GUM Flashcards
What type of virus is HPV?
Double-stranded DNA virus
What proportion of PID cases are caused by CT?
14-35%
What is the estimated transmission risk of CT with a single episode of UPSI?
10%
What proportion of women with CT will develop SARA?
<1%
What proportion of patients with untreated CT will spontaneously clear by 12 months?
50%
What are rates of concordance when one partner is diagnosed with CT?
75%
What is the first-line management of uncomplicated CT?
Doxycycline 100mg bd for seven days
or
Azithromycin 1g orally as a single dose, followed by 500mg once daily for two days
If first line management options are contraindicated in CT, what should be used instead?
Erythromycin 500mg bd for 10–14 days
or
Ofloxacin 200mg bd or 400mg od for seven days
What are the management options for uncomplicated CT in pregnancy?
Azithromycin 1g orally as a single dose, followed by 500mg once daily for two days
or
Erythromycin 500mg four times daily for seven days
or
Erythromycin 500mg twice daily for 14 days
or
Amoxicillin 500mg three times a day for seven days
In whom should a TOC be performed for re: CT?
- Pregnancy
- Where poor compliance is suspected
- Where symptoms persist
Co-infection of M.gen is reported in what proportion of CT infections?
3%-15%
What type of bacteria is chlamydia trachomatis?
Gram negative
How does chlamydia trachomatis replicate?
WITHIN a cell
Which CT serovars account for trachoma?
A-C
Which CT serovars account for genital infection?
D-K
Which CT serovars account for LGV?
L1-L3
What is the lifecycle of CT?
Elementary bodies (EB) are the infectious forms of CT and are spore like structures with a hard cell wall allowing its survival in the environment outside the cell.
They are 200-400 nanometres in size.
An EB attaches to the new host cell and enters the cytoplasm surrounded by a vacuole called an inclusion.
Within this inclusion, the EB transforms into a Reticulate body (RB) and rapidly replicates by binary fission.
RB’s transform back into EB’s with increasing expansion of the inclusion within the host cell cytoplasm.
The host cell ruptures causing expulsion and release of the EB’s into the environment before they re-infect further epithelial cells.
What are the risks of CT in a pregnant pt?
- Neonatal conjunctivitis
- Pre-term labour
Where is LGV endemic?
Southern Africa, West Africa, Madagascar, India, South-East Asia and the Caribbean
What is the most common serovar of CT associated with LGV infection?
L2
What is the incubation period of LGV?
3-30 days
What is the primary manifestation of LGV in MSM?
Haemorrhagic proctitis - 96% of cases in Western Europe
Can LGV cause systemic symptoms?
Yes - fever and malaise
What is ‘groove’ sign in LGV?
When both inguinal and femoral lymph nodes are involved, they may be separated by the so-called ‘‘groove sign,’’ which consists of the separation of these two lymph node systems by the inguinal ligament