7.1 Genital tract sexually T INFECTIONS Flashcards
Name 4 commonly diagnosed STIs:
- chlamydia (49%)
- first episode genital warts (13%)
- gonorrhoea (13%)
- first episode genital herpes (8%)
Pathogen of chlamydia ?
Chlamydia trachomatis
Chlamydia pathogen type ?
obligate intracellular GN bacteria
Chlamydia:
1. typically infects where in men & women
2. can also infect where ?
- men = urethra, women = cervix/urethra
- conjunctiva , rectum, nasopharynx
% asymptomatic in women and men for chlamydia ?
women 70% , men 50%
men, women , rectal
Chlamydia presentation ?
Men
* dysuria
* urethral discharge
* epididymo-orchitis
Women
* abnormal discharge
* unscheduled bleeding
* dysuria
* cervicitis
* pelvic inflammatory disease
Rectal
* proctitis (inflammation of the lining of the rectum)
* discharge
Chlamydia management
doxycycline
Pathogen causing lymphogranuloma venereum
Chlamydia trachomatis
What is lymphogranuloma venereum associated with ?
- small skin lesion
- regional lymphadenopathy
- severe proctitis
- rectal discharge
- tenesmus (frequent urge to go to bathroom without being able to go)
- endemic of lymphogranuloma venereum which countries ?
- In US, europe, australia it’s associated with which people group ?
- african, india, SEA
- GBMSM and HIV+
Gonorrhoea pathogen ?
Neisseria gonorrhoeae
- GN diplococcus
gonorrhoea :
1. primarily affects age and population group?
2. associated with what complications ?
- < 25y and GBMSM
- pregnancy complications
men , women
Gonorrhoea presentation ?
Men
* dysuria (painful/uncomfortable urination )
* muco-purulent urethral discharge
Women
* abnormal discharge (thin, watery, green/yellow)
* dyspareunia (painful intercourse)
* endocervical discharge, cervical bleeding
Gonorrhoea management ?
ceftriaxone IM
Trichomoniasis caused by ?
protozoan parasite called Trichomonas vaginalis
Presentation of trichomoniasis that’s 2% of women
strawberry cervix
Trichomoniasis:
1. > 90% diagnosed in ?
2. Up to …% men and women are asymptomatic
- women
- 50
men, women
Presentation of Trichomoniasis
Men
* dysuria (painful urination )
Women
* abnormal discharge (classic frothy/yellow discharge, ‘fishy’ smelling )
* vulva itching / pain
* dyspareunia (painful intercourse)
Trichomonas vaginalis management ?
metronidazole
Genital herpes infection caused by ?
herpes simplex virus (HSV) - 2 types (HSV-1 and HSV-2)
Both HSV-1 and HSV-2 are causes of genital herpes infection , what is HSV-1 also associated with ?
- gingivostomatitis
- cold sores
Genital herpes reactivation associated with ?
- trauma
- UV light (e.g. sun bathing, tanning beds)
- HIV
- immunocompromise
- psychological stress
Genital herpes simplex presentation ?
- painful crops of genital blisters (clusters of blisters)
- ‘tingling’ or burning pain
- lesions localised to dermatome
- redness
- dysuria
- proctitis
Genital herpes simplex is transmission with ..1.. but infectious ….2.. shedding
- asymptomatic
- viral
Genital herpes management ?
Acyclovir
Genital warts include benign, proliferative growths in which areas ?
- genital
- perineal (area between the pubic symphysis and coccyx )
- anal
- perianal (area surrounding anus)
Genital warts is generally ..1.. but. can be ..2..
- asymptomatic
- painful
genital warts most commonly HPV genotype ?
6 and 11
Genital warts:
1. ~92% cases in ?
2. peak age of prevalence ?
3. diagnosed mainly how ?
- heterosexual men and women
- 20-24
- clinical diagnosis
genital warts management ?
- surgical excision
- cryotherapy
- Infection type of molluscum contagiosum
- what it’s caused by ?
