Aani Micro: STIs Flashcards
Painless genital ulcer?
Syphilis or LGV (lymphogranuloma verenum)
Painful genital ulcer?
Herpes or Chancroid
What is Chancroid (+cause?)
Chancroid is a bacterial sexually transmitted disease (STD) caused by infection with Haemophilus ducreyi.
Gram - diplococci?
Gonorrhoea
Gram + diplococci?
Strep Pneumonia
Symptoms if gonorrhoea is passed to child during birth?
Opthalmia Neonatorum - conjunctivitis.
+ Pharyngitis + Pneumonia
Treatment of Gonorrhoea?
IM Ceftriaxone 500mg
+
ORAL Azithromycin 1g
Treatment of resistant Gonorrhoea?
Spectinomycin IM 2g single dose
Gold standard diagnosis of Gonorrhoea?
Produce culture from rectal or urethral smear
Which smear is more sensitive for Gonorrhoea - rectal or urethral?
urethral - 95%
Rectal 20%
Which pt groups are at high risk of v bad gonorrohoea?
Pts with complement deficiencies - disseminated infection - septicaemia/rash/arthritis
What are the features of complicated Gonorrhoea infection in men?
Prostitis
What are the features of complicated Gonorrhoea infection in women?
PID –> Perihepatitis
how do you treat children with gonorrhea infection?
Topical Abx e.g. Erythromycin
Which groups get rectal proctitis from gonorrhoea?
MSM
What gram stain is Chlamydia?
Gram -
What organism causes Chlamydia?
Chlamydia Trachomatis
Which age group get Chlamydia more often?
Young, <25 years
Which serovars of chlamydia cause blindness?
A,B,C, (cause Trachomas)
Song: ABC, trachomas now I cant see
Which serovars of chlamydia cause genital infection ?
D, K
What do Chlamydia serovars D and K cause?
Genital infection and also Opthalmia Neonatorum in babies
What is Reiter’s syndrome?
Conjunctivitis
Reactive Arthritis
Urethritis
Gold standard for Chlamydia diagnosis?
NAAT Nucleic acid amplification test
What are the 2 forms of Chlamydia (in diff growth cycles)?
Elementary Bodies (extracellular) Reticulate particles (intracellular)
Treatment of uncomplicated Chlamydia?
Azithromycin 1g stat
Doxyclicline 100mg BD 1 week
What do you give for Chlamydia in pregnancy?
Azithromycin 1g stat
Erythromycin (don’t give Doxy- causes bone disturbances and teeth decolouration)
What is LGV?
Lymphogranuloma Vereneum
Lymphatic infection with Chlamydia Trachomatis
Which Chalmydia serovars
IL1 IL2 IL3
What are the stages in LGV disease?
primary- painless ulcers
secondary - becomes painful, fever etc
tertiary - abscess, inguinal LNs, lymphorroids
What is the diagnosis of LGV?
NAAT and then PCR to confirm
Genotypical identification of serovars IL1-3
Treatment of LGV?
Doxycycline 100mg BD 3 weeks
and erythro/azithro
Which organism causes Syphilis?
Treponema Pallidum
What does Syphilis look like microscopically?
gram Neg Spirochaete
How do you test for Syphilis?
Treponemal or Non treponemal Ab tests.
Non-trep Abs include LIPOIDAL Abs made against antigens released by damaged cells
What are the clinical phases of Syphilis infection?
Primary
Secondary
Latent
Tertiary
Describe primary Syphilis
Weeks - painless ulcer
Describe secondary Syphilis
Months - condylomata acuminata lata, oral ulcers, fever, malaise, maculopapular rash basically everywhere (back/feet/palms)
Some neurological involvement e.g. optic neuritis
Describe Tertiary Syphilis
Years - cardio, neuro, gumma granuloma (growth).
Cardio - arotic inflam
Neuro -insanity, ataxia, Argyll-Robertson-Pupil (Accom reflex present, pupil reflex absent) - constrict with distance but not light
Describe Latent Syphilis
No symptoms but positive serology
How do you treat Syphilis ?
Single Dose Benzathine penicillin
Side effect of Syphilis treatment?
Jarisch Heimer Reaction (fever,headache, myalgia, exaggerated syphilis symptoms)
Which organism causes Chancroid?
Haemophilus Ducreyi
What gram stain/shape is it?
Gram Neg coccobacillus
What gram stain is Klebsiella Granulomatis?
Gram Neg Bacillus
What does Klebsiella Granulomatis cause?
Donovanosis
What are the clinical features of Donovanosis?
Beefy Red ulcers (Don is red and beefy, going out with Giemsa)
How do you diagnosis Donovanosis?
Giemsa Stain - will see Donovan Bodies
Tx of donovanosis?
Azithramycin
What organism causes molluscum contagiosum in adults?
HIV (until proven otherwise)
RFs for molluscum contagiosum?
Sex
Swimming
Eczema
Describe Trichomoniasis Vaginalis organism?
Flaggelated protozoan
What will the vagina look like when infected with Trichomonas Vaginalis?
Strawberry Cervix
Describe the discharge in Trichomonas Vaginalis?
Green/yellow
Smelly
Treatment for Trichomonas Vaginalis?
Metronidazole
Bacterial Vaginosis organism?
Gardenrella Vaginalis
Treatment for Bacterial Vaginosis?
Metronidazole 5-7 days
Diagnosing Bacterial Vaginosis? (Ix?)
High pH
Clue Cells
Whiff Test
Diagnosing Trichomonas Vaginalis?
Wet Prep microscopy - flagellated football shaped
Candidiasis cause?
Candida Albicans
Candida symptoms?
Thick white discharge, itchy, sore, red
Treatment for Candida?
Clotrimazole
Fluconazole
It’s thick so it clots.
What kind of genetic material does Molluscum contageosum have?
POX virus dsDNA
Which age group are most affected by Molluscum Contageosum?
90% less than 15 years old
Treatment of Molluscum?
Cryotherapy
Another term for Genital Warts?
Condylomata Acuminata
Which organism causes genital warts? (and strain)?
HPV Strain 6 & 11
Trearment for Genital Warts?
Podophilotoxin (not for pregnant ladies)
Cryotherapy
Imiquimod
Which HPV types are oncogenic?
16 and 18
What causes Pityriasis Versicolour?
Yeast called Malassezia (mala says ya to decolouring)
Features of pityriasis Versicolour?
Small patches of skin to become scaly and discoloured.
Treatment of Pityriasis Versicolour?
Ketokonazole
How to diagnose Fungal infections?
Woods lamps (black light)
Types of tinea?
Athletes foot
Ring worm
Superficial fungal infections?
Tinea and Pityriasis Versicolour
Deep fungal infections?
Candida
Aspergillus
Cryptococcus
Which types of cryptococcus causes cryptococcus meningitis?
Cryptococcus Neoformans
Cryptococcus Gattii
Which part of the fungus does this antifungal target?
Azoles
Cell Membrane Synthesis
An Azole (asshole) is building a wall(membrane)- Trump
Which part of the fungus does this antifungal target?
Polyene
Cell membrane integrity
Poly has integrity
Which part of the fungus does this antifungal target?
Terbinafine
Cell membrane
‘thats a Terble Fine membrane
Which part of the fungus does this antifungal target?
Flucytosine
DNA synthesis
Making the DNA was a fluke (fluc)
Which part of the fungus does this antifungal target?
Achinocandin
Cell Wall
Chino (cat) sat on the wall