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Reproduction and Sexual Health > STIs > Flashcards

STIs Flashcards

1
Q

what microorganism causes chlamydia

A

chlamydia trachomatis

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2
Q

outline the 3 main serovars that cause chlamydia

A

A-C causing trachoma (eye infection)
D-K causing genital infection
L1-L3 causing lymphogranuloma venereum

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3
Q

how does chlamydia present in men and women

A

men - asymptomatic or urethritis with dysuria and discharge

women - majority are symptomatic, post-coital or interenstrual bleeding, discharge, lower abdominal pain

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4
Q

if untreated what are the complications of STIs in men and women

A

men - proctitis and epididymitis

women - salpingitis, infertility and pelvic inflammatory disease

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5
Q

what type of bacterium is chlamydia

A

obligate intracellular bacterium

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6
Q

what is the best test for diagnosing chlamydia

A

NAAT - nucleic acid amplification test

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7
Q

how are specimens obtained from men and women for NAAT

A

women - vulvovaginal swab
men - first catch urine
men who have sex with men can have rectal swab if anoreceptive sex

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8
Q

the incubation period for chlamydia is 3-21 days, how many days after exposure should a chlamydia test be taken for a correct result

A

14 days

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9
Q

list some advantages and disadvantages of NAAT

A

less invasive specimens required
more sensitive than culture
can detect dead organisms, must wait 5 weeks for test of cure

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10
Q

what is the first line treatment for chlamydia

A

100mg doxycycline BDS for 7 days

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11
Q

what is the second line treatment for chlamydia

A

1g azithromycin for one day then 500mg daily afterwards

azithromycin is first line for pregnant women

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12
Q

outline some complications of chlamydia

A

transmission to neonate
reactive arthritis
Fitzhugh-Curtis syndrome
pelvic inflammatory disease

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13
Q

outline the features of reactive arthritis

A

anterior uveitis
urethritis
arthritis of knees, hands

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14
Q

outline the features of Fitzhugh-Curtis syndrome

A

liver capsule inflammation with perihepatic adhesions

improves on management of chlamydia

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15
Q

what is the partner notification period for chlamydia

A

if male urethral sex - 4 weeks

any other infection is 6 months

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16
Q

what organism causes gonorrhoea

A

neisseria gonorrhoea

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17
Q

what type of bacteria is gonorrhoea

A

gram -ve intracellular diplococcus

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18
Q

what are the symptoms of gonorrhoea

A

asymptomatic
urethritis, dysuria, mucopurulent discharge
pelvic pain, post-coital or intermestrual bleeding

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19
Q

how is gonorrhoea managed

A

IM ceftriaxone 1g stat

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20
Q

what is the partner notification period for gonorrhoea

A

male urethral - 2 weeks

any other infection - 3 months

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21
Q

where is lymphogranuloma venereum endemic

A

tropics, africa, south east asia

higher in men with HIV and hep C co-infection

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22
Q

how does lymphogranuloma venereum present

A

painless ulcerating papule on genitalia several weeks after infection
later the ulcer heals and regional lymphadenopathy develops
acute proctitis and perirectal abscess

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23
Q

outline the management of lymphogranuloma venereum

A

exclude syphilis and viral infections
doxycycline 100mg twice daily for 21 days
follow up until symptoms have resolved

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24
Q

what organism causes syphilis

A

treponema pallidum

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25
Q

what type of bacteria is syphilis

A

motile spirochete acquired through sexual contact

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26
Q

what are the 4 stages of syphilis

A

primary syphilis
secondary syphilis
latent
late stage

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27
Q

how does primary syphilis present

A

10-90 days after exposure
papule develops into painless, firm chancre at the site of exposure eg penis, endocervix or rectum
painless lymphadenopathy is association

28
Q

how and when does secondary syphilis present

A

4-10 weeks after primary lesion
fever, malaise, arthralgia, sore throat
maculopapular non-itchy rash on palms and soles
snail track ulcers in oropharynx and genitalia

