STI's Flashcards
(35 cards)
Gonorrhoea - What is it caused by?
Neisseria gonorrhoeae, inncubation period - 5/6 days.
Gonorrhoea - sy/sx men
10% have no sy, sx - thick profuse yellow discharge, dysuria. Rectal and pharyngeal infeciton is often asymptomatic
Gonorrhoea - sy/sx women
vaginal discharge, dysuria or intermenstrual/post-coital bleeding
Gonorrhoea - dx/ix
Nucleic Acid Amplification Test (NAAT) on urine or swab from an exposed site – vagina, rectum, throat. Could be self-obtained or clinician-obtained.
Gram stained smear from urethra/cervix/rectum in symptomatic people.
Culture of swab-obtained specimen from an exposed site using highly selective lysed blood agar in a 5% CO2 environment. Should be done for all confirmed cases to assess antibiotic sensitivity.
Gonorrhoea - tx
Ceftriaxone. Followup if tx is working after 2 weeks.
Gonorrhoea - complications
Male: Epididymitis, Female: Pelvic inflammatory disease. Bartholin’s abscess. [Gonococcal ophthalmia neonatorum.] Both: Acute monoarthritis usually elbow or shoulder.
Chlamydia - what is it caused by?
Chlamydia trachomatis, people under 25, sexually active teenage women
Chlamydia - sy/sx men
> 70% asymptomatic, sx- Slight watery discharge, dysuria,
Chlamydia - sy/sx women
> 80% asymptomatic, vaginal discharge, dysuria, intermenstrual/post-coital bleeding. Both men and women may get Conjunctivitis
Chlamydia - dx/ix
First void urine in men. Self-taken or clinician-taken swab from cervix, urethra, rectum as appropriate.
All specimens tested using a NAAT
Chlamydia - Tx
Doxycycline 100mg for 1 week (if pregnant give Azithromycin once), then followup at 3-12 months
Chlamydia - complications
Men Epididymitis. Women: PID and hence ectopic pregnancy, pelvic pain and infertility. Probably only ~1% of women who get chlamydia will develop a problem with their fertility Both: Reactive arthritis/ Reiter’s syndrome – urethritis/cervicitis + conjunctivitis + arthritis
Herpes - what is it caused by?
HSV1 and 2 (inncubation period of 5 days to months, some may nnever get symptoms), very common, HSV2 is an important cofactor for HIV transmission
Herpes - sy/sx
80% have no symptoms. The rest have recurring symptoms – monthly, annually. Burning/itching then blistering then tender ulceration. Tender inguinal lymphadenopathy. Flu-like symptoms. Dysuria, Neuralgic pain in back, pelvis and legs,
Herpes - dx/ix
clinical, swab from lesionn then PCR
Herpes - tx
Primary outbreak: Aciclovir: various regimens – eg 400mg tds for 5 days, Lidocaine ointment.
Infrequent recurrences: Lidocaine ointment. Aciclovir 1.2g once daily until symptoms gone (1-3 days)
Frequent recurrences: Aciclovir 400bd long-term as suppression.
Herpes - complications
Autonomic neuropathy, (urinary retention), neonatal infection, secondary infection.
Syphilis - what is it caused by?
Treponema pallidum subspecies pallidum, >90% MSM
Syphilis- sy/sx
Primary Local ulcer (CHANCRE), Secondary Rash, mucosal ulceration, neuro symptoms, patchy alopecia, other symptoms.
Early latent no symptoms but <2years since caught. Late latent no symptoms but >2 years since caught. Tertiary Neurological, cardiovascular or gummatous – skin lesions, (all v rare).
Syphilis - dx/ix
Clinical signs, urethral swab then TPPA - Serology for TP IgGEIA, and RPR, PCR on sample from an ulcer
Syphilis - tx
Early (<2 yrs and no neurological involvement): Benzathine penicillin 2.4 MU im once Or Doxycycline 100mg bd po 2 weeks
Late (>2 years) and no neurological involvement: Benzathine penicillin 2.4MU im weekly for 3 doses, Doxycycline 100mg bd po 28 days
Syphilis - complications
neurosyphilis – cranial nerve palsies are commonest, cardiac or aortal involvement.
infectious diseases wihich may be accquired from abroad on a buisniess trip…
HIV, HCV, chlamydia, genital or oral HSV, HBV, anal genital warts.
Trichomoniasis - What is it caused by?
Trichomonas vaginalis, more common in middle aged women
