STIs- path guide Flashcards

(49 cards)

1
Q

Which STIs cause discharge?

A
  1. chlamydia
  2. gonorrhoea
  3. TV
  4. candida
  5. BV
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2
Q

Which STIs cause ulceration?

A
  1. Syphyllis: painless
  2. HSV- painful
  3. LGV
  4. Chancroid
  5. DOnovanosis
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3
Q

Which STis cause rashes, lumps, growths?

A

Genital warts: HPV

Molluscum contagiosum

Scabies

Pubic lice

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4
Q

Description of neisseria gonorrhoeae

A

obligate intracellular gram negative diplococcus

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5
Q

WHat is the most common STI in europe?

A

Gonococcal urethrtitis

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6
Q

Uncomplicated gonococcal infection in men

A
  1. gonococcal urethritis
  2. post-gonococcal urethritis - happens following treatment. prevented by concomitant treatment with a tetracylcine
  3. rectal proctitis - mainly in MSM
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7
Q

Uncomplicated gonococcal infection in women

A

mucopurluent cervicitis

  • erythema and oedema
  • urethra (baginal leakage)
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8
Q

what type of discharge do you get in gonoccoal infection?

A

mucopurulent

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9
Q

Examples of complicated gonoccocal infection in men and women

A

Men: prostatitis

Women: PID (salpingitis) - i.e. ascending infection

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10
Q

What can gonorrhoea lead to in baby if left untreated in mother?

A

neonatal conjunctivitis

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11
Q

Diagnosis of gonorrhoea

A

*can culture but doesn’t grow very easily*

hence you do NAAT from genital swabs/urine sample

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12
Q

Treatment of gonorrhoea

A

SINGLE DOSE IM ceftriaxone

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13
Q

Description of chlamydia trachomatis

A

Obligate intracellular gram -ve pathogen

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14
Q

How do you culture chlamydia?

A

Cannot be cultured on agar

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15
Q

Symptoms of chlamydia

A

Often asymptomatic

If it does cause symptoms then these would include:

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16
Q

Classification of chalmydia

A

Classification:
o Serovars A, B, C: trachoma (infection of the eyes which can cause blindness)

o Serovars D-K: genital chlamydia, ophthalmia neonatorum

  • serovars L1, L2, l3: LGV
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17
Q

Diagnosis of chlamydia

A

Diagnosis: NAAT (nucleic acid amplification tests) from genital swabs or urine test

**can’t culture on agar**

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18
Q

Treatment of chlamydia

A

azithromycin stat (1mg) OR doxycycline 100mg 7 days (BD)

**learn the doses**

(Gynae- doxycycline first line, second line is azithromycin stat)

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19
Q

Complications of chalmydia infection

A

PID à tubal factor infertility, ectopic pregnancy, chronic pelvic pain o Epididymitis o Reiter’s syndrome o Adult conjunctivitis, ophthalmia neonatorum

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20
Q

What causes LGV?

A

Lymphatic infection with Chlamydia trachomatis: serovars L1, L2 and L3
• Endemic in parts of developing world. More recently MSM in developed world

21
Q

Sx of LGV

A

Early LGV (1° stage): 3-12 days, painless genital ulcer, proctitis, balanitis,
cervicitis

o Early LGV (2° stage): 2wks – 6 months, painful inguinal buboes, fever,
malaise
§ Rarely: hepatitis, meningo-encephalisis, pneumonitis
48
o Late LGV: inguinal lymphadenopathy, genital elephantiasis, genital and
perianal ulcers / abscesses, frozen pelvis

o Current LGV outbreak: rectal symptoms / proctitis (pain, tenesmus, bleeding)

22
Q

Treatment of LGV

A

doxycycline 100mg BD for 3wk

23
Q

What cuases syphyllis?

A

Treponema pallidum

24
Q

Description of treponema pallidum

A

Obligate gram-negative spirochaete

25
Stages of syphllis
PRIMARY: painless ulcer (chancre) SECONDARY: systemic, soles (palms and soles) TERTIARY: three diff characteristic syndromes (gummatous, cardiac, neuro) Argyl roberston pupil:accommodates but doesn't react to light
26
Microscopy findings of syphlis
treponemes seen on dark ground microscopy
27
Blood tests for syphyllis
\*\*need to do both non-treponemal and treponemal for diagnosis because non-treponemal, even tho less specific will show you if you currently have the infection, whereas trepnonemal, while more specific, will stay positive for years even after you've cleared the infection \*\*
28
29
Treatment of syphlis
30
What causes chancroid?
Haemophilus ducreyi
31
What type of organism is Haemophilus ducreyi?
. Gram -ve coccobacillus (like Hib)
32
Which agar does haemophilus ducreyi grow in?
chocolate agar
33
What type of ulcers does chancroid cause?
painful ulcers
34
What causes donovanosis?
Klebsiella granulomati
35
WHat type of bacteria is klebsiella granulomatosis?
Gram negative bacillus
36
Stain for donovanosis
Diagnosis: Giemsa stain of biopsy or tissue crush. Donovan bodies
37
What type of uclers does donovanosis cause?
Large beefy red ulcers
38
Treatment of donovanosis
Azithromycin
39
What is trichomonas vaginalis?
Flagellated protozoan i.e. not a bacterium\*\*\*\*
40
CLassic symptoms of trichomonas vaginalis
* *Men:** usually asymptomatic, sometimes urethritis * *Females:** discharge, strawberry cervix
41
Treatment of trichomonas
metronidazole
42
What is bacterial vaginosis?
Abnormal vaginal flora, polymicrobial, ↓lactobacilli. • Discharge, odour • Sexually associated, not transmitted. Associated with hygiene practices (soaps) • Diagnosis: microscopy of gram stain, **raised pH, whiff test, clue cells** • Treatment: lifestyle - just use water for washing (no soaps). Metronidazole PO/topical
43
Candidasis
Usually Candida albicans, yeast • Thick white discharge (“cottage cheese”), itching, soreness, redness • Vulvovaginitis in women, balanitis in men • Not sexually transmitted; can be part of normal flora • Associated with immunodeficiency (incl. pregnancy, DM), hygiene practices (soaps) • Treatment: PO / topical antifungals, e.g. clotrimazole or fluconazole
44
What type of virus is molluscum contagiosum?
pox virus - dsDNA
45
Description of mollsucum contagiosum
Small papules with central punctum
46
How is molluscum contagiosum spread in children vs adults?
Children: skin to skin contact Adults: sexually transmitted
47
Treatment of molluscum
usually don't need therapy can use cryptherapy if persistent/extensive
48
Which forms of HPV cause genital warts?
HPV6 and HPV 11 \*\*not associated with
49
Treatment of genital warts
Home treatment – Podophyllotoxin solution or cream. Not for pregnant women • Clinic treatment – Cryotherapy. 2nd line – Imiquimod