GUM Flashcards
What are the 3 commonest symptoms of STI?
Urethral discharge
Genital ulcer
Vaginal discharge
How does bacterial vaginosis occur?
When the normal flora (lactobacillus) of the vagina is replaced by a mixed flora of gardnerella vaginalis and anaerobes
What type of bacteria is gonorrhoea?
Gram negative
Intracellular diplococcus
What are the common complications of gonorrhoea?
Salpingitis
Bartholin’s abscess
Perihepatitis
Men = epididymitis and prostatitis
What urine test can be used to diagnose gonorrhoea?
NAAT
Nuclei acid amplification test
Which antibiotics are used to treat chlamydia?
Doxycycline
Azithromycin
What is the causative organism of syphilis?
Treponema pallidum
Describe the early stages of syphilis
Incubation period of 10 to 90 days
Papules develop which also for it to become a painless, firm chancre
This heal spontaneously in 2 to 3 weeks
Describe the secondary infection of syphilis
4 to 10 weeks after the appearance of the primary lesion
Constitutional symptoms with fever, sore throat and arthralgia
Generalised lymphadenopathy, widespread rash, superficial ulcers in mouth and genitalia
Most symptoms subside in 3 to 12 weeks
Describe tertiary syphilis
This occurs after a latent period of two years or more
The characteristic lesion is a gumma
Gumma = A granulomatous, ulcerating lesion that can occur in skin, bones, liver and testes
Cardiovascular and neurosyphilis
Described congenital syphilis
30% are stillborn
2 to 6 weeks after birth there is nasal discharge, skin and mucous membrane lesions and failure to thrive
How do we diagnose syphilis?
Dark ground microscopy from swab
Serological tests-enzyme assay
What is the management of syphilis?
Early-intramuscular benzol penicillin for 10 days
Erythromycins if penicillin allergic
What are the routes of transmission of HIV?
Sexual intercourse
Mother to child
Contaminated blood, blood products and organ donations
Contaminated needles
What is the risk of getting HIV following a needlestick injury from a positive patient?
0.3%
3 in 1000
Describe the HIV virus
An outer envelope and inner core
The core contains RNA and the enzyme reverse transcriptase which allows viral RNA to be transcribed into DNA and incorporated into the host cell Gino
Which cells are attacked by HIV?
CD 4 cells
What causes the immuno suppression with HIV?
A progressive and severe depletion of infected CD 4 helper lymphocytes which results in host susceptibility to infections with intracellular bacteria and mycobacteria
Describe the primary HIV infection
Also called seroconversion
Illness occurs 2 to 4 weeks after infection
Symptoms are non-specific: fever, maculopapular rash, myalgia, headache
Illness last up to 3 weeks and recovery usually complete
What is the management of HIV?
Antiretroviral drugs (HAART)
Social and psychological support
Prevention of opportunistic infections and transmission of HIV
What factors contribute to the management decisions in a patient with HIV?
Clinical assessment
Viral load
CD 4 count
What is the characteristic sign of acute PID?
Cervical motion tenderness
What are the symptoms of bacterial vaginosis?
Vaginal discharge
Fishy odour
Not itchy
What is the management of bacterial vaginosis?
Oral metronidazole or clindamycin
What are the symptoms of vaginal Candida?
Intense pruritus
Vulvovaginal erythema
Curd like discharge
What is the management of vaginal candida?
Topical clotrimazole
Oral fluconazole
What are the symptoms of trichomonas vaginalis?
Profuse, malodorous vaginal discharge
Post-coital bleeding
Vulvovaginal erythema
What is the management of trichomonas vaginalis?
Oral metronidazole
Is bacterial vaginosis sexually transmitted?
No
Is trichomonas vaginalis sexually transmitted?
Yes
What virus causes genital warts?
Human papilloma virus
Which type of herpes simplex is the commonest cause of genital herpes?
Type 2
What is the management of genital herpes?
Oral aciclovir
What organism causes syphilis?
Treponema pallidum
What is the management of syphilis?
IM benzathine penicillin
What are the risk factors for PID?
Multiple sexual partners Frequent vaginal douching IUD insertion Previous PID No contraception
How many sperm per ml should be present?
15 million
What percentage of sperm should demonstrate normal motility for a normal analysis?
50%
What percentage of sperm need to have a normal form for a normal analysis?
At least 4%
