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Y3 - Repro > STIs > Flashcards

STIs Flashcards

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1
Q

What organism causes candida?

A

Candida albicans

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2
Q

What are risk factors for candida?

A

Antibiotic use
COCP/pregnancy - raised oestrogen
Diabetes
Immunocompromised

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3
Q

What is the presentation of candida?

A

Thick white discharge (‘curd-like’)

Very itchy

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4
Q

How is candida diagnosed?

A

Clinically

High vaginal swab isf unsure

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5
Q

What is the treatment for candida?

A

Topical clotrimazole

Oral fluconazole

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6
Q

What organism causes bacterial vaginosis?

A

Gardenella vaginali or anaerobes - imbalance of flora

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7
Q

How is bacterial vaginosis diagnosed?

A

Clinically
High vaginal swab - clue cells on microscopy
Increased pH (>4.5)

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8
Q

What is the management for bacterial vaginosis?

A

Oral metronidazole

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9
Q

What organism causes pubic lice?

A

Phthirus pubis

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10
Q

What is the presentation of pubic lice?

A

Itchy pubic area

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11
Q

What is the management of pubic lice?

A

Malathion lotion

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12
Q

What are the sexually transmitted bacterial infections?

A

Chlamydia
Gonorrhoea
Syphilis

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13
Q

What are the sexually transmitted viral infections?

A

HPV
Herpes simplex
HIV
Heb B or C

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14
Q

What are the sexually transmitted parasitic infections?

A

Trichomonas vaginalis
Scabies
Crabs

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15
Q

What organism causes chlamydia?

A

Chlamydia trachomatis

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16
Q

What gram is chlamydia trachomatis?

A

Gram negative

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17
Q

What is the most common bacterial STI?

A

Chlamydia

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18
Q

Where in the body does chlamydia infect?

A

Endocervix

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19
Q

What is the presentation of chlamydia?

A 
80% asymptomatic
Male
- urethritis
- urethral milky discharge
- dysuria
- orchiditis/proctitis
Female 
- mucopurulent cervicitis
- dyspareunia
- abnormal bleeding
Abdominal Pain
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20
Q

What are signs of upper genital disease?

A

Suprapubic tenderness
Mucopurulent cervicitis and contact bleeding on bimanual examination
Dyspareunia

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21
Q

What are the complications of chlamydia?

A

Pelvic inflammatory disease
Neonatal conjunctivitis
Reiter’s syndrome
Fitz-Hugh-Curtis syndrome

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22
Q

What is Reiter’s syndrome?

A

Reactive arthritis

Triad of: uveitis, urethritis, arthitis

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23
Q

What is Fitz-Hugh-Curtis syndrome?

A

Adhesions and inflammation of he liver capsule

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24
Q

What investigations are done for chlamydia?