29
Q

what is the term used to describe the maculopapular rash

A

condylomata lata

30
Q

how does latent syphilis present

A

no symptoms

not usually infectious during this time

31
Q

how and when does late stage syphilis present

A

can develop several years after primary infection

CVS, CNS and gummatous involvement

32
Q

is treponema pallidum picked up in vitro culture

A

no

33
Q

what is the best test for picking up treponema pallidum

A

dark field microscopy

34
Q

what test for syphilis is best for monitoring response to therapy

A

rapid plasma reagin

35
Q

how is syphilis managed

A

IM penicillin for 10 days

late stage, extend for another week

36
Q

what is the partner notification look back period for syphilis

A

primary - 90 days

secondary - 2 years

37
Q

which type of herpes simplex virus is most common

A

HSV 2

38
Q

how does primary genital herpes present

A

systemic - fever, myalgia, headache
genital - multiple shallow ulcers which crust over after 10 days
tender inguinal lymphadenopathy

39
Q

how is HSV diagnosed

A

usually clinical diagnosis

HSV PCR using swab of lesion or culture of virus lesion

40
Q

how is HSV managed

A

symptomatic - saltwater bathing or warm bath, aciclovir 200mg 5 times a day
rest, analgesics and anti-pyretics

41
Q

recurrent attacks of HSV are more or less severe

A

less severe - can be managed with simple measures

42
Q

what strains of HPV are most likely to cause genital warts

A

types 6 and 11

43
Q

how does HPV genital infection present

A

development of warts around fourchette, perianal region, penile shaft and vagina

44
Q

how is HPV infection treated

A

local agents - podophyllin extract and trichloracetic acid for non-keratinising lesions
physical therapies such as cryotherapy, laser ablation and electrocautery are best for keratinising lesions
imiquimod also

45
Q

how can HPV infection be prevented

A

HPV vaccine, protects against types 6, 11, 16 and 18

given to girls and boys before they are sexually active

46
Q

what type of organism is trichomonas vaginalis

A

flagellated protozoon infection

47
Q

how does trichomonas vaginalis present in men and women

A

men - urethral discharge, irritation and frequency

women - offensive discharge causing local irritation ad frothing

48
Q

what test confirms diagnosis of trichomonas vaginalis

A

culture

49
Q

what antibiotic is used to treat trichomonas vaginalis

A

metronidazole either single dose of 2g orally or 400mg twice daily for 7 days

50
Q

what are the risk factors for developing candida infection

A

pregnancy and COCP use
use of broad spectrum antibiotics and corticosteroids
diabetes
immunosuppression - very florid infection

51
Q

how does candidiasis present in women

A

pruritis of the vulva
red, fissured and sore external genitalia
altered vaginal discharge, curdy

52
Q

what is the most likely organism to cause candida infection

A

candida albicans

more resistance types could be due to candida glabrata

53
Q

what are the topical treatments used for candida infection

A

pessaries or creams containing clotrimazole (antifungal) 500mg

54
Q

what are the oral treatments used for candida infection

A

fluconazole or itraconazole but only if topical therapy has failed

55
Q

is it likely that candida infection is passed on sexually

A

unlikely

56
Q

what causes bacterial vaginosis to develop

A

imbalance of normal bacteria, mixed flora of gardnerella, anaerboes and mycoplasma hominis

57
Q

what is the main commensal bacteria of the vagina

A

lactobacilli

58
Q

a pH of what is likely to be bacterial vaginosis

A

> 4.5

59
Q

how does bacterial vaginosis present

A

homogenous, grey/white adherent discharge that has very strong odour

60
Q

what is the main complication of BV in pregnancy

A

chorioamnionitis causing increases incidence of premature rupture of membranes

61
Q

how is BV diagnosed

A

fishy odour on mixing discharge with 10% potassium hydroxide
microscopy

62
Q

what cells are seen on BV microscopy

A

clue cells - granular appearance

63
Q

how is bacterial vaginosis managed

A

metronidazole

recurrence rate is high

64
Q

what organism causes pubic lice

A

Phthirus pubis

65
Q

what is the main presenting complaint of pubic lice

A

itch

66
Q

how is pubic lice treated

A

0.5% malathion lotion
1% permethrin
apply to whole body and wash off after 12 hours

Reproduction and Sexual Health (22 decks)

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