CSIM 1.38 Sexually Transmitted Diseases including HPV Flashcards
What STIs have no cures?
Viral STIs:
• HIV
• HSV
• HPV
Which bacterium is responsible for:
1) Chlamydia
2) Gonorrhoea
3) Syphilis
1) C. trachomatis
2) N. gonorrhoea
3) T. pallidum
What discharge is seen in gonorrhoea?
Mucopurulent discharge (mucus and puss)
What lesion is seen in syphilis?
Is it painful?
Chancre
Painless
What is the most common bacterial STI in the UK? How can it be transmitted?
Chlamydia trachomatis
- Unprotected oral, vaginal or anal sex
- Vertically
Describe Chlamydia trachomatis
- Intracellular parasite
- Gram negative
- Cocci
What are the serotypes of chlamydia and what does each cause?
A-C:
• Granular conjunctivitis
D-K - Azithromycin (1g dose) or Doxycycline BD 7 days
• Pelvic inflammatory disease
• Urethritis
• Ectopic pregnancy
• Neonatal conjunctivitis and pneumonia
L - Doxycycline or ERYthromycin
• Lymphogranuloma
> Fibrosis and blockage of the regional lymphatic system
> Swollen ulcerated inguinal lymph node
What proportion of men and women with chlamydia are asymptomatic?
80% of women
50% of men
What are the male symptoms of chlamydia?
- Nongonococcal urethritis
- If this isn’t treated, this can lead to epididymitis
- Proctitis
- Conjunctivitis
What are the female symptoms of chlamydia?
- Cervicitis
- Vaginal discharge
- Endometritis (and endometrium goes up to fallopian tubes where it shouldn’t be) - this can cause ectopic pregnancy
- Proctitis
- Salpingitis
- Conjunctivitis
How is chlamydia identified?
PCR primers
What is the second most common bacterial STI in the UK?
Niesseria gonorrhoea
Describe the Neisseria gonorrhoea bacterium
- Gram negative
* Aerobic diplococci
What proportion of men and women are asymptomatic? (gonorrhoea)
50% of women
5% of men
What symptoms can result from mother-to-baby transmission of Niesseria gonorrhoea?
Opthalmia neonatorum
What are the male clinical manifestations of gonorrhoea?
- Urethritis
- Dysuria
- Asymptomatic rectal infection
- Asymptomatic pharyngeal infection
What are the female clinical manifestations of gonorrhoea?
- Endocervical infection (abnormal vaginal discharge 50%, asymptomatic 50%)
- Pelvic inflammatory disease
What is the treatment for gonorrhoea?
ceftriaxone AND azithromycin
Which STI causes conjunctivitis?
Chlamydia
Gonorrhoea (VERTICAL NEONATAL ONLY)
Describe Treponema pallidum (syphilis) bacterium
- Neither gram negative or positive (too thin for staining)
* Spirochete
What are the clinical manifestations of syphilis?
Stage 1:
• Chancre
• Heals without treatment
Stage 2:
• Maculopapular rash 6 weeks after the primary (chancre) lesion
• Condylomata lata in anogenital region
• Heals without treatment
Stage 3 (40% reach this stage):
• Dementia and paralysis (neurosyphilis)
• Gummata
• Stroke & heart disease
What can untreated congenital syphilis lead to?
- Stage 2 symptoms
* Schemata: CNS and developmental abnormalities (particularly in teeth and bones)
Describe the pappilomaviruses virology
- 170 serotypes
- DNA
- Non-enveloped
Which papillomavirus serotypes infect/cause:
1) Anogenital tract
2) Condylomata acuminata
3) Malignant lesions
4) Plantar and facial warts
5) Warts on knees and fingers
1) 6, 11, 16, 18
2) 6, 11
3) 16, 18
4) 1, 4
5) 2, 3, 10
What is condylomata acuminata?
Genital wart, caused by HPV 6 & 11
What dysplasias are caused by which HPV viruses?
HPV 16 & 18:
• Bowenoid papulosis (benign) - vulva/penis
• Carcinoma - cervix/penis
Which serotypes do current HPV vaccines protect against?
6, 11, 16, 18
