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SpM GUM > General STIs > Flashcards

General STIs Flashcards

1
Q

Which condition(s) present with genital warts?

A

Human papilloma virus

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2
Q

Which condition(s) present with genital ulcers?

A

Genital herpes - vesicles/papules around genitals
Syphilis - macule to papule to painless ulcer
Chlamydia - can present with a painless papule/ulcer

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3
Q

How does genital herpes present?

A

A flu-like prodrome, the vesicles/papules filled around genitals/anus. These burst forming painful shallow ulcers. Can also get urethral discharge, dysuria, urinary retention and proctitis.

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4
Q

How is genital herpes diagnosed?

A

Swab taken for PCR

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5
Q

How is genital herpes treated?

A

Topical analgesia (lipocaine) and antivirals (aciclovir)

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6
Q

What are the symptoms of the three stages of syphilis?

A

Primary - <90days after inoculation - macule to papule to painless ulcer (Chancre)
Central slough, defined rolled edge, highly contagious
Secondary (4-10 weeks after chancre) - maculopapular rash (50-75%), mucous patches, condyloma lata (raised pale plaques on extensor surfaces), fever headache, hepatitis
Tertiary - 20-40yrs after infection - Neurosyphilis - focal neurological deficits, seizures, psychiatric symptoms

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7
Q

How is syphilis diagnosed?

A

PCR and serology

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8
Q

How is syphilis treated?

A

Benzylpenicillin

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9
Q

What are the four main diseases that are swabbed for in individuals presenting with risk of sti?

A

Gonorrhea, chlamydia, HIV and syphilis

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10
Q

In a male presenting with discharge what would you swab for?

A

Gonorrhea and chlamydia

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11
Q

Which bacterial sti do you culture for?

A

Culture for gonorrhoea but not chlamydia

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12
Q

What kind of organism is syphilis?

A

Called treponema and in the bacterial subtype spirochaetes

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13
Q

What kind of organism is chlamydia?

A

Intracellular bacteria

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14
Q

What kind of organism is gonorrhea?

A

It is a gram negative (pink staining) diplococci

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15
Q

What routine blood tests are done for people who are worried they have been exposed to stis?

A

HIV, syphilis and hep B

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16
Q

How well do you know your syphilis serology? it might well come up

A

Learn it

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17
Q

How is syphilis diagnosed using serology?

A

There must be 2 positive specific results e.g. TPPA, TPHA, EIA and IgM
This window period for serology is only up to 3 months

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18
Q

What serology can be done for syphilis early on in the infection?

A

Specific results e.g. TPPA and IgM
VDRL or cardiolipin can be used to determine staging of syphilis but is not very specific
T. Pallidum can be isolated from chancres in early syphilis and identified by PCR

19
Q

What does high titre VDRL or cardiolipin suggest?

A

Primary or secondary syphilis

20
Q

What does low titre VDRL or cardiolipin suggest?

A

Tertiary syphilis

21
Q

What does a negative VDRL or cardiolipin with positive syphilis serology suggest?

A

Suggests syphilis that has been treated

22
Q

What is the presentation of chlamydia?

A

Usually asymptomatic and picked up on screening

Dysuria and discharge main symptoms

23
Q

How is a diagnosis made for chlamydia?

A

Through nucleic acid amplification testing (NAAT) of:

  • Swabs in women
  • First pass urine in men
24
Q

How is chlamydia treated?

A

Azithromycin 1g single dose or 100mg doxycycline BD for 7 days
Partner tracing, screening, treatment
Avoid sex until treated

25
Q

What are the complications fo chlamydia?

A

Pelvic inflammatory disease in women
Epidiymorchitis in men
reactive arthritis

26
Q

What is the presentation of gonorrhoea?

A

Urethral/vaginal discharge, dysuria

Asymptomatic in 50% women and 10% men

27
Q

How is a diagnosis made for gonorrhoea?

A

Using nucleic acid amplification testing (NAAT):
Vaginal swab in women
First pass urine in men
Need to remember to culture for sensitivity to antibiotics

28
Q

What is the treatment for gonorrhoea?

A

Ceftriaxome 500mg IM + Azithromycin 1g PO
Partner tracing, screening and treatment
Avoid sex until after treatment

29
Q

What are the complications of gonorrhoea?

A

pelvic inflammatory disease in women
epididymitis in men
Reactive arthritis

30
Q

What is the presentation of non-gonococcal urethritis?

A

Urethral discharnge, dysuria

31
Q

How is non-gonococcal urethritis diagnosed?

A

Urethral swab shows increased polymorphonuclear leucocytes. Need testing for chlamydia and gonorrhoea and exclude UTI

32
Q

How is non-gonococcal urethritis treated?

A

It is treated same as chlamydia with 1g PO of azithromycin single dose
Give 5 days azithromycin patient positive for mycoplasma genitalium

33
Q

What is the presentation of trichomonis vaginalis?

A

It presents with vaginal discharge and itch in women

Asymptomatic in men

34
Q

How is trichomonis vaginalis diagnosed?

A

NAAT, culture and microscopy (mobile trichomonads)

35
Q

How is trichomonis vaginalis treated?

A

Metronidazole 2g single dose
Partner tracing, screening and treatment
No sex until after treatment

36
Q

What are the complications of trichomonis vaginalis?

A

Increased risk of preterm delivery in pregnancy

37
Q

How does genital candidiasis present?

A

Itching, burning, cottage cheese like discharge

38
Q

How is genital cadidiasis diagnosed?

A

With microscopy and culture for candida

39
Q

How is genital candidiasis treated?

A

Antifungals e.g. clotrimazole

40
Q

What is the presentation of bacterial vaginosis?

A

Thin white fishy smelling discharge
No itch or soreness
Can be asymptomatic

41
Q

What is the diagnosis of bacterial vaginosis?

A

Gram staining to examine vaginal flora

Shows too many or too few lactobacilli

42
Q

What is the treatment of bacterial vaginosis?

A

It is treated with oral or PV metronidazole

43
Q

What is a nice way of refering to syphilis in front of patients?

A

Treponemal infection

SpM GUM (4 decks)

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