- general skin infection
- DNA poxvirus
9/10 cases of molluscum contagiosum occur in children due to non-sexual skin contact , therefore why is it considered a sexual transmitted infection ?
Since it’s spread through skin contact it can also be transmitted during sexual intercourse
Management of molluscum contagiosum ?
generally harmless and gets better in a few months without any specific treatment
what’s not indicated with molluscum contagiosum ?
contact tracing
pubic lice infestation (pediculosis pubis) is caused by ?
Phthirus pubis
What is phthirus pubis ?
an obligate ectoparasite that causes pediculosis pubis
Phthirus pubis ?
1. usually found on ?
2. also known as ?
- pubic and perianal hairs
- ‘crab’s bcos of crab like shape
pediculosis pubis is spread and presents how ?
- spread through sexual contact
- presents as general itching, worse at night
pubic lice management ?
permethrin cream
What causes scabies ?
human itch mite Sarcoptes scabiei
Action of sarcoptes scabiei ?
burrows into human skin and lay eggs
Scabies …
1. acquired how ?
2. what’s worse at night ?
3. Presentations usually seen where?
- frequently sexual
- generalised itching (type 4 hypersensitivity reaction)
- upper medial aspects of thighs, penis, scrotum
scabies management ?
permethrin cream
Syphilis cause ?
spirochete bacterium Treponema pallidum
Presentations during each stage of syphilis ?
- primary - painless ulcer (chancre) on the genital area
- secondary - lymphadenopathy, macropapular rash, condylomata lata, fever, headache
- latent - no current clinical features
- tertiary - cardiac disease (angina, heart failure) , neurological disease (meningitis, cranial nerve defects, infarction)
duration of primary syphilis?
~ 12 weeks
duration of secondary syphilis ?
1-6 months
early latent syphilis duration ?
< 2 years
late latent syphilis duration ?
> 2 years
tertiary syphilis duration ?
> 5 years
management for syphilis ?
benzylpenicillin IM
Mgen long version ?
Mycoplasma genitalium
Mgen commonly associated with what in ?
1. men
2. women
- urethritis
- cervicitis
Features of bacteria mycoplasma genitalium ?
- slowly growing bacteria
- lacks a cell wall therefore can’t culture/ gram stain or use beta-lactam antibiotics
- Mgen impacts what ?
- with increased risk of ?
- pregnancy outcome
- preterm birth, spontaneous abortion, PID, infertility
Presentations of Mgen in Men & women ?
Men: dysuria, testicular pain
Women: vaginal discharge, lower abdominal pain, abnormal vaginal bleeding
Management for Mgen ?
doxycycline , azithromycin
Mpox is what disease ? cause by what ?
Rare disease , caused by Monkeypox virus ds DNA virus
Presentation of Mpox ?
most cases mild symptoms
small lesions on :
* hands
* mouth
* genitals
* anus
Recovery period for Mpox ?
2-4 weeks
Risk level of HPV 16 & 18 ? and what it’s risk for ?
- high risk
- cervical intraepithelial neoplasia, cervical carcinoma
genital HPV infection influence by what activity ?
sexual
HPV infection most common in what age and group ?
sexually active young women 18-30 years old
age range that cervical cancer more common in ?
> 35 yr
what does cervical screening test for ?
high risk HPV
what cancers can HPV also cause ?
- oropharyngeal
- anal
- penile
What is HIV ?
retrovirus that can lead to AIDS
what does HIV reduce ?
CD4+ T cell count in body leading to opportunistic infections
- In most cases how is HIV transmitted ?
- how can it also be transmitted ?
- sexually
- pregnancy, childbirth, blood transfusion
How is hepatitis B transmitted ?
- perinatally
- sexual contact
- needle sharing in IVDU
How is hepatitis C transmitted ?
- perinatally
- needle sharing
hepatitic C can be transmitted perinatally and associated with ..1…, .2… people and people with ..3… , needle sharing
- GBMSM
- HIV positive
- multiple partners
Hepatitis B and C presentation ?
- malaise
- poor appetite
- RUQ (right upper quadrant) pain
- jaundice
- may be asymptomatic