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MD3002 WEEK 10 - A > 10. STIs > Flashcards

10. STIs Flashcards

1
Q

Name the 4 STI syndromes?

A

Genital discharge
Genital warts
Genital ulcers
Sexually transmitted and bloodborne viruses

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2
Q

What is the main presentation of HPV?

A

Genital warts found on:

  • Shaft of penis (male)
  • Vagina, vulva, cervix (female)
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3
Q

What is the main presentation of chlamydia trachomatis?

A

Urethritis

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4
Q

What is the main presentation of candida albicans?

A

vaginal thrush

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5
Q

What is the main presentation of trichomonas vaginalis?

A

Vaginitis

Lymphogranuloma venereum

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6
Q

What is the main presentation of Herpes simplex virus?

A

Genital herpes

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7
Q

What is the main presentation of neisseria gonorrhoeae?

A

Gonorrhoea

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8
Q

What is the main presentation of HIV?

A

AIDS

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9
Q

What is the main presentation of treponema pallidum?

A

Syphilis

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10
Q

What is the main presentation of hep b?

A

Hepatitis

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11
Q

What is the main presentation of Hsemophilus ducreyi?

A

Chancroid

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12
Q

STI risk factors?

A 
Young age
Failure to use barrier contraceptives
Non-regular sexual relationships
Homosexuality
IV drug use
African origin
Social deprivation
Prostitution
Poor access to advice and treatment of STIs
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13
Q

What individual factos predispose to risky sexual behaviour?

A

Low self-esteem
Lack of skills
Lack of knowledge of the risks of unsafe sex

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14
Q

What external influences predispose to risky sexual behaviour?

A

Peer pressure
Attitude
Prejudices of society

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15
Q

Which service provisions predispose to risky sexual behaviour?

A

Accessibility of sexual health services

Lack of resources such as condoms

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16
Q

HPV, mechanism?

A

Induces hyperplastic epithelial lesions

Types exhibit tissue/cell specificity

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17
Q

Incubation period of HPV

A

1-6 months

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18
Q

which HPV types are most important?

A

Types 6, 11, 16 and 18 most important

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19
Q

What is are variety of consequences of HPV?

A

Cervical carcinoma
Urogenital warts
Laryngeal papillomas
Common, flat and plantar warts

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20
Q

Identification and treatment of HPV?

A

Seen on colposcopy after staining

Treatment:

  • Podophyllum
  • Cryo
  • Laser
  • Surgery
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21
Q

HPV vaccine, what is available?

A

Based on VLP1 (papillomavirus-like particle) a major capsid protein
Two killed vaccines available:
1. Cervarix
2. Gardasil

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22
Q

What is the current administration plan for HPV?

A

To girls 12-13yrs before they are sexually active

Protection against most cases of cervical cancer.

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23
Q

Characteristics of chlamydia trachomatis?

A

Obligate
Intracellular
Gram neg

24
Q

What do the following serotypes of chlamydia cause:
A,B, C?
D-K?
L1, L2, L3?

A

A,B, C: Trachoma
D-K: Genital infection
L1, L2, L3: Lymphogranuloma venereum, cancer

Although often asymptomatic infection

25
Q

Female chlamydia symptoms?

A 
Vaginal/anal discharge
Post-coital bleeding
Abdominal tenderness
Pelvic tenderness 
Infertility 
Reiter's syndrome (Arthritis, cervicitis, conjunctivitis)
Proctitis (anus and rectum inflammation)
Pharyngitis 
Perihepatitis: Upper abdominal pain
26
Q

Male chlamydia symptoms?

A 
Urethral/anal discharge
Epididymal tenderness
Prostatitis 
Reiter's syndrome (Arthritis, cervicitis, conjunctivitis)
Proctitis (anus and rectum inflammation)
Pharyngitis 
Perihepatitis: Upper abdominal pain
27
Q

What is a NAAT test?

A

A nucleic acid test (NAT) or nucleic acid amplification test (NAAT) is a molecular technique used to detect a particular pathogen (virus or bacterium) in a specimen of blood or other tissue or body fluid.

28
Q

What are the investigations available for chlamydia?

A

Urine- NAATs

Endocervical swab- Cell culture

29
Q

Treatment of chlamydia?

A

Azithromycin resistance increasing

Tetracycline (doxycycline)

30
Q

Candida albicans:

  • Presentation?
  • Diagnosis?
  • Treatment?
A

Presents as intensely itchy vaginitis.
Diagnosed by microscopy and cell culture. Dismiss presentation as UTI.
Treatment: Oral fluconozole plus topical nystatin

31
Q

What is trichomonas vaginalis?

A

Anaerobic, single cell, flagellated protozoa

32
Q

MoA of trichmonas vaginalis?

A

Attaches to squamous epithelium and infects vagina and urethra.
Incubation: 4d-3wks
–> Trichomoniasis

33
Q

Presentation of trichomonas vaginalis infection?