A

Male - first pass urine sample
Female - endocervical swab
Combined NAATs/PCR

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25
What is the management for chlamydia?
``` Oral doxycycline (100mg BD 7 days) Second line - azithromycin Cover for PID if signs of upper genital disease - ceftriaxone, doxycycline and metronidazole ```
26
How should contacts of someone with chlamydia be managed?
Treat without need to test
27
What is lymphogranuloma venerium?
STI caused by chlamydia trachomatis types LGV 1, 2 and 3
28
Where is lymphogranuloma venerium most common?
Africa, India, SE asia
29
What are risk factors for lymphogranuloma venerium?
HIV positive MSM
30
What is the presentation of lymphogranuloma venerium?
Rectal symptoms and genital ulceration Stage 1 - painless ulcerating papule on genetalia 7-21 days after exposure Stage 2 - regional lymphadenopathy - fixed and painful with overlying erythema Stage 3 - nodes become fluctuant and can rupture
31
How is lymphogranuloma venerium diagnosed?
Nucleic acid amplification for LGV serovar
32
What is the management for lymphogranuloma venerium?
Doxycycline or erythromycin
33
What is the complication of lymphogranuloma venerium?
Chronic infection can result in extensive scaring, abscess and sinus formation
34
What organism causes gonorrhoea?
Neisseria gonorrhoea
35
What is the description of the organism neisseria gonorrhoea?
Gram positive diplococci (kidney bean shaped)
36
Where does gonorrhoea infect?
Intracellular, infects the epithelium of the urogenital tract, rectum, pharynx and conjuntivae
37
What is the incubation period of gonorrhoea?
2-14 days
38
What is the presentation of gonorrhoea?
Purulent urethral discharge Dysuria Rectal infection - proctitis with pain, discharge and itch Can be asymptomatic
39
What are the complications of gonorrhoea?
``` Infection of epididymis, prostate Bartholin's abscess Neonatal conjunctivitis Disseminated gonorrhoea Upper genital infection ```
40
What is the presentation of disseminated gonorrhoea?
Arthritis (monoarticular) Papular or pustular rash with erythematous base Fever and malaise
41
What is the investigation for gonorrhoea?
Male - first pass urine Female - endocervical swab Combined NAAT/PCR
42
What is the management for gonorrhoea?
IM ceftriaxone | Second line - cefixime and azithromycin (if IM injection contraindicated or refused)
43
What is the management for contacts of someone with gonorrhoea?
Treat with ceftriazone without need to test
44
What organism causes syphilis?
Treponema pallidum (a spirochete)
45
What is the incubation period for syphilis?
9-90 days
46
What are stages of presentation of syphilis?
``` Stage 1 (primary) - chancre (painless ulcer) - local lymphadenopathy - heals without treatment Stage 2 (secondary) - 4-10 weeks after appearance of primary lesion - copper palmar-plantar rash - snail track mouth ulcers - patchy alopecia - flu-like illness - generalised lymphadenopathy Stage 3 (latent) - no symptoms Stage 4 (tertiary) - neurosyphilis - Argyll-Robertson pupil (miotic - accomodates but doesn't react) - CVS effects - Cardiovascular - aortic aneurysm, aortic regurgitation - 4-20+ years after initial infection ```
47
How is syphilis diagnosed?
Swab of stage 1 or 2 lesion Spirochetes on dark ground microscopy (PCR) Serology specific tests fo diagnosis (IgM and IgG ELISA for screening, TPPA)
48
What is the management of syphilis?
Benzathine penicillin IM | For pen allergy - doxycycline or erythromycin
49
What strain of herpes simplex virus causes genital herpes?
HSV2 majority
50
Who is more severely affected by genital herpes?
Immunocompromised
51
What is the presentation of genital herpes?
``` Ulcers/blisters on external genitalia Painful Dysuria Local lymphadenopathy - tender Systemic symptoms - fever, myalgia, headache ```
52
What are the complications of genital herpes?
Neurological - aseptic meningitis, involvement of sacral plexus leading to retention of urine
53
How is genital herpes diagnosed?
Swab vesicles - PCR
54
What is the management of genital herpes?
Oral acyclovir + lidocaine topical If lesions already crusting antivirals won't do anything Secondary bacterial infection - rest, analgesia, antipyretics Supportive - saline bathing, analgesia
55
What is the risk of genital herpes in pregnancy?
Transplacental infection or infection via birth canal causing neonatal HSV
56
What is the management of genital herpes in pregnancy?
Acyclovir can b given in 1st or 2nd trimester depending on clinical condition Acyclovir can be given during the last 4 weeks of pregnancy to prevent recurrence at term Primary acquisition in 3rd trimester or term with high levels of viral shedding - c-section
57
Are condoms effective in preventing genital herpes?
May not be - lesions may occur outside areas covered
58
Which strains of HPV cause genital warts?
HPV 6 and 11
59
How is HPV spread?
Skin contact
60
What is the presentation of HPV?
Anogenital warts that are: - white - rough - raised - not painful
61
How is HPV diagnosed?
Clinically
62
What is the management of HPV?
Cryotherapy Podophyllotoxin cream Imiquimod cream
63
What organism causes trichomonas vaginalis?
Protozoal parasite
64
What is the presentation of trichomonas vaginalis?
Discharge - purulent, green, frothy, musty odour Irritation and itch Strawberry spots Males are usually asymptomatic but may have urethritis
65
What are strawberry spots?
Multiple small haemorrhagic areas on the cervix | Sign of trichomonas vaginalis
66
How is trichomonas vaginalis diagnosed?
High vaginal swab for microscopy - motile trophozoites | No test for males
67
What is the management for trichomonas vaginalis?
Oral metronidazole
68
What is the lookback period for contact tracing for chlamydia?
Male urethral - 4 weeks | Endocervix, anal, oral - 6 months
69
What is the lookback period for contact tracing for gonorrhoea?
Male urethral - 2 weeks | Endocervix, anal, oral - 3 months
70
What is the lookback period for contact tracing for syphilis?
Primary - 90 days | Secondary - 2 years
71
What is the lookback period for contact tracing for trichomonas vaginalis?
4 weeks
72
What is the lookback period for contact tracing for PID?
6 months
73
What is the lookback period for contact tracing for HIV?
3 months
74
What conditions is contact tracing not needed for?
Genital warts Genital herpes Thrush Bacterial vaginosis

Y3 - Repro (13 decks)

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