Year 4 OBGYN > STI > Flashcards

STI Flashcards

(66 cards)

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1
Q

How does Gonorrhoea present in Women?

A

Altered Vaginal Discharge
Lower Abdo Pain
Dysuria
Altered Menstrual Bleeding

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2
Q

How should you investigate suspected Gonorrhoea?

A

Vaginal or Endocervical Swab

Culture for sensitivity

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3
Q

How is Gonorrhoea managed?

A

Ceftriaxone IM
(If complicated add Doxycycline or Metronidazole)

Partner Tracing
Avoid Sexual Contact until treatment complete

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4
Q

Name three complications of Gonorrhoea in Pregnancy

A

Spontaneous Abortion
Premature Labour
Gonococcal Conjunctivitis

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5
Q

Give three general complications of Gonorrhoea

A

PID
Infertility
Ectopic Pregnancy

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6
Q

How does Chlamydia present in Women?

A

Dysparenuria
PCB/IMB
Increased Discharge

Or

Reiters Syndrome (Urethritis/Arthritis/Conjunctivitis)

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7
Q

How should you investigate suspected Chlamydia?

A

Vulvovaginal Swab and NAAT

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8
Q

How should you manage suspected Chlamydia?

A

100mg Doxycycline BD for one week

Partner Tracing

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9
Q

Give three complications of Chlamydia in Pregnancy

A

Premature Delivery
Neonatal Conjunctivitis
Pneumonia

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10
Q

Give three complications of Chlamydia

A

PID
Infertility
Ectopic Pregnancy

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11
Q

Name the four ways Syphilis can be transmitted

A

Sexual
Vertical
Blood Transfusions
Breaks in Skin

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12
Q

How does Primary Syphilis present?

A

Develops at site of inoculation less than 90 days after
Transforms from Macule to Papule to Painless Ulcer/Chancre
Highly Infectious

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13
Q

How does Secondary Syphilis present?

A

Usually 6 weeks after Primary Lesion

Polymorphic Rash affecting palms and soles
Systemic: Night time headaches, Malaise, Slight Fever

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14
Q

How does Tertiary Syphilis Present?

A

Neurological: Tapes Dorsalis (Sensory Ataxia and Pain), Dementia
Cardiovascular: Aortitis
Gummata: Inflammatory nodules that can occur in any organ

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15
Q

How would you investigate Syphilis?

A

Treponemal Enzyme Immunoassay for IgM, IgG or both

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16
Q

How would you manage Syphilis?

A

Benzathine Penicillin 2.4 Mega Units

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17
Q

What is Jarisch Herxheimer Reaction?

A

Reaction to Syphilis treatment

Febrile, Myalgia, Chills, Headaches

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18
Q

Describe the features of Congenital Syphilis

A

Saddle Nose
Rashes
Failure to gain weight

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19
Q

What are Genital Warts?

A

Benign epithelial growths caused by HPV 6 and 11

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20
Q

Give three risk factors for Genital Warts

A

Smoking
Multiple Sexual Partners
Immunosupression

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21
Q

How do Genital Warts present?

A

Painless lesions causing itching/bleeding/Dysparenuria

On moist hairy skin (soft and non keratinised) on dry skin (firm and keratinised)

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22
Q

How would you counsel patients on a Genital Warts diagnosis?

A

Explain long latent period and that the recurrence of warts does not mean infidelity

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23
Q

How would you manage Genital Warts?

A

May choose no treatment

Non Keratinised - Podophyllotoxin Cream
Keratinised - Imiquimod Cream

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24
Q

Trichomonas Vaginalis is spread almost exclusively through Sexual Intercourse, how does it present?

