50 HIV and STDs Flashcards
Differentiate between an STI, STD and GID:
STI: infection transmitted by sexual contact.
STD: STI + symptoms.
GTD: not all acquired via sexual contact.
Which bacteria commonly cause STIs? (6).
Neisseria gonorrhoea. Chlamydia trachomatis. Ureaplasma. Mycoplasma. Gardnerella vaginalis. Anaerobes.
Which virus’ commonly cause STIs? (3).
Herpes simplex virus (HSV).
Human papilloma virus (HPV).
Pox virus.
Which protozoa commonly causes STIs?
Trichomonas vaginalis.
Which fungus commonly causes STIs?
Candida albicans.
Which ectoparasites commonly cause STIs? (2).
Pthirus pubis (crabs). Sarcoptes scabiei.
What is the most common STI in England?
Chlamydia.
Which organism causes gonorrhoea?
Neisseria gonorrhoea.
Which characteristic of Neisseria gonorrhoea makes it more likely to infect columnar/cuboidal epithelium?
Pilli on cell surface increases ability to attach to mucosal epithelia.
What are the symptoms of gonorrhoea?
60% are asymptomatic.
Urethral discharge, dysuria.
What are the local complications of gonorrhoea? (6).
Epididymitis. Prostatitis. Barthonilitis (Bartholin's gland) Salpingitis (fallopian tubes) Peritonitis. Fitz-Hugh-Curtis syndrome.
What are the systemic complications of gonorrhoea? (4).
Disseminated Gonococcal Infection.
Bacteraemia, arthritis, dermatitis, meningitis.
What can gonorrhoea cause in pregnancy and neonates?
Preg: spontaneous abortion, premature labour.
Neo: ophthalmia neonatorum (purulent conjunctivitis that may cause blindness).
What is the recommended treatment of gonorrhoea?
Ceftriaxone and azithromycin.
Which antibiotics in gonorrhoea commonly resistant to? (3).
Tetracycline.
Penicillin.
Ciprofloxacin.
Which organisms cause non-gonococcal urethritis? (2)
Chlamydia trachomatis.
Ureaplasma urealyticum.
How is non-gonococcal urethritis treated?
Doxycycline, + azithro/erythromycin.
What is the lifecycle of chlamydia trachomatis?
Extracellular infectious form: Elementary body.
Intracellular replicative form: Reticulate body.
Which tissues does chlamydia trachomatis target? (5).
Endocervix/upper genital tract (f)
Conjunctiva, urethra, rectum (m+f)
Infant respiratory tract (infants)
Describe the national chlamydia screening program:
All sexually active under 25’s yearly or on change of partner.
Opportunistically.
If +ve, 3 months post Rx.
What are the clinical features of chlamydia? (5).
Women > men asymptomatic.
Urethritis and mucopurulent cervicitis.
Dysuria.
Cause of sterile pyuria.
What are the complications of chlamydia infection? (5)
Pelvic inflammatory disease.
Tubal infertility.
Neonatal conjunctivitis/pneumonia.
Reiter’s syndrome.
What is Reiter’s syndrome? (4).
Arthritis.
Conjunctivitis.
Urethritis.
Skin lesions.
How is chlamydia treated?
Azithromycin or doxycycline.
How is chlamydia treated in neonates?
Erythromycin.
Which infections cause pelvic inflammatory disease?
Neisseria gonorrhoea.
Chlamydia trachomatis.
What commonly causes genital warts?
Human papilloma virus.
Types 6 + 11.
How are genital warts treated?
Burn: podphyllin, salicylic/ tirchloracetic acid.
Freeze: liquid nitrogen.
Cut.
Imiquimod.
Which type of genital herpes is more common in women than men?
HSV 2.
What are the features of primary genital herpes infection? (5).
Pain, itching, dysuria, vaginal/urethral discharge.
Bilateral ulcers.
Where does genital herpes lie dormant?
How is it reactivated? (3).
Sensory neuron cels - sacral nerve ganglia.
Trauma, menstruation, stress.
What is the treatment for genital herpes?
Aciclovir.
What are the complications of genital herpes? (4).
Meningitis.
Encephalitis.
Sacral nerve parasthesiae.
Urinary retention.
What is syphilis caused by?
Treponema pallidum.
Why is syphilis hard to detect?
Too small for light microscopy.
Can’t be cultured in vitro.
What is the characteristic histology of syphilis?
Obliterative endartertitis.
Concentric endothelial/fibroblast proliferation.
What is the incubation period of syphilis?
21 days.
What is the 1o phase of syphilis?
Chancre: painless indurated lesion.
Heals spontaneously in 3-6 weeks.
What is the 2o phase of syphilis? (5).
2-8 wks post chancre onset. Maculopapular rash. Condylomata lata. Fever, malaise, weight loss. Lymphadenopathy. Headache + meningismus in 40%.
What are condylomata lata?
Highly infectious, grey erythematous plaques that occur in warm bodies areas during 2o syphilis.
What are the features of the 3o phase of syphilis? (3).
Neurosyphilis.
Cardiovascular.
Late benign gummas.
What are the features of neurosyphilis? (7).
Hemiplegia.
Seizures.
Personality changes, Argyll-Roberton pupils.
Ataxic, wide based gait, loss of position/vibratory sense.
What are the features of cardiovascular syphilis? (2).
Aortitis: aortic regurgitation and saccular aneurysm.
What are the signs of congenital syphilis? (6).
Rash. Hepatosplenomegaly. Frontal bosses. Saddle nose. Sabre shins. Hutchinsons incisors.
How is syphilis monitored?
Microscopy and PCR.
Antitreponemal antibodies for diagnosis.
Non-specific tests for monitoring.
How is syphilis treated?
Penicillin.
What is the Jarish-Herxheimer reaction?
Occurs during syphilis treatment.
Fever, chills and myalgia.
Hypersensitivity to protein released during organism lysis.
What is trichomoniasis caused by?
Trichomonas vaginalis.
What is the symptom of trichomoniasis?
How is it treated?
Profuse, green, frothy vaginal discharge.
Metronidazole.
What is bacterial vaginosis caused by?
Reduced vaginal lactobacilli.
Increased Gardnerella vaginalis + anaerobes.
What are the clinical features of bacterial vaginosis?
Watery discharge.
+ve KOH test (fishy smell).
Vaginal pH >4.5.
What are the treatments for bacterial vaginosis? (3).
Metronidazole.
Amoxycillin.
Topical clindamycin.
What are the three causative factors of candidiasis?
Oral contraceptives.
Poorly controlled diabetes.
Antibiotics.
What are the features of candidiasis? (5).
Erythema. Itching. Thick discharge. White plaques. Fissuring lesions.
How is uncomplicated candidiasis treated?
Topical co-trimazole.
Oral fluconazole.
How was AIDs first recognised?
Pneumocystis jirovecci pneumonia.
Kaposi’s sarcoma.
How does the HIV virus enter CD4 cells?
Viral glycoprotein gp120 interacts with cell receptor CD4 and chemokine receptor CCR5 to gain host cell entry.
What is the common primary infection after HIV? Symptoms? (4).
Acute retroviral syndrome.
Fever, pharyngitis, lympadenopathy, rash.
What are the early symptoms/infections in HIV? (5).
Pulmonary TB. Persistent oral candidiasis. Chronic diarrhoea. Persistant fever. Severe bacterial infections.
What tests are used in HIV diagnosis?
Antibody testing.
PCR.
CD4 cell count.
What are the five types of HIV drugs?
NRTIs. NNRTIs. Protease inhibitors. Viral entry inhibitors. Integrase strand transfer inhibitors.
