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Flashcards in STI's Deck (45)
1

What is the most commonly reported STI

Chlamydia

2

What percentage of people with chlamydia are asymptomatic

70 percent of women
50 percent of men

3

What organism causes chlamydia

gram negative chlamydia trachomatis bacteria

4

Which age group has the highest incidence of chlamydia infection

20-24 year olds

5

What percentage of women with chlamydia develop Pelvic inflammatory disease

9 percent

6

What other conditions does PID put a woman at risk of

10 times more likely to have a ectopic pregnancy
15-20 percent increased risk of tubal factor infertillity

7

How may a symptomatic woman present with chlamydia infection

post coital or intermenstrual bleeding
lower abdo pain
dyspareunia
mucopurulent cervicitis

8

How can a man present with chlamydia

urethral discharge
dysuria
urethritis
epididymo-orchitis

9

What are the main complications of chlamydia infection

PID
tubal damage
chronic pelvic pain
neonatal transmission
conjunctivitis
SARA/reiter's syndrome - more common in men
Perihepatitis (Fitz-Hugh-CUrtis syndrome)

10

What is the diagnostic test of choice for chlamydia

NAAT - nucleic acid amplification test

11

How should chlamydia be tested for

two weeks after possible exposure
females- vulvovaginal swab
men- first void urine
MSM- rectal swab also if receptive anal intercourse

12

How is chlamydia treated?

Azithromycin 1g single dose
Or Doxycycline 100mg BD for one week
No need to retest to ensure infection has cleared

13

What causes gonorrhoea and what are the common infection sites

gram negative intracellular diplococcus
Mucous membranes- urethra, endocervix, rectum and pharynx

14

How long is the incubation period of gonorrhoea infection in a man in the urethra

2-5 days

15

What is the risk of transmission of gonorrhoea between an uninfected and infected individual

20 percent risk from infected woman to male partner
50-90 percent risk from infected man to female partner

16

How does gonorrhoea present in males

Asymptomatic in less than 10 percent of cases
Urethral discharge in 80 percent
Dysuria
pharyngeal/rectal infections usually asymptomatic

17

how can gonorrhoea present in females

asymptomatic in up to 50 percent
increase/altered vaginal discharge (40 percent)
dysuria
pervic pain
pharyngeal and rectal infection usually asymptomatic

18

how is gonorrhoea diagnosed

Microscopy - urethral and endocervical swab
Culture- male urethra, femal endocervic
NAATs

19

How is gonorrhoea treated

1st line - ceftriaxone 500mg IM
Second line- Cefixime 400mg oral
Co treat with azithromycin 1g
Test cured in all patients

20

What organism causes syphilis?

treponema pallidum

21

How is syphilis usually transmitted?

sexual contact
trans placental/during birth
blood transfusions
non sexual contact- health care workers
It may be congenital or acquired

22

what are the stages of acquired syphilis infection

Early infections - primary, secondary, early latent
Late non- infectious - late latent, tertiary

23

how long is the incubation period for primary syphillus

9-90 days (mean is 21)

24

what are the features of primary syphilis

Lesion is traditionally known as a primary chancre (painless)
Lesions appear at the site of inoculation
Sites are genital in 90 percent of cases
non tender local lymphadenopathy`

25

what are the features of secondary syphilis

skin rash
lesions on mucous membranes
generalized lymphadenopathy
patchy alopecia
condylomata lata

26

how is syphilis treated

early- 2.4 MU benzathine penicillin x 1
late- 2.4MU benzathine penicillin x 3

27

what is the incubation period for genital herpes

3-6 days

28

how long does a primary herpes infection last

14-21 days

29

what are the clinical features of genital herpes

blistering and ulceration of external genitalia
pain
external dysuria
vaginal or urethral discharge
local lymphadenopathy - tender
fever and myalgia

30

What HSV type is more commonly associated with recurrent episodes

HSV 2
milder- thrush like symptoms
unilateral, small blisters
minimal systemic upset
resolves 5-7 days

31

How is HSV diagnosed

swab ulcer for PCR

32

how is HSV managed

oral acyclovir
lidocaine topical if pain
saline bathing
analgesia

33

what is the most common viral sti in the uk

HPV - 80 percent lifetime risk of infection

34

which types of HPV cause genital warts

6 and 11

35

what is the incubation period of hpv

3 weeks to 9 months

36

how is hpv warts treared

podophyllotoxin (warticon) - cytotoxic
imiquimod- can be used on all anogenital warts
cryothraphy
electoclautery

37

What is the normal vaginal flora

Lactobacillus spp. with lactic acid +/- hydrogen peroxide

Step viridans
Group B strp
Small numbers of candida

38

What predisposes to candidda

recent antibiotics
high oestrogen levels eg. pregnancy, certain contraceptives
diabetes
immunocompromised

39

How does candida presetn

itchy white vaginal sicharge

40

How Is candida diagnose

HVS for culture (usually c.albicans)

41

How is candida treated

Cltrimazole cream or pessary
Oral fluconazole

42

What causes bacterial vaginosis

Gardnerella vaginalis/mobiluncus sp.

43

What are the symptoms of BV

thin watery fishy smelling discharge

44

How is BV diagnosed

clinically
raised vaginal pH (more than 4.5)
HVS for microscopy - GLUE CELLS- subjective/inaccurate

45

What is the treatment of bacterial vaginosis

metronidazole