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ADELE-Repro Ramblings > STIs > Flashcards

STIs Flashcards

1
Q

Name 3 bacterial STIs

A

Chlamydia
Gonorrhoea
Syphillis

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2
Q

4 viral STIs

A

HPV
Herpes Simplex
Hepatitis
HIV

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3
Q

3 Parasitic STIs

A

Trichomonas Vaginalis
Crabs (Pubic Lice)
Scabies

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4
Q

The main mode of transmission is human-human. Which STI can have some inanimate sources?

A

T vaginalis

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5
Q

What factors affect the infectiousness of the index case?

A

Concentration and phenotype of the organism
Susceptibility of the sexual partner
Resistance of the host

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6
Q

Classic catchphrase

Immunity is —-, reinfections are ——, vaccine development is ———

A

Immunity is rare, reinfections common and vaccine development difficult (Hep B and HPV)

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7
Q

Which bacteria predominate in the healthy vagina?

A

Lactobacillis spp.

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8
Q

What do Lactobacillis spp produce?

A

Lactic acid +- hydrogen peroxide (they suppress growth of other bacteria)

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9
Q

What bacteria is part of a normal vagina and would only be of worry if picked up on the swab of a pregnant lady?

A

Group B beta-haemolytic streptococcus

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10
Q

What bacteria is only worrying in the vagina if symptomatic?

A

Candida spp

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11
Q

What is the normal pH of the vagina?

A

PH 4-4.5

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12
Q

What two bacteria cause urethritis?

A

Gonorrhoea

Chlamydia

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13
Q

What greatly increases the probability of HIV acquisition?

A

Genital Ulcers

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14
Q

What does candida look like?

A

Creamy white discharge with redness

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15
Q

What is the most common type of candida?

A

Candida-albicans

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16
Q

Predisposing factors to candida

A

Recent antibiotic therapy
high oestrogen levels
diabetes (if poorly controlled)
Immunocomprimised

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17
Q

With repeated treatment albicans die as they are less resistant and —- ——– which are resistant to treatment grow

A

non-albicans

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18
Q

What type of infection in candida?

A

fungus

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19
Q

How do you diagnose candida?

A

Vaginal swab for culture

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20
Q

Is candida itchy?

A

INTENSELY ITCHY

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21
Q

Treatment for candida

A

Topical Clotrimazole (oral fluconazole?)

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22
Q

What does this describe- The vagina is not inflamed, itch is rare, vagina pH is more alkaline

A

Bacterial vaginosis

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23
Q

Describe the discharge bacterial vaginosis

A

Fishy smelling, white homogenous, may contain frothy bubbles

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24
Q

In bacterial vaginosis what is seen on wet mount?

A

Clue cells

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25
Q

Bacterial vaginosis is an STI TRUE/FALSE

A

FALSE

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26
Q

Treatment of bacterial vaginosis

A

Metronidazole (or clindamycin cream)

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27
Q

What are the 5 places that Chlamydia/Gonorrhoea can infect?

A 
Urethra
Rectum
Throat
Eyes
Endocervix
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28
Q

What is the commonest STI in the UK?

A

Chlamydia

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29
Q

Which organism does not stain with the gram stain as no peptidoglycan in the cell wall (but if it did it would be gram negative)?

A

Chlamydia

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30
Q

What are the 3 serological subgrouping of Chlamydia

A

Serovars A-C –> Trachoma (eye infection-not STI)
Serovars D-K –> genital infection
Serovars L1-L3 –> LGV

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31
Q

What does gonorrhoea look like on microscopy?

A

Two kidney beans facing each other

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32
Q

Treatment of Gonorrhoea

A

IM Ceftriaxone (2nd line - Cefixime oral)

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33
Q

Test of cure is recommended in all STI cases TRUE/FALSE

A

FALSE- only recommended in gonorrhoea due to concerns of resistance

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34
Q

What is the incubation period of urethral infections of gonorrhoea in men?

A

Usually short (2-5 days)

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35
Q

Treatment of chlamydia

A

Uncomplicated- Doxycycline

Complicated- Azithromycin

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36
Q

Presentation of chlamydia

A

-Pain when peeing
-Unusual discharge (mild, watery)
WOMEN
-Pain in tummy
-Bleeding after sex/between periods
MEN
-Pain/swelling in testicles

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37
Q

Complications of Chlamydia

A

PID
Reactive arthritis
Epididoymo-orchitis

38
Q

What are the three main components of reactive arthritis (formerly known as Reiters syndrome)

A

Urethritis
Conjunctivitis
Seronegative arthritis

39
Q

Where is there a lot of genetic exchange of resistance within……

A

the pharynx

40
Q

Presentation of gonorrhoea

A

Thick green/yellow discharge
Pain when urinating
Bleeding between periods

41
Q

What proportion of people with gonorrhoea are asymptomatic?

A

10% Men

50% Women

42
Q

If someone presents with Chlamydia/ Gonorrhoea how do you diagnose them?

