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Clinical food and microbiology > 7. STIs > Flashcards

7. STIs Flashcards

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1
Q

What is an STI?

A

an illness caused by an infectious microorganism with a propensity for transfer between humans through sexual contavt

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2
Q

Who is affected by STI?

A
  • young people with high risk sexual lifestyles
  • men who have sex with men (MSM)
  • disadvantaged socio-economic communities
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3
Q

Which bacteria cause STI?

A
  • chlamydia trachomatis
  • neisseria gonorrhoea
  • treponema pallidum (syphilis)
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4
Q

What viruses cause STI?

A
  • papillomavirus HPV; genital warts
  • Herpes simplex HSV; genital herpes
  • Hepatitis B/C; Hepatitis
  • HIV; AIDS
  • Monkeypox; rash and blisters
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5
Q

What fungi causes STI?

A

candida albicans; thrush

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6
Q
A
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7
Q

What parasites cause STI?

A

Trichonomoas vaginalis; vaginitis

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8
Q

What arthropods (insect) cause STI?

A
  • sacroptes scabei; genital scabies
  • phthirus pubis; pediculosis pubis
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9
Q

What factors cause STI?

A
  • multiple partners
  • pregnancy; morning after pill
  • internet chat rooms
  • dugs/alcohol
  • MSM/TPSM
  • contraceptive pill
  • lack of education/ awareness
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10
Q

How is chlamydia transmitted?

A
  • vaginal/anal/oral sex
  • mother to baby
  • incubation: 1-3weeks
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11
Q

What is the clinical manifestation of chlamydia?

A
  • frequently asymptomatic (75% F, 25%M)
  • M; urethritis (watery. mucoid discharge)
  • F; urethritis, cervicitis, vaginitis
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12
Q

What are the complications of chlamydia?

A
  • pelvic inflammatory disease
  • infertility in men and women; ascend to ovaries and testicles
  • ocular infection; neonates/ adults
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13
Q

What is chlamydia?

A

an obligate intracellular organism; cant be cultured

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14
Q

What is the NCSP?

A

National Chlamydia Screening Programme
- control and prevention programme
- aim; detection/treatment of asymptomatic carriers
- target population; under 25s (sexually active)
method; obligate intracellular NAAT (PCR)8

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15
Q

What is the treatment for Chlamydia?

A

Azithromycin (clamelle)- single dose 2 x 500mg
Doxycycline (vibramycin) - 7-14days 200mg

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16
Q

What is the transmission of genital warts (HPV)?

A
  • vaginal/ana/oral sex
  • incubation; 1-6month, years
  • greatest prevalence in 17-33 YOA
17
Q

What are the clinical manifestations of HPV?

A
  • warts- 90 types, multiple, dry, keratinised, cauliflower appearance, painless
18
Q

What can HPV cause?

A

serotypes 16/18 can cause:
neoplasia - cancer
- neoplasmic conversion; cervical cancer

19
Q

What is the treatment for HPV?

A
  • genital warts; podophyllin (cytotoxic) and imiquimod (immunostimulatory)
  • cervical/intraurethral; carbon dioxide laser removal
20
Q

How can HPV be prevented?

A
  • vaccination (protects against serotypes 6, 11, 16, 18) for 13 y/o
  • safe sex
21
Q

How is herpes transmitted?

A
  • vaginal/oral/anal sex
  • incubation 3-7 days
22
Q

What is the clinical manifestation for primary infection of Herpes?

A
  • 70% asymptomatic
  • symptoms; constitutionalised and localised
  • untreated attack lasts 28 days
23
Q

What is the clinical manifestation for reactivation of Herpes?

A
  • tenderness, pain and burning to site of eruption lasting 2hrs - 2 days
  • women; lesion on labia and perineum
  • men; lesions in shaft, prepuce, glans
    lesions heal in 7-10 days; can get dissemination and encephalitis
24
Q

How can herpes be treated/prevented?

A
  • Acyclovir (Zofirax): 200mg 5x a day for 7 days
  • Famciclovir (Famvir): 200-250mg 3x a day for 7 days
  • safe sex
25
Q

What is the microorganism that causes gonorrhoea?

A
  • Neisseria gonorrhoeae
  • gram negative diplococcus
  • intracellular survival
  • strict human pathogen
26
Q

What is the transmission of Gonorrhoea?

A
  • vaginal/oral/anal sex
  • incubation; 2-7days
  • transmission rates; 80% female, 20% male
  • mother to baby transmission
27
Q

What is the epidemiology of gonorrhoea?

A
  • higher in urban areas
  • men form 70% of diagnoses; MSM, black ethnic groups
  • female 16-19, men 20-24
28
Q

What is the clinical manifestation of gonorrhoea?

A

male 10%
female 70%

male:
- urethritis
- dysuria
- thick, purulent penile discharge

female:
-dysuria
- cervicitis
- thick, purulent vaginal discharge

-rectal infection: anal discharge
-throat infection; tonsilitis, purulent exudate

29
Q

What are complication of gonorrhoea?

A
  • males; epididymitis, prostatitis
  • females; spread to fallopian tubes (salpingitis), pelvic inflammatory disease and infertility
  • opthalmia neonatorum
  • disseminated gonococcal infection DGI
30
Q

What are the virulence factors in stage 1 of gonorrhoea pathogenesis?

A

adherence and endocytosis

  • Pili; nonciliated
    epithelial cells
  • Opa proteins and LOS (lipooligosaccharide)
  • Por proteins (parasite directed endocytosis)
31
Q

What are the virulence factors in stage 2 of gonorrhoea pathogenesis?

A

Avoidance of host defences

  • capsule; sialic acid from host to form capsule- molecular mimicry
    IgA protease
32
Q

What are the virulence factors in stage 3 of gonorrhoea pathogenesis?

A

Formation of transferrin and lactoferrin binding receptors

  • Tbp1, Tbsp2
  • Lbp1
33
Q

What is the laboratory diagnosis of gonococcal infection?
sample collection

A
  • males; urethral swab
  • females; multiple samples: urethral, endocervical/ vaginal
  • other samples can be requested: throat, rectal, blood cultures
  • transport medium, eg. Stuart’s
34
Q

What is the laboratory diagnosis of gonococcal infection?
Non-culture techniques

A
  • direct microscopy of discharge; presumptive diagnosis if positive; initiative treatment
  • nucleic acid amplification tests (NAAT);
    PCR-based: Rapid, detects/amplifies specific DNA; bacterial viability not essential
35
Q

What is the laboratory diagnosis of gonococcal infection?

A

Culture
-enriched agar; blood/chocolate agar
-selective agar; modified Thayer-Martin? New York city agar, vancomycin, colistin, nystatin, trimethrim
- opaque, grey colonies

36
Q

How to identify N.gonorrheae?

A
  • colonies: gram-negative diplococci
  • oxidase +
  • catalase +
  • CHO fermentation
  • Prolyl aminopeptidase
37
Q

What is the treatment and prevention of gonococcal infection?

A
  • ceftriaxone 250mg, injection
  • cefixime 400mg oral singe dose
  • azithromycin 2g single dose

-safe sex

Clinical food and microbiology (12 decks)

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