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Y4 - GOSH > Chlamydia > Flashcards

Chlamydia Flashcards

1
Q

What factors increase the risk of chlamydia transmission?

A
  • being young (under 25)
  • multiple sexual partners
  • sexually active from a young age
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2
Q

How many cases of chlamydia are asymptomatic?

A
  • 75% cases are asymptomatic in women
  • 50% cases are asymptomatic in men
  • asymptomatic patients can still pass on the infection
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3
Q

What is involved in the National Chlamydia Screening Programme (NCSP)?

A
  • every sexually active person under 25 should be screened annually

OR

  • when they change their sexual partner
  • everyone is retested after 3 months to ensure they have not contracted chlamydia again
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4
Q

What are individuals tested for during an STI screening?

A
  • chalmydia
  • gonorrhoea
  • syphilis (blood test)
  • HIV (blood test)
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5
Q

What are the 2 different types of swabs used in sexual health screening?

A
  • charcoal swabs
  • nucleic acid amplification test (NAAT) swabs
charcoal swab
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6
Q

What are charcoal swabs used for?

A
  • microscopy (looking at the sample under the microscope)
  • culture (growing the organism)
  • sensitivities (which antibiotics are effective)
  • the Aimes transport medium in the tube keeps the micro-organisms alive during transport
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7
Q

What organisms can be confirmed through use of a charcoal swab?

A
  • a charcoal swab can be used for an endocervical** and **high vaginal swab (HVS)
  • they can confirm:
  1. bacterial vaginosis
  2. candidiasis
  3. gonorrhoea (endocervical swab)
  4. trichomonas vaginalis (swab from posterior fornix)
  5. group B streptococci
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8
Q

How do NAAT swabs work?

What do they test for?

A

they check directly for the DNA or RNA of an organism

they are used specifically for chlamydia** or **gonorrhoea

OR to test specifically for mycoplasma genitalium

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9
Q

How are NAAT swabs taken in women and men?

A

women:

  • an endocervical swab is preferred
  • can be taken as a vulvovaginal swab that the patient takes themselves

men:

  • a first-catch urine sample is used
  • urethral swab may be used in some situations
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10
Q

When may additional NAAT swabs be considered?

A

rectal and/or pharyngeal NAAT swabs can diagnose chlamydia in the rectum or throat

(consider if anal / oral sex has taken place)

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11
Q

What is done when gonorrhoea is demonstrated on a NAAT test?

A

endocervical charcoal swab

  • this is required for MC&S
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12
Q

How is a high vaginal swab and vulvovaginal swab taken?

A

high vaginal swab:

  • swab is rotated for 10-15 seconds in the posterior fornix of the vagina

vulvovaginal swab:

  • swab is rotated against the vaginal walls
  • patient is able to perform this themselves
HVS
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13
Q

How may symptomatic women with chlamydia present?

A
  • abnormal vaginal discharge
  • pelvic pain
  • IMB or PCB
  • dyspareunia
  • dysuria
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14
Q

How may symptomatic men with chlamydia present?

A
  • urethral discharge or discomfort
  • dysuria
  • epididymo-orchitis
  • reactive arthritis
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15
Q

What are the typical examination findings in chlamydia?

A
  • pelvic / abdominal tenderness
  • cervical motion tenderness
  • cervicitis (inflamed cervix)
  • purulent discharge
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16
Q

How is chlamydia diagnosed?

A

nucleic acid amplification test (NAAT):

  • vulvovaginal / endocervical swab in women
  • first-catch urine sample in men
  • rectal / pharyngeal swabs for anal / oral sex
17
Q

What is the treatment for chlamydia?

A

doxycycline 100mg twice a day for 7 days

18
Q

When is doxycycline contraindicated?

What are the alternatives?

A

contraindicated in pregnancy + breastfeeding

  • azithromycin, erythromycin or amoxicillin may be used
19
Q

When is a test of cure recommended for chlamydia?

A
  • test of cure is not routinely recommended
  • performed in rectal chlamydia, pregnancy or where symptoms persist
20
Q

What other advice should be given to patients with a chlamydia diagnosis?

A
  • abstain from sex for 7 days to all partners to reduce risk of re-infection
  • ways to prevent future infections
  • contact tracing and notification of sexual partners
21
Q

What are the possible complications of chlamydia infection?

A
  • PID
  • chronic pelvic pain
  • infertility
  • ectopic pregnancy
  • epididymo-orchitis
  • conjunctivitis
  • lymphogranuloma venereum
  • reactive arthritis
22
Q

What are the pregnancy-related complications of chlamydia infection?

A
  • preterm delivery
  • premature rupture of membranes
  • low birth weight
  • postpartum endometritis
  • neonatal infection (conjunctivitis + pneumonia)
23
Q

What is lymphogranuloma venereum (LGV)?

A
  • affects the lymphoid tissue around the site of infection with chlamydia
  • most commonly affects MSM
24
Q

What are the 3 stages of LGV?

A

primary stage:

  • painless ulcer on the penis / vaginal wall / rectum

secondary stage:

  • lymphadenitis - swelling, pain + inflammation in the infected lymph nodes
  • tends to affect inguinal or femoral LNs

tertiary stage:

  • inflammation of the rectum and anus (proctocolitis)
  • proctocolitis results in pain, change in bowel habit, tenesmus + discharge
25
Q

What is the treatment for LGV?

A

doxycycline 100mg twice daily for 21 days

26
Q

How can chlamydial conjunctivitis occur?

A
  • when genital fluid comes into contact with the eye
  • presents with chronic erythema, irritation + discharge
  • lasts for more than 2 weeks
  • usually unilateral
27
Q

What type of organism is chlamydia?

A
  • gram-negative bacteria
  • it is an intracellular organism
    • it replicates within cells before rupturing this and spreading to others

Y4 - GOSH (62 decks)

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