A

Swab- Men (1st void early morning urine), Women (Vaginal swab)
Then NAAT –> Tests for both organisms in one test

43
Q

How does LGV present?

A

Rectal pain
Discharge
Bleeding

44
Q

LGV rectally has identical histology with what?

A

Crohns

45
Q

Treatment of LGV

A

3 week course of doxycycline

46
Q

What is proctitis?

A

Inflammation of the lining of the rectum

47
Q

Presentation of acute bacterial prostatitis

A

Symptoms of UTI
Pain (lower abdomen pain/back/perineal pain)
Tender prostate on examination

48
Q

Acute bacterial prostatitis can be caused by different things in younger v older men

A

Young- Chlamydia/Gonorrhoea

Older- UTI

49
Q

Treatment of acute bacterial prostatitis

A

Ciprofloxacin 28 days

50
Q

What is the bacterium that causes syphillis?

A

Treponema pallidum

51
Q

As treponema palladium does not stain on gram stain what does the diagnosis depend on?

A

PCR test

52
Q

What are the 4 stages of syphillis infection

A

Primary lesion
Secondary stage
Latent stage
Late stage syphillis

53
Q

What is the primary lesion of syphillis

A

Chancre

Organism multiplies at the inoculation sites

54
Q

Chance is painful TRUE/FALSE

A

TRUE

Painless, non-tender lymphadenopathy

55
Q

What is the secondary stage of syhpillis?

A

Large numbers of bacteria circulating in blood with multiple manifestations at different sites

56
Q

What is the most highly infectious lesion in syphillis?

A

Condylomata Lata

57
Q

What is late stage syphillis?

A

Cardiovascular or neurovsacular complications many years later

58
Q

What is the screening test for syphillis?

A

Combined IgG and IgM ELISA

59
Q

IgM ELISA is a marker of….

A

Recurrent, untreated infection (of syphillis)

60
Q

TPPA and VDRL are marker are…

A

Untreated active infection (of syphillis)

61
Q

What are the specific serology used in Syphillis?

A

Combined IgG and IgM ELISA

TPPA

62
Q

TRUE/FALSE TPPA remains positive for life

A

TRUE, therefore not useful for monitoring

63
Q

What are the non specific serology used in syphillis?

A

VDRL

RPR

64
Q

What is non-specific serology good/bad for

A

Useful for mentoring response to therapy (usually decline and can become negative after successful treatment)
Indicate tissue inflammation, may be false positive

65
Q

Treatment of syphillis

A

Penecillin

66
Q

Which two serology stay positive for life in syphillis?

A

IgG

TPPA

67
Q

Which serology becomes negative after treatment?

A

IgM

VDRL

68
Q

If syphillis but penicillin allergic what do you do

A

Penecillin desensitisation

69
Q

Penecillin has a very —- rate of replication

A

slow

70
Q

What is the cause of Genital Herpes?

A

HSV

71
Q

What are the two types of HSV that can cause genital herpes?

A

HSV type 1 (also cause cold sores)

HSV type 2 (more common)

72
Q

Presentation of genital herpes

A 
Blistering/ulcerating pain
Extreme dysuria
Discharge
Lymphadenopathy 
Fever
73
Q

In genital herpes there can be exquisitely painful multiple small vesicles. What specifically causes this?

A

Inflammation at nerve endings

74
Q

TRUE/FALSE

HSV2 viral shedding more than HSV1

A

TRUE

75
Q

What is the best test for HSV carriage between recurrences?

A

There is no good test. PSYCH

76
Q

Treatment of genital herpes

A

aciclovir + lignocaine

77
Q

What is the Ddx you need to consider when there is a vanishing and recurring rash

A

Most likely HSV

Shingles (rare)

78
Q

Are recurrent episodes more common with HSV-1 or HSV-2

A

HSV-2

79
Q

What causes genital warts?

A

HPV

80
Q

What is the most common viral STI in the UK?

A

HPV

81
Q

What types of HPV are the most common causes of anogenital warts

A

HPV6 and HPV11

82
Q

TRUE/FALSE Subclinic disease is common in genital warts

A

TRUE ( likely to have acquired HPOV from an asymptomatic partner)

83
Q

What is the incubation period of genital warts?

A

3wks-9months

84
Q

Who is able to get the HPV vaccination?

A

Girls 11-13years

MSM <45

85
Q

Treatment for genital warts

A

Podophyllotoxin (Warticon)
Imiquimod
Cryotherapy
Electrocautery

86
Q

Presentation of trichomonas vaginalis

A

Yellowish/green vaginal discharge frothy
Itching
Soreness
(IN FEMALES)

87
Q

Diagnosis for trichomonas vaginalis

A

HVS for microscopy

88
Q

Treatment of trichomonas vaginalis

A

Oral metronidazole

89
Q

How are pubic lice acquired?

A

Close genital skin contact

90
Q

What actually causes the itching with pubic lice?

A

Lice bites skin and feed on skin which causes itching in pubic area

91
Q

Treatment for pubic lice

A

Malathion lotion

ADELE-Repro Ramblings (21 decks)

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