403. Malaria, Fever in travellers and STI's Flashcards
In patients with suspected STI’s what areas should be examined?
Retract foreskin, inspect urethral meatus, scortum (standing up)
Vulval examiantion, speculum, bimanual, abdo/pelvis
Genitoanal area, protoscopy, inguinal lymph nodes, oral mucosa
Discuss the various types of syphillis?
Primary- <90d post infection, painless ulcers (chancre). Highly infectious
Secondary- 4-10 weeks, rash, mucou spatches, fever, headache, myalgia
Tertiary- 20-40yrs later, neurosyphillis- aseptic meningitis, focal neurology, argyll orbertson pupil.
Discuss the presentation of lymphogranuloma venerum
MSM
Painless papule/ulcer. Lymphadenopathy, fever, arthritis, pneumonitits.
What two tropical diseases can cause genital ulceration and lymphadenitis?
Chancroid and Donovanosis
Describe the various presnetations of vaginal discharge?
Candidiasis- cottage cheese and itch
Vaginosis- white fishy smelling vaginal discharge
Vagnialis- discharge and itch
Gonorrheoa- discharge, dysuria
Chlamydia- inter-menstrual beleding, dysuria, discharge
How is chlaymdia treated?
Azithromycin or dox 7 days
How is gonorrheoa treated?
Ceftriaxone and azithromycin
If complicated add dox and met
How is uretheritis treated?
azithromycin or dox 7 days
How is vaginalis treated?
Metrinidazole
How is vaginosis treated?
Oral or pV ,metronidazole
or clindamycin
How is candidiasis treated?
-azoles e.g. cloitrmazole cream
Oral fluconazole if severe
What are the key points for fever in the returning traveller?
Exclude malaria from all tropical travellers
Exclude HIV in all
Many will just have self limiting illnss from the UK
What diseases are common in sub saharan africa?
Malaria
HIV
Rickettsiae
What diseases are common in south east as
Malaria
Chikngunya
Dengue
Enteric fever
Name the common diseases of south and central asia as well as south america and the carribean?
Malaria
Dengue
Enteric Fever
