Aani Micro: STIs Flashcards by S Chakka

Painless genital ulcer?

Syphilis or LGV (lymphogranuloma verenum)

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Painful genital ulcer?

Herpes or Chancroid

herpes = lots of ulcers

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What is Chancroid (+cause?)

Chancroid is a bacterial sexually transmitted disease (STD) caused by infection with Haemophilus ducreyi.

painful single ulcer
tender lymph nodes

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Gram - diplococci?

Gonorrhoea

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Gram + diplococci?

Strep Pneumonia

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Symptoms if gonorrhoea is passed to child during birth?

Opthalmia Neonatorum - conjunctivitis.

+ Pharyngitis + Pneumonia

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Treatment of Gonorrhoea?

IM Ceftriaxone 500mg
+
ORAL Azithromycin 1g

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Treatment of resistant Gonorrhoea?

Spectinomycin IM 2g single dose

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Gold standard diagnosis of Gonorrhoea?

Produce culture from rectal or urethral smear

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Which smear is more sensitive for Gonorrhoea - rectal or urethral?

urethral - 95%

Rectal 20%

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Which pt groups are at high risk of v bad gonorrohoea?

Pts with complement deficiencies - disseminated infection - septicaemia/rash/arthritis

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What are the features of complicated Gonorrhoea infection in men?

Prostitis

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What are the features of complicated Gonorrhoea infection in women?

PID –> Perihepatitis

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how do you treat children with gonorrhea infection?

Topical Abx e.g. Erythromycin

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Which groups get rectal proctitis from gonorrhoea?

MSM

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What gram stain is Chlamydia?

Gram -

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What organism causes Chlamydia?

Chlamydia Trachomatis

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Which age group get Chlamydia more often?

Young, <25 years

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Which serovars of chlamydia cause blindness?

A,B,C, (cause Trachomas)

Song: ABC, trachomas now I cant see

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Which serovars of chlamydia cause genital infection ?

D, K

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What do Chlamydia serovars D and K cause?

Genital infection and also Opthalmia Neonatorum in babies

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What is Reiter’s syndrome?

Conjunctivitis
Reactive Arthritis
Urethritis

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Gold standard for Chlamydia diagnosis?

NAAT Nucleic acid amplification test

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What are the 2 forms of Chlamydia (in diff growth cycles)?

Elementary Bodies (extracellular) 
Reticulate particles (intracellular)

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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 single painless ulcer with tender lymph nodes

Which Chalmydia serovars cause lgv

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