Chlamydia

Question 1

most common STI in UK?

Answer 1

chlamydia

Question 2

what bacteria causes chlamydia?

Answer 2

chlamydia trachomatis

Question 3

is chlamydia trachomatis gram neg or gram positive?

Answer 3

gram neg

Question 4

what type of epithelium does chalmydia thachomatis typically infect?

Answer 4

columnar epithelium at mucosal sites

Question 5

presentation of chlamydia in women?

Answer 5

70-80% of women are asymptomatic
* Dysuria (pain peeing)
* Abnormal vaginal discharge
* Intermenstrual or postcoital bleeding
* Dyspareunia (painful sex)
* Lower abdo pain
* Cervicitis +/- contact bleeding
* Pelvic tenderness
* Cervical excitation

Rectal: discomfort, discharge, bleeding and change in bowel habits

Question 6

presentation of chlamydia in men?

Answer 6

MEN:
50% of men are asymptomatic
* Urethritis
-discharge (milky)
-dysuria (painful peeing)
* Epididymo- orchitis
- Testicular pain

Rectal: discomfort, discharge, bleeding and change in bowel habits

Question 7

investigations for chamydia?

Answer 7

NAAT- nucleic acid amplification tests
* Women
First line= vulvovaginal swab,
Other= endocervical swab or first catch urine sample

* Men First line= first catch urine Other= urethral swab

Rectal or pharyngeal can be used for throat or rectal chlamydia

Question 8

treatment for chlamydia?

Answer 8

1st line= doxycycline 100mg BD x1 week
2nd line= Azithromycin 1G stat followed by for 2 days
(also covered by ofloxacin)

Doxycycline is CI in PREGNANCY
-Azithromcycin
-Erythromcycin

Question 9

complications chamydia?

Answer 9

-PID
-Reactive Arthritis
-Ectopic pregnancy
-Conjunctivitis
-Fitz Hugh Curtis
-Salpingitis
-Endometritis
-Tubal infertility
-Perihepatitis
-Lymphogranuloma Venerum
-Conjunctivitis

Question 10

what is lymphagranuloma venerum?

Answer 10

STI affecting lymphoid tissue around site of infection caused by a strain of chlamydia (serovars L1, L2 or L2)

Question 11

what causes lymphogranuloma venerum?

Answer 11

strain of chlamydia
-serovars L1, L2 or L3

Question 12

who is lymphogranuloma venerum more common in?

Answer 12

MSM
-tropical regions

Question 13

presentation of lymphgranuloma venerum?

Answer 13

Occurs in 3 stages: primary, secondary and tertiary

Primary- painless ulcers (primary lesions)
-on penis, vaginal wall or rectum

Secondary- lymphadenitis
-pain and inflammation in lymph nodes

Tertiary- proctitis
-inflammation of rectum and anus
-presents with anal pain, change in bowel habits, tenesmus and discharge

Question 14

how can you tell the difference between LGV and syphillis?

Answer 14

syphillis= non painful lymph nodes
LGV= painful lymph nodes