STI/UTI Flashcards
(31 cards)
What is the syndromic management approach to STIs in South Africa?
It involves identifying consistent symptom groups and signs and treating for the most common and serious pathogens using standardised flowcharts. It’s cost-effective and doesn’t rely on lab confirmation.
What counselling topics are included in STI management?
HIV testing, condom promotion/demonstration, adherence, partner notification/treatment, circumcision, contraception advice.
How are STIs linked to HIV?
STIs increase HIV acquisition and transmission via mucosal disruption and increased viral load. HIV also alters STI progression.
What is Vaginal Discharge Syndrome (VDS)?
Abnormal discharge, itching or irritation. Caused by:
Low-risk: Candidiasis, BV, Trichomoniasis
High-risk: Gonorrhoea, Chlamydia
What is Male Urethritis Syndrome (MUS)?
Dysuria, urethral itching, discharge (may contain pus/blood), pain during sex. Pathogens: Gonorrhoea, Chlamydia, Trichomoniasis.
What is Genital Ulcer Syndrome (GUS)?
Presence of genital ulcers, causes include:
Syphilis
Herpes
Chancroid
LGV
Granuloma inguinale
What causes scrotal swelling in STIs?
Often epididymo-orchitis (infection/inflammation).
<35 years → STI-related
35 years → Non-STI causes
Gonorrhoea: cause, symptoms, treatment?
Neisseria gonorrhoeae
Symptoms: Discharge, dysuria (asymptomatic common)
Tx: Ceftriaxone 250 mg IM stat
Chlamydia: organism, symptoms, treatment?
Chlamydia trachomatis
Often asymptomatic
Symptoms: Discharge, burning urination
Tx: Azithromycin 1 g PO stat
Syphilis progression (4 stages)?
TREPONEMA PALLIDUM
Primary: Painless ulcer
Secondary: Rash, flu-like
Latent: Asymptomatic, transmissible in pregnancy
Tertiary: Brain/heart damage, irreversible
What are RPR and VDRL used for?
Serological tests to screen and monitor syphilis treatment. Early stages may give false negatives.
Chancroid: cause, key features?
Haemophilus ducreyi – painful ulcer, purulent, lymphadenopathy. HIV co-factor.
Granuloma inguinale (Donovanosis)?
Klebsiella granulomatis – painless ulcer, bleeds easily, no lymphadenopathy.
Genital warts: cause and prevention?
HPV.
Symptoms: Warts on genitals, anus, cervix.
Prevention: Pap smear, HPV vaccine (Gardasil, Cervarix).
Neonatal conjunctivitis causes?
<24 hrs: Chemical (e.g. silver nitrate)
2–5 days: Gonorrhoea
5–14 days: Chlamydia, HSV
Severe cases → blindness if untreated
STIs in pregnancy – most serious risks?
Syphilis → miscarriage, stillbirth, congenital syphilis
Gonorrhoea → neonatal blindness
Chlamydia → neonatal conjunctivitis/pneumonia
What defines a UTI?
Presence of microorganisms in urine not due to contamination.
Differentiate between lower and upper UTIs.
Lower: Cystitis, urethritis, prostatitis
Upper: Pyelonephritis (kidneys)
What are complicated vs uncomplicated UTIs?
Uncomplicated: No structural/neurologic issues
Complicated: Involves lesions, stones, catheters, obstruction, etc.
What is asymptomatic bacteriuria?
> 10⁵ bacteria/mL in urine without symptoms. Common in elderly.
What is symptomatic abacteriuria?
Symptoms of UTI but no significant bacteriuria. Often linked to Chlamydia
What is the most common UTI cause?
Escherichia coli (E. coli) from bowel flora.
3 infection pathways in UTIs?
Ascending (most common in females)
Hematogenous (rare)
Lymphatic (rare)
Host factors that resist UTI?
Complete bladder emptying, low pH, Tamm-Horsfall protein, normal flora.
