STIs 2 Flashcards
(49 cards)
gonorrhea
reduced susceptibility to first line treatment is emerging in urban australia
caused by neisseria gonorhhoae
clinical presentation of gonorrhea
anal and pharyngeal infections are usually asymptomatic
penile urethral gonorrhea is usually symptomatic
causes penile urethral discharge, dysuria, vaginal discharge, dyspareunia with cervicitis, conjunctivitis, anorectal symptoms
complications of gonorrhea
epidydimo-orcitis (uncommon)
prostatitis
PID
bartholin gland abscess
disseminated disease (rarely)
meningitis or endocarditis (raarely)
diagnosis for gonorrhea
always collect samples when treating to contribute to antimicrobial reesistance surveillence but never delay treatment while waiting for these culture results
first pass urine NAAT - less sensitive
penile urethral swab
clinician collected or self collected vaginal swab
for men who have sex with men, always aalso collect an anal and pharyngeal swab
gonoccoccal culture
high specificity and allows for antibiotic susceptibility testing
much less sensitive than NAAT
clinicians must specify ‘gonococcal culture’ rather than general culture
treatment for uncomplicated genital and anorectal infection gonorrhea
ceftriaxone 500mg stat
PLUS
azithromycin 1g PO stat
is gonorrhea notifiable
yes
other management for gonorrhea
no sexual contact for 7 days after treatment is commenced, or until the course is complete and symptoms resolved, whichever is later
no sex with partners from the last 2 months until they have all been tested and treated
recommend partner notification
provide patient fact sheet
notify the state
test of cure for gonorrhea
TOC by NAAT should be performed 2 weeks after treatment is completed
hepatitis A
acute infection of the liver
usually from contaminated food and water but faecal-oral transmission can occur during sex, especially in men who have sex with men
care is supporrtive, infection confers lifelong immunity
people at risk of hep A
men who haave sex with men
people who inject drugs
aboriginal and torres strait islander people
people in custodial settings
sex workers
symptoms of hep A
acute hepatitis: lethargy, nausea, fever, anorexia, jaundice, pale stools and dark urine
usually aysmpomatic in children, more severe illness in elderly and pregnant people
usually resolves in one month
tests for hep A
AST, ALT, bilirubin - raised in acute hep
Anti-HAV IgM - raised in acute illness and persists for 3-6 months
anti-HAV Ig- total - previous infection or vaccination
is hep A notifiable
yes
hepatitis B
anyone with positive hep B surface antigen (HBsAg) needs ongoing monitoring and needs to be considered for treatment
infection causes acute hepatitis, which may progress to chronic infection
hep B clinical presentation
asymptomatic infection is common
acute hepatitis - rght upper quadrant pain, lethargy, nausea, fever, anorexia for a few days then jaundice
is hep B notifiable
yes
interpreting Hep B serology
positive HBsAg - acute or chronic infection
positive anti-HBc - current or past infection
positive ant-HBs - immunity due to past infection or vaccination
how to tell the difference between acute or chronic hep B
acute hep B will have highh titre of anti-HBc IgM
HIV
treated with anti-retroviral therapy rehardless of CD4+ T cell count
people who achieve and maintain an undetectable HIV viral load cannot sexually transmit the virus
symptoms of HIV
acute infection - fever, rash, lymphadenopathy, pharyngitis, myalgia, diarrhoea
immune deficiency - multiple symptoms related to declining CD4 T cell couth such as oral thrush, diarrhea, weight loss, skin infections, herpes zoster
PEP
post exposure prophylaxs can be offered 72 hours after potential HIV exposure
PrEP
prevention option for HIv negative people
lymphogranuloma venerum is caused by
chlamydia trachomatis
