis
TPPA (treponemal pallidum particle agglutination) ELISA/EIA - enzyme immunoassay screening test INNO-LIA - line immunoassay FTA abs (fluorescent treponemal antibody absorbed)
47
treatment for early syphilis
2.4 intramuscular Benzathine penicillin x1
48
treatment for last syphilis
2.4 intramuscular benzathine penicillin x3
49
what follow up is done for syphilis
syphilis becomes late syphilis when RPR is negative or serofast titres should decrease fourfold by 3-6 months in early syphilis
50
which type of genital herpes has higher rates of viral shedding
HSV 2

3 Reproduction (49 decks)

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