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3RD YEAR SYSTEMS: Repro > STIs > Flashcards

STIs Flashcards

1
Q

What organism causes Gonorrhoea?

A

Neisseria gonorrhoeae

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2
Q

Gonorrhoea symptoms in Men and Women

A

Men

  • Majority symptomatic (90%) - 10% have no symptoms but may still have clinical signs
  • Thick, profuse yellow discharge
  • Dysuria
  • Rectal and pharyngeal infection is often asymptomatic

Women

  • >50% have no symptoms
  • Vaginal discharge
  • Dysuria
  • Intermenstrual/post-coital bleeding
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3
Q

Complications of Gonorrhoea in Men and Women

A
  • Men
    • Epididymitis
  • Women
    • Pelvic inflammatory disease, Bartholin’s abscess
  • Both (rare!)
    • Acute monoarthritis usually elbow or shoulder
    • Disseminated Gonococcal infection: skin lesions
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4
Q

What is the incubation period of Gonnorrhoea?

A
  • On average 5-6 days
  • But can be from 2 days to 2 weeks.
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5
Q

Epidemiology of Gonnorrhoea

A
  • Much less common than chlamydia
  • Most cases are in men and specically men who have sex with men
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6
Q

How is Gonnorrhoea diagnosed?

A
  • Nucleic Acid Amplification Test (NAAT) from urine sample or swab from an exposed site (vagina, rectum, throat)
  • Gram stained smear from urethra/cervix/rectum in symptomatic people.
  • Culture of swab-obtained specimen from an exposed site - should be done for all confirmed cases to assess antibiotic sensitivity.
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7
Q

Treatment for Gonorrhoea

A

Blind treatment with ceftriaxone 1g im (injection)

Can also treat according to antibiotic sensitivities (once culture has been done)

Follow up = another swab/test at 2 weeks and again at 3 months

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8
Q

What organism causes Chlamydia?

A

Chlamydia trachomatis serovars D to K

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9
Q

Chlamydia symptoms in Men and Women?

A

Men

  • >70% are asymptomatic
  • Slight watery discharge
  • Dysuria

Women

  • >80% asymptomatic
  • Vaginal discharge
  • Dysuria
  • Intermenstrual/post-coital bleeding

Both

  • Conjunctivitis
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10
Q

Complications of Chlamydia in Men and Women

A

Men

  • Epididymitis

Women

  • Pelvic inflammatory disease - ectopic pregnancy
  • Pelvic pain
  • Infertility

Both

  • Reactive arthritis / Reiter’s syndrome - urethritis/cervicitis + conjunctivitis + arthritis
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11
Q

How is Chlamydia diagnosed?

A

Females - swab from cervix or urethra or rectum - Nucleic Acid Amplification Test (commonly use PCR technique)

Males - First void urine in men or rectal swab - NAAT

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12
Q

Treatment and follow up for Chlamydia

A
  • Doxycycline 100mg twice a day
  • Azithromycin if pregnant

Test for reinfection at 3-12 months

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13
Q

What organisms cause Herpes?

A

Herpes simplex 1 + 2

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14
Q

Symptoms of Herpes

A

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
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15
Q

Complications of herpes virus

A
  • Autonomic neuropathy (urinary retention)
  • Neonatal infection - TORCH
  • Secondary infection
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16
Q

What is the incubation period for herpes?

A
  • About 5 days to months
  • Some people never report symptoms
17
Q

Epidemiology of herpes

A
  • Very common - 15 to 20% of the UK population has it
  • Both strains equally common and roughly equal between sexes
18
Q

How is herpes diagnosed?

A
  • Clinical impression
  • Swab from lesion tested using PCR
19
Q

Treatment of herpes

A
  • Primary outbreak
    • Aciclovir (5 days)
    • Lidocaine ointment
  • Infrequent recurrences
    • Lidocaine ointment
    • Aciclovir - once daily until symptoms are gone (1-3 days)
  • Frequent recurrences
    • Aciclovir - long term as suppression
20
Q

Trichomiasis:

  • Causative organism
  • Symptoms
  • Epidemiology
  • Complications
  • Diagnosis
  • Treatment
A
  • Causative organism - Trichomonas vaginalis
  • Symptoms:
    • Men
      • Usually asymptomatic
    • Women
      • 10-30% asymptomatic
      • Profuse thin vaginal discharge - greenish, frothy and foul smelling
      • Vulvitis
  • Epidemiology
    • Uncommon, more common in middle aged women than other STIs
  • Complications
    • Miscarriage and preterm labour
  • Diagnosis
    • PCR on vaginal swab
    • No test for men as not validated on urine yet
  • Treatment
    • Metronidazole for 5 days or single dose available
21
Q

What organism causes anogenital warts?

A

Human Papilloma virus types 6 and 11

22
Q

Epidemiology of genital warts

A

>90% of UK population have a genital HPV infection at some point in their life

Only about 20% of those infected with a wart-causing strain of human papilloma virus get warts.

23
Q

Treatment of anogenital warts

A
  • Podophyllotoxin or imiquimod - both are home treatments.
  • Others – cryotherapy (freezing)
  • Bulky warts – diathermy, scissor removal.
24
Q

What organism causes syphillus?

A

Treponema pallidum

25
Q

Symptoms/stages of syphillis

A

Often entirely asymptomatic or mild symptoms which go unreported

  • Primary - local ulcer
  • Secondary - rash, mucosal ulceration
  • Early latent - no symptoms
  • Late latent
  • Tertiary - neurological, CV or gummatous skin lesions
26
Q

Diagnosis of syphillis

A
  • Clinical signs
  • Serology for TP IgGEIA, TPPA and RPR tests
  • PCR on sample from an ulcer
27
Q

Treatment of syphillis

A

Early (2 years) and no neurological involvement

  • Benzathine penicillin im once
  • Doxycycline 2x daily oral 2 weeks

Late >2 years and no neurological involvement

  • Benzathine penicillin im weekly for 3 doses
  • Doxycycline 2x daily oral 28 days

3RD YEAR SYSTEMS: Repro (34 decks)

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