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GP Conditions Year 4 > STI > Flashcards

STI Flashcards

1
Q

What bacteria causes chlamydia and is it gram positive or negative?

A

chlamydia trachomatis

gram negative

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2
Q

what is the most common STI in the UK and what is it a common cause of?

A

chlamydia

infertility

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3
Q

Risk factors for chlamydia

A

young
sexually active
multiple partners

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4
Q

What % of people with chlamydia are asymptomatic?

A

50% men

75% females

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5
Q

What does the National Chlamydia Screening programme entail?

A

everyone under 25 and sexually active to be screened annually for chalmydia or if partner changes
positive re-test 3 months

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6
Q

GUM clinic STI screening list

A

chalmydia
gonorrhoea
syphilis - blood
HIV - blood

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7
Q

2 types of swabs used

A

charcoal swabs

NAAT swabs

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8
Q

What do charcoal swabs allow for?

A

microscopy
culture
sensitivities

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9
Q

transport medium - charcoal swab

A

amies transport medium

keep microorganisms alive

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10
Q

What does microscopy entail?

A

gram staining

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11
Q

What can charcoal swabs be used for?

A

endocervical swabs

high vaginal swabs

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12
Q

What can charcoal swabs confirm?

A 
bacterial vaginosis 
candidiasis
gonorrhoea 
trichomonas vaginalis 
group B strep
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13
Q

What do NAAT detect?

A

DNA or RNA

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14
Q

What STIs use NAAT?

A

chlamydia

gonorrhoea

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15
Q

What can NAAT be performed on?

A

vulvovaginal swab
endocervical swab
first catch urine sample

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16
Q

What can NAAt be performed on - men

A

first catch urine

urethral swab

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17
Q

Rectal and pharyngeal NAAT swabs

A

chlamydia in rectum or throat

anal or oral sex

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18
Q

After gonorrhoea is demonstrated on NAAT what is done next?

A

endocervical charcoal swab

microscopy, culture, sensitivities

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19
Q

Who to consider chlamydia in - women

A 
sexually active 
abnormal discharge 
pelvic pain 
abnormal vaginal bleeding
painful sex
painful urination
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20
Q

Who to consider chalmydia in - men

A

urethral discharge or discomfort
painful urination
epididymo-orchitis
reactive arthritis

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21
Q

Examination findings

A

Pelvic or abdominal tenderness
cervical motion tenderness
inflamed cervix
purulent discharge

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22
Q

First line treatment - uncomplicated chlamydia

A

doxycycline 100mg 2 daily for 7 days

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23
Q

When is doxycycline CI?

A

breastfeeding and pregnancy

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24
Q

treating chlamydia in pregnancy/breastfeeding

A

azithromycin 1g then 500mg for 2 days
erythromycin 500mg 4xdaily for 7 days
amoxicillin 500mg 3xdaily 7 days

25
When could a test of cure be done?
rectal chlamydia pregnancy symptoms persist
26
Factors to consider going forward
GUM - contact trace look for other STIs prevention safeguarding - young people
27
Complications - chlamydia
``` PID chronic pelvic pain infertility ectopic pregnancy reactive arthritis epididymo-orchitis ```
28
Pregnancy related complications - chlamydia
preterm delivery low birth weight postpartum endometriosis neonatal infection - conjunctivitis
29
What is lymphogranuloma venereum?
condition affecting lymphoid tissue around site of infection with chlamydia MSM
30
3 stages of LGV
primary stage - painless ulcer lymphadenitis proctitis (tenesmus)
31
treating LGV
doxycycline 100mg 2xdaily for 21 days
32
Chlamydia conjunctivitis
chronic erythema, irritation and discharge more 2 weeks unilateral young adults and neonates with affected mothers
33
What bacteria causes syphilis?
treponema pallidum
34
What type of bacteria is treponema pallidum?
spirochete | spiral shaped bacteria
35
incubation period syphilis
21 days
36
How can syphilis be contracted?
``` oral, vaginal or anal sex vertical transmission IVDU blood transfusions transplants ```
37
Name different phases of syphilis
``` primary secondary latent tertiary neurosyphilis ```
38
primary syphilis
painless ulcer - chancre | local LN
39
secondary syphilis
systemic sx - skin and mucous membranes maculopapular rash condylomata lata LN, fever, alopecia, oral lesions
40
latent syphilis
asymptomatic | within 2years of infection (early latent) and after 2 years is late latent
41
tertiary syphilis
many years after development of gummas aortic aneurysms neurosyphilis
42
When can neurosyphilis occur?
any stage
43
What are gummas?
granulomatous lesions that affect skin, organs and bones
44
neurosyphilis symptoms
``` headache altered behaviour dementia tabes dorsalis ocular syphilis paralysis sensory impairment ```
45
tabes dorsalis
demylination of spinal cord posterior columns
46
specific pupil finding in neurosyphilis
Argyll-Robertson pupil
47
Argyll-Robertson pupil
constricted pupil that accommodates when focusing on near object but does not respond to light
48
diagnosing syphilis
antibody test - screening rapid plasma regain and VDRL dark field microscopy and PCR
49
Managing syphilis
screening other STIs sexual activity advice until treated contact tracing
50
treating syphilis
deep im dose of penicillin
51
Treating HPV
local cytotoxic therapy - 5FU cryotherapy surgical - laser, curettage
52
Treating HSv2/genital herpes
acyclovir
53
Treating HIV
Systemic ART nucleoside reverse transcriptase inhibtor integrase inhibitor, reverse transcriptase inhibitor, protease inhibitor
54
Treating hep B
ART - entecavir | interferon sc or im
55
Treating gonorrhoea
ceftriaxone im | azithromycin
56
symptoms gonorrhoea
urethritis, Bartholin gland cyst, salpingitis, PID | epididymitis
57
Treating candida albicans
local antimycotic agent - clotrimazole | fluconazole PO
58
Treating pubuc lice
permethrin 1% - insecticide

GP Conditions Year 4 (72 decks)

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