A

Often confused for Bacterial Vaginosis

Vaginal Discharge, Vulval Itching, Dysuria, Offensive Odour

Strawberry Cervix

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25
How do you investigate Trichomonas Vaginalis?
High Vaginal Swab
26
How should Trichomonas Vaginalis be managed?
Avoid intercourse for at least one week Single dose 2g Oral Metronidazole
27
What is Bacterial Vaginosis?
Overgrowth of predominantly anaerobic bacteria in Vagina (Gardnerella Vaginalis) Outgrow Lactobacilli so pH increases
28
Give three risk factors and three protective factors for Bacterial Vaginosis
Risk Factors: Sexual Activity, IUCD, Douching | Protective Factors: COCP, Condoms, Circumcised Partner
29
How does Bacterial Vaginosis present?
Offensive fishy smelling discharge without irritation
30
Diagnosis of Bacterial Vaginosis is difficult in Primary Care so generally just treated empirically. How is it managed?
Asymptomatic don’t need treating unless pregnant Avoid Douching Oral Metronidazole 400-500mg BD for 5-7 days
31
How is Genital Herpes transmitted?
Through skin to skin contact during Vaginal/Oral/Anal Sex Can lie dormant (in nearest nerve ganglion) and reoccur
32
What are the two different types of Genital Herpes?
HSV1 - Genital and Oral | HSV2 - Genital and Anal
33
What are the clinical features of Primary Genital Herpes?
Small red blisters that are very painful and can form open sores Vaginal/Penile Discharge Flu Like
34
What are the clinical features of Secondary Genital Herpes?
Shorter and less severe | Burning/Itching/Painful Red Blisters
35
How is Primary and Secondary Genital Herpes managed respectively?
1 - Acyclovir, Contact Tracing 2 - Painkillers, Petroleum Jelly, Ice Packs, Episodic Acyclovir
36
Describe the effect of Genital Herpes on Pregnancy
Baby is normally protected via placental antibodies , last trimester is more dangerous as antibodies not formed
37
What are the three types of Neonatal Herpes?
- SEM (Skin, Eyes, Mouth) - DIS (Disseminated) - CNS Herpes
38
Describe the pathophysiology of HIV
Penetrates CD4, empties contents, reverse transcriptase, combined with host DNA via integrase, maturation with protease
39
Define Seroconversion
Process of producing anti HIV antibodies during primary infection Extremely infectious Flu like symptoms
40
How does Symptomatic HIV present?
Weight Loss, High Temperature, Diarrhoea, Frequent Minor Opportunistic Infection
41
How should you investigate HIV?
ELISA - for salivary/serum antibodies, gives reliable results in 4-6 weeks Contact Tracing
42
What is HAART?
Highly Active Anti-Retroviral Therapy Aims to reduce load to virtually undetectable Eg Nucleoside Reverse Transcriptase Inhibitors, Protease Inhibitors
43
When should PEP be given?
Within 72 hours of exposure
44
What is monitored in HIV?
``` CD4 count HIV viral load FBC U&Es Urinalysis ```
45
What is Vulvovaginal Candidiasis?
Fungal infection of lower reproductive tract with Candida Albicans
46
Give three risk factors for Vulvovaginal Candidiasis
Pregnancy Diabetes Immunosupression
47
Name three symptoms of Vulvovaginal Candidiasis
Pruritus Vulvae Vaginal Discharge (white, curd like, non offensive) Dysuria
48
How would Vulvovaginal Candidiasis present OE?
Erythema and Vulval Swelling Satellite Lesions (Red Pustular with White Superficial Plaques) Curd like discharge
49
How is Vulvovaginal Candidiasis managed?
1) Intravaginal Clotrimazole (oil based so may weaken condoms) 2) Oral Antifungal (Fluconazole/Itraconazole) (Not in Pregnancy)
50
Why does Pregnancy encourage Vulvovaginal Candidiasis?
Increased Oestrogen stimulates glycogen production (more favourable environment) Encourages growth and sticking to vaginal walls
51
Define Pelvic Inflammatory Disease
Infection of the Upper Genital Tract affecting Uterus/Fallopian Tubes/Ovaries
52
How does PID present?
``` Lower Abdo Pain Deep Dysparenuria PCB Abnormal Discharge Fever ```
53
Give three differentials of PID
Ectopic Pregnancy Ruptured Ovarian Cyst Endometriosis
54
How would you investigate PID?
``` Endocervical Swabs (Chlamydia, Gonorrhoea) High Vaginal Swabs (TV and BV) Urine Dip Pregnancy Test Transvaginal USS ```
55
Describe the antibiotic therapy for PID
Oxaflocin Doxycycline Ceftriaxone Metronidazole All partners from last 6 months should be tested/treated
56
Give three complications of PID
Ectopic Pregnancy Tubo- Ovarian Abscess Fitz Hugh Curtis (Perihepatitis)
57
What should you treat needle phobic patients with for Gonorrhoea?
Cefixime and Azithromycin (PO)
58
Name the three features of Disseminated Gonococcal infection
Dermatitis Migratory Arthritis Tenosynovitis
59
Hen should you treat Chlamydia?
Before you get the results
60
When should you test for Chalmydia?
2 weeks after suspected exposure
61
Describe contact tracing for STIs
Female -all sexual partners in last 6 months Males - all sexual partners in last 4 weeks
62
Name three similarities between BV and TV
pH<4.5 Foul smelling discharge Both treated with Metronidazole
63
Name two differences between BV and TV
BV: Thin white watery discharge, Clue Cells on microscopy TV: Yellow/Green frothy discharge, Protozoa on microscopy
64
How do you treat pregnant women with Genital Herpes?
>28 weeks - caesarean Recurrent during pregnancy - Prophylactic Aciclovir
65
How should you treat gonorrhoea in needle-phobic patients?
Single dose cefixime and azithromycin
66
What is disseminated gonoccal infection?
Tenosynovitis, Migratory Polyarthritis and Dermatitis

Year 4 OBGYN (15 decks)

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