Bacterial STDs Flashcards
4 features of chlamydia in females
Increased discharge
Post-coital/ intermenstrual bleeding
Dysuria
Dyspareunia
4 features of chlamydia in males
Urethral discharge
Dysuria
% of patients asymptomatic with chlamydia
85%
Ix for chlamydia
Nucleic acid amplification test on:
F: Vulvovaginal swab
M: FPU. Oral/ anal swabs if appropriate.
Tx for chlamydia
Doxycycline 100mg BD 7/7
Partner screening
Avoid SI until tx complete
3 features of gonorrhoea in females
Asymptomatic in 50%
Viscous + purulent discharge
Dysuria
3 features of gonorrhoea in males
Asymptomatic in 10%
Viscous + purulent urethral discharge
Dysuria
Ix for gonorrhoea
NAAT on:
F: Vaginal or endocervical swab
M: FPU
+ve chocolate agar culture of swab
Tx for gonorrhoea
Ceftriaxone 1g IM STAT
Sensitivities known: Ciprofloxacin 500mg PO STAT
Partner screening
Avoid SI until tx complete
Tx for gonorrhoea in penicillin allergy
Azithromycin 2g PO STAT + Gentamicin 240mg IM
Needle phobic: Cefixime 400mg PO + Azithromycin 2g PO
Tx for chlamydia in pregnancy
Azithromycin 1g PO STAT
Tx for gonorrhoea in pregnancy
Ceftriaxone 1g IM STAT
4 features of primary Syphilis
Macule- Papule - Ulcer (Chancre)
Appears 2-3 weeks after exposure
Heals in 2-6 weeks
Local lymphadenopathy
Describe 5 features of the chancre seen in primary syphilis
Single Round/ oval Painless Defined rolled edge Discharging clear serum
When and how does secondary Syphilis arise?
~4-10 weeks after chancre appearance.
Within 2 years of infection
Haematogenous dissemination
6 features of secondary Syphilis
Diffuse rash Fever Headache Myalgia Condyloma lata Lymphadenopathy
4 features of the rash in secondary syphilis
Macular, Papular or Maculopapular
Symmetrical
Often involves mucous membranes
Usually non-itchy
What are condyloma lata?
Raised pale plaques
Painless
Wart-like
What is early latent syphilis?
Asymptomatic infection diagnosed on +ve serology alone, acquired <2 years previously
Relapse to secondary syphilis may occur
What is late latent syphilis?
Asymptomatic infection acquired >2 years previously
Pt is not known to have been seronegative within the past 2 years
What are the 3 manifestations of tertiary syphilis?
Neurosyphilis (though not always considered tertiary)
Gummatous syphilis
Cardiovascular syphilis (aortitis)
3 signs of neurosyphilis
Tabes dorsalis (dorsal column loss)
Dementia (general paralysis of the insane)
Aseptic meningitis
5 characteristics of Tabes dorsalis
Sensory ataxia Lightning pains Areflexia/ Extensor plantar reflex Charcot joints Argyll-Robertson pupils
2 features of gummatous syphilis
Destructive granulomatous lesions with necrotic centre
Affect skin, mucous membranes, bones, viscera
