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4: Y4 - Gynaecology [8] > [2] Trichomoniasis > Flashcards

[2] Trichomoniasis Flashcards

1
Q

What is trichomoniasis?

A

A curable sexually transmitted infection caused by the protozoan trichomonas vaginalis (TV)

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2
Q

How common is trichomoniasis?

A

The most common curable STI worldwide

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3
Q

What is happening to the incidence and prevalence of trichomoniasis?

A

Decreasing

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4
Q

How does the incidence of trichomoniasis in the UK compare to worldwide statistics?

A

Less common - 7000 cases in 2016

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5
Q

What age group is trichomoniasis most common in?

A

Under 25s

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6
Q

Which ethnic group is trichomoniasis most common in?

A

Black

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7
Q

How is trichomonas vaginalis transmitted?

A
  • Vaginal sexual intercourse

- Rarely vertical transmission at delivery

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8
Q

Is trichomonas vaginalis spread through oral or anal sex?

A

No

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9
Q

What type of organism is trichomonas vaginalis?

A

Anaerobic flagellated protozoan

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10
Q

Does trichomonas vaginalis affect males or females?

A

Both

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11
Q

Where can trichomonas vaginalis infect in women?

A
  • Urethra
  • Vagina
  • Paraurethral glands
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12
Q

Where can trichomonas vaginalis affect in men?

A
  • Urethra

- Underneath foreskin

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13
Q

What site is most commonly affected by trichomonas vaginalis?

A

Urethra

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14
Q

How many sites are often affected by trichomonas vaginalis?

A

More than one

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15
Q

How does trichomonas vaginalis affect the site it colonises?

A

Replicates via binary fission whilst destroying epithelial cells through direct cell contact and by the release of cytotoxins

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16
Q

How can trichomonas vaginalis affect the immune system?

A

Binds to host plasma proteins preventing recognition by complement pathway

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17
Q

What can trichomonas vaginalis infection increase the risk of contracting?

A

HIV

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18
Q

What are the risk factors for trichomoniasis?

A
  • Multiple sexual partners
  • Unprotected sexual intercourse
  • History of other STIs
  • Older women
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19
Q

What proportion of trichomoniasis cases are symptomatic?

A

Many

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20
Q

In which gender is asymptomatic trichomoniasis more common?

A

Men

21
Q

How do most men with trichomoniasis present?

A

As a partner of a symptomatic infected woman

22
Q

When do symptoms of trichomoniasis develop after infection?

A

Within 28 days

23
Q

What are the symptoms of trichomoniasis in women?

A
  • Offensive vaginal discharge
  • Abnormal vaginal discharge
  • Itchiness or soreness of the vulva
  • Dyspareunia
  • Dysuria
24
Q

What is the appearance of the discharge in trichomoniasis?

A

Can be thick or thin and frothy yellow-green colour

25
Q

What are the symptoms of trichomoniasis in men?

A
  • Urethral discharge
  • Dysuria
  • Urinary frequency
  • Pain or itching around foreskin
26
Q

What are the signs of trichomoniasis in women?

A
  • Abnormal vaginal discharge
  • Vulvitis
  • Vaginitis
  • Strawberry cervix
27
Q

What is a strawberry cervix?

A

Punctate and papilliform appearance

28
Q

What are the signs of trichomoniasis in men?

A
  • Urethral discharge

- Balanoposthitis

29
Q

What is balanoposthitis?

A

Inflammation of the glans penis

30
Q

How common is balanoposphitis?

A

Rare

31
Q

What are the differentials for trichomoniasis?

A
  • Other vaginal infections
  • Other causes of vaginal discharge
  • Atrophic vaginitis
  • Post-surgery discharge
  • Other causes of prostatitis, cervicitis and cystitis
32
Q

What are some other vaginal infections?

A
  • Candidiasis
  • BV
  • Chlamydia
  • Gonorrhoea
33
Q

What are some benign causes of vaginal discharge?

A
  • Physiological
  • Chemical irritants
  • Pregnancy
34
Q

What steps are important to attempt to diagnose trichomoniasis before investigations?

A
  • History

- Examination

35
Q

How is trichomoniasis investigated?

A

Culture and sensitivity testing

36
Q

How are sample obtained for trichomoniasis culture testing in women?

A
  • High vaginal swab from posterior fornix

- OR self administered vaginal swab

37
Q

How are samples obtained for trichomoniasis culture testing in men?

A
  • Urethral swab

- First void urine sample

38
Q

What is required if a patient tests positive for trichomoniasis?

A
  • Contact tracing

- Full STI screen

39
Q

What type of medication is used to treat trichomoniasis?

A

Anti-protozoan

40
Q

What is the drug of choice for trichomoniasis in men and non-pregnant/breast-feeding women?

A

Metronidazole

41
Q

What are the treatment regimes for trichomoniasis with metronidazole?

A
  • 2g orally as single dose

- OR 400-500mg BD for 5-7 days

42
Q

What is an alternative single dose medication for trichomoniasis?

A

2g tinidazole

43
Q

Which contacts should be tested for trichomoniasis?

A

Any current or previous sexual partners in the preceding 4 weeks

44
Q

For how long should patients with trichomoniasis abstain from sex?

A
  • Whilst being treated

- OR 1 week after single dose

45
Q

When is a test of cure required for trichomoniasis?

A
  • Patient is not responding to treatment

- Re-infected

46
Q

What is the risk of trichomoniasis in pregnancy?

A
  • Pre-term labour
  • Low birth weight
  • Maternal post-partum sepsis
47
Q

How is trichomoniasis treated differently in pregnancy?

A

Avoid high (single) dose metronidazole

48
Q

How is trichomoniasis treated when breast feeding?

A
  • Avoid single dose

- OR avoid breast feeding for 12-24 hours after single dose

4: Y4 - Gynaecology [8] (52 decks)

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