23. STDs Flashcards
What pathogen causes syphilis?
Treponema pallidum
How long is the incubation period of syphilis?
3-90 days
What are symptoms of primary syphilis?
single painless chancre at sight of innoculation
How long after the primary infection is the secondary syphilis infection?
2-12 weeks
What are the signs and symptoms of a secondary syphilis infection?
Rash on palms and soles
Fever, sore throat, malaise
CNS
Condyloma lata
What are the symptoms of tertiary syphilis?
Aortitis
Neurosyphilis: meningitis, spinal cord lesions
Gummas (granulomatous)
What are the symptoms of early congenital syphilis?
Baby under 2
Hepatomegaly, lymphadenopathy
Rhinitis, rash
Skeletal abnormalities
What are the symptoms of late congenital syphilis?
Baby older than 2
Facial features, Hutchinson teeth
Intellectual disability
How is syphilis diagnosed?
Dark field microscopy of chancre
Serology: specific and qualitative vs non-specific quantitative
CSF serology if neurosyphilis
What is the treatment for syphilis?
Penicillin G
What is the treatment for syphilis if the patient has a penicillin allergy?
Doxycycline
How long is the treatment for early, late and neurosyphilis?
Early: 1 dose IM
Late: 3 weeks 1 dose IM
Neuro: 10-14 IV
What adverse reaction occurs when treating syphilis?
Jarisch Herxheimer reaction
Release of spirochaete antigens once the treatment begins causes an immune response
What agar is used to culture neisseria gonorrhoea?
NYC
What are the clinical features of gonorrhoea?
Majority asymptomatic
Men: urethritis and epididymitis
Women: cervicitis, PID
What can gonorrhoea cause in infants?
Ophthalmia neonatorum
How is gonorrhoea diagnosed?
Microscopy and culture: urethral swab, conjunctival swab
NAAT: first void urine, endocervical/vulvovaginal swab
What is the treatment for neisseria gonorrhoea?
IM ceftriaxone
What are the symptoms of chlamydia D-K in women?
Cervicitis
Urethritis
PID and pregnancy complications
What are the symptoms of chlamydia D-K in men?
Urethritis
Acute epididymitis
Proctitis
How is chlamydia diagnosed?
NAAT on swabs
aspirate buboes in L serovars
What is the treatment for chlamydia D-K?
Macrolide or doxycylcine
What are the stages of a lymphogranulomatous venerum infection?
Primary: ulcer
Secondary: inguinal lymphadenopathy, proctitis
Late: fibrosis
What is the treatment for lymphogranuloma venerum?
Doxycycline for 3 weeks
What kind of pathogen is trichomonas vaginalis?
Protozoa
What is the clinical significance of trichomonas vaginalis?
Women: vaginal discharge, itchy vulva, dysuria, prem rupture of membranes and low birth weight
Men mostly asymptomatic
What is the treatment for trichomonas vaginalis?
Metronidazole
What pathogen causes chancroid?
Haemophilus ducrej
What are the features of chancroid?
Ulcer and tender inguinal lymphadenopathy
What is the management of chancroid?
Aspirate
Azithro, ceft and cipro
Where does latent herpes reside?
Sacral nerve ganglia
What management can reduce the incidence of neonatal herpes simplex?
Suppressive therapy in third trimester
C-section
Which HPV viruses cause genital warts?
6 and 11
What treatments can be used to remove genital warts?
Chemical/physical destruction with trichloroacetic acid
Immunological therapy with imiquimod
Surgical excision/cryotherapy
What links are there between HIV and other STDs?
Disrupted mucosa allows HIV to enter easily
Increased HIV secretion in co-infection