A

Yellowish vaginal discharge

Which is dianosed by dark-phase microscopy

34
Q

Treatment of trichomonas vaginalis infection?

A

Metronidazole

35
Q

What is the difference between HSV1 and HSV2?

A

Herpes simplex virus
HSV type 1: Usually affects the oral region and causes cold sores
HSV type 2: Associated with genital infection (penis, anus, vagina)

However, both can infect the mouth and/or genitals due to oral sex or autoinoculation

36
Q

Transmission of genital herpes?

A

By sexual contact or during birth (30-40% risk)

Neonatal infection may result in desseminated infection often involving CNS

37
Q

Presentation of genital herpes during the primary infection?

A

Febrile flu-like prodome (5-7 days)
Tingling neuropathic pain in genital areas/ buttocks/legs
Extensive BILATERAL crops of PAINFUL blisters/ulcers in the genital area (inc cervix and vagina)
Tender inguinal lymph nodes
Local oedema
Dysuria
Vaginal or urethral discharge

38
Q

Treatment of genital herpes primary infection

A

Aciclovir

39
Q

What is the process of genital herpes recurrence?

A

After primary infection, the virus becomes dormant in local sensory ganglia
Periodic reactivation can cause:
-Symptomatic lesions
-Asymptomatic viral shedding (still infectious)

HSV-2 has more frequent reactivation

40
Q

Diagnosis of HSV?

A
  1. Clinical appearance
  2. Viral culture
  3. DNA detection using NAAT of swab from the base of ulcer / vesicle fluid.
  4. Serology occasionally to identify those with asymptomatic infection and to distinguish between HSV1 and HSV2
41
Q

Features of neisseria gonorrhoeae infective agent?

A

Gram negative
Intracellular diplooccus
Human only host
Infects epithelial cells of mucous membrane of GU tract or rectum.
Develops localised infection with pus production

42
Q

Describe the consequences of gonorrhoea?

A

Male patients: Acute inflammation and discharge
Female patients: Cervical discharge
Male homosexuals: Rectal infectons
Oral pharyngitis contracted by oral-genital contact
Disseminated infection –> Septic arthritis

43
Q

Female presentation/symptoms of gonorrhoea?

A 
Dysuria
Rectal infection= Asymptomatic 
Salpingitis (fallopian tube inflammation), PID
Pharyngeal infection
Post-coital bleeding
Septic arthritis
44
Q

Male presentation/symptoms of gonorrhoea?

A 
Urethral discharge
Anal discharge, pain and bleeding
Epididymal tenderness
Pharyngeal infection
Septic arthritis
45
Q

Babies presentation/symptoms of gonorrhoea?

A

Ophthalmia neonatorum- Blindness

46
Q

What is ophthalmia neonatorum?

How do babies get it?

A

Conjunctivitis contracted by newborns during delivery
Mothers infected with N. gonnorrhoeae or C. trachomatis
Without treatment can cause blindness.

47
Q

Lab diagnosis of gonorrhoea?

A

Light microscopy of gram-stained genital specimens to look for gram negative diplococci
NAAT- Can use urine or swabs
PMN in urethral pus

48
Q

Treatment of gonorrhoea?

A

For confirmed, uncomplicated infection in adults… give single dose of one of the following:

  • Cleftriaxone 250mg IM
  • Cefizime 400mg oral
  • Ciprofloxacin 500mg oral (if beta-lactam allergy)
49
Q

Infection of preponema pallidum leads to..

A

Syphillus

50
Q

What are the three stages of syphilis?

A

PRIMARY: Hard genital or oral ulcer (chancre) at the site of infection after 3 weeks
-Can be asymptomatic for up to 24 weeks

SECONDARY: Red maculopapular rash anywhere plus pale moist papules in urogential region and mouth (condylomas)

TERTIARY: Degeneration of nervous system, aneurysms and granulomatous lesions in liver, skin and bones (gummas) in about 40% of patients

51
Q

How is syphilis transferred congenitally?

A

Placental transfer after 10-15 weeks of pregnancy
Infection can cause death or spontaneous abortion of foetus
Survivors develop secondary syphilis symptoms

52
Q

Syphilis diagnosis?

A

From lesions or infected lymph nodes in early symphilis
Dark field microscopy
Direct fluorescent antibody (DFA) test
NAAT
EIA- Can be for ImM for early infection of IgG for week 5+

53
Q

Major side effect of haemophilus ducreyi?

A

Chancroid (venereal infection causing ulceration of groin lymph nodes)
Cause by gram negative bacterium
Characterised by painful genital ulcers

54
Q

Diagnosis and treatment of chancroid?

A

Diagnosed by microscopy/culture

Treatment: Macrolide (e..g erythromycin or ceftriaxone)

55
Q

How to reduce risk of STI?

A

Less sexual partners

Use condoms

MD3002 WEEK 10 - A (10 decks)

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