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Reproduction and Sexual Health > STIs > Flashcards

STIs Flashcards

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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
what type of bacteria is syphilis
motile spirochete acquired through sexual contact
26
what are the 4 stages of syphilis
primary syphilis secondary syphilis latent late stage
27
how does primary syphilis present
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
how and when does secondary syphilis present
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
what is the term used to describe the maculopapular rash
condylomata lata
30
how does latent syphilis present
no symptoms | not usually infectious during this time
31
how and when does late stage syphilis present
can develop several years after primary infection | CVS, CNS and gummatous involvement
32
is treponema pallidum picked up in vitro culture
no
33
what is the best test for picking up treponema pallidum
dark field microscopy
34
what test for syphilis is best for monitoring response to therapy
rapid plasma reagin
35
how is syphilis managed
IM penicillin for 10 days | late stage, extend for another week
36
what is the partner notification look back period for syphilis
primary - 90 days | secondary - 2 years
37
which type of herpes simplex virus is most common
HSV 2
38
how does primary genital herpes present
systemic - fever, myalgia, headache genital - multiple shallow ulcers which crust over after 10 days tender inguinal lymphadenopathy
39
how is HSV diagnosed
usually clinical diagnosis | HSV PCR using swab of lesion or culture of virus lesion
40
how is HSV managed
symptomatic - saltwater bathing or warm bath, aciclovir 200mg 5 times a day rest, analgesics and anti-pyretics
41
recurrent attacks of HSV are more or less severe
less severe - can be managed with simple measures
42
what strains of HPV are most likely to cause genital warts
types 6 and 11
43
how does HPV genital infection present
development of warts around fourchette, perianal region, penile shaft and vagina
44
how is HPV infection treated
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
how can HPV infection be prevented
HPV vaccine, protects against types 6, 11, 16 and 18 | given to girls and boys before they are sexually active
46
what type of organism is trichomonas vaginalis
flagellated protozoon infection
47
how does trichomonas vaginalis present in men and women
men - urethral discharge, irritation and frequency | women - offensive discharge causing local irritation ad frothing
48
what test confirms diagnosis of trichomonas vaginalis
culture
49
what antibiotic is used to treat trichomonas vaginalis
metronidazole either single dose of 2g orally or 400mg twice daily for 7 days
50
what are the risk factors for developing candida infection
pregnancy and COCP use use of broad spectrum antibiotics and corticosteroids diabetes immunosuppression - very florid infection
51
how does candidiasis present in women
pruritis of the vulva red, fissured and sore external genitalia altered vaginal discharge, curdy
52
what is the most likely organism to cause candida infection
candida albicans | more resistance types could be due to candida glabrata
53
what are the topical treatments used for candida infection
pessaries or creams containing clotrimazole (antifungal) 500mg
54
what are the oral treatments used for candida infection
fluconazole or itraconazole but only if topical therapy has failed
55
is it likely that candida infection is passed on sexually
unlikely
56
what causes bacterial vaginosis to develop
imbalance of normal bacteria, mixed flora of gardnerella, anaerboes and mycoplasma hominis
57
what is the main commensal bacteria of the vagina
lactobacilli
58
a pH of what is likely to be bacterial vaginosis
>4.5
59
how does bacterial vaginosis present
homogenous, grey/white adherent discharge that has very strong odour
60
what is the main complication of BV in pregnancy
chorioamnionitis causing increases incidence of premature rupture of membranes
61
how is BV diagnosed
fishy odour on mixing discharge with 10% potassium hydroxide microscopy
62
what cells are seen on BV microscopy
clue cells - granular appearance
63
how is bacterial vaginosis managed
metronidazole | recurrence rate is high
64
what organism causes pubic lice
Phthirus pubis
65
what is the main presenting complaint of pubic lice
itch
66
how is pubic lice treated
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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