GUM / HIV Flashcards
Ix for Chlamydia in Men
NAATs of first pass urine sample
Chlamydia - how long should an individual not have sex?
7d after starting Abx
What is chlamydia Mx in pregnancy?
PO azithromycin (doxycycline is CI)
How long does it take to for a Chlamydia / Gonorrhoea / HIV / Syphilis / Hep B test to be positive?
Gonorrhoea - 1 week Chlamydia - 2 weeks HIV - 6 weeks Hep B - 3 months Syphilis - 3 months
Describe the organism that causes syphilis.
Treponema Pallidum - spiral shaped
What is the classification of ‘Early Latent’ syphilis? How many Latent progress to Tertiary syphilis?
Acquired syphilis in last 2 years.
33% progress to Tertiary Syphilis
Which single antibody needs to fall by 4-fold to diagnose treated syphilis?
RPR
Ix for genital herpes
PCR of swab (NOT culture)
Describe genital herpes rash
Vesicular, painful, multiple ulcers
Which condition can spread by skin to skin contact (e.g. can spread even with condom)
Genital warts (HPV)
Ix for bacterial vaginosis
None - clinical diagnosis. Most of us have candida on skin so swab + culture is not useful
Which discharge has a pH >4.5?
Bacterial vaginosis
Trichomonas
How is trichomonas spread?
STI - partners need treating
Sx of lichen sclerosis
White plaques which are ITCHY
Sx of molluscum contagiosum
ITCHY plaques with central bump, after trauma, not painful
What type of organism is pneumocystis jiroveci?
Fungus
How do you manage a pneumocystis jiroveci which is a first presentation of HIV?
Co-trimoxazole now
Wait 2 weeks before starting CART
Why and when are steroids used in pneumocystis jiroveci?
Steroids used if pO2 < 9.3.
Steroids reduce the need for mechanical ventilation, which is risky as it can lead to pneumothorax (HIV lungs are very delicate)
How do you manage a tuberculosis which is a first presentation of HIV?
Wait 2 months before starting CART
(if CD4<50, then wait 2 weeks)
(if CNS TB, wait longer)
What are Sx of cryptococcal meningitis?
Non specific - fever, headache, confusion
There’s poor inflammatory response in immunocompromised, so normal meningitis Sx (neck stiffness, photophobia) won’t be seen
Ix in cryptococcal meningitis?
CT scan > LP
Even if neurological exam is normal, can’t rule out SOL as it doesn’t always present with Sx in immunocompromised patients. Hence we always do CT in HIV patients before LP
What does cryptococcal meningitis appear as on LP?
Cryptococcus is invisible!
Which organism causes Progressive Multifocal Leukoencephalopathy?
JC virus
Ix for Progressive Multifocal Leukoencephalopathy
- MRI to view demyelination
2. LP for PCR fo JC virus
When should you give CART in cryptococcal meningitis
DON’T GIVE CART, PATIENT WILL DIE IN 10 MINUTES
Mx of Progressive Multifocal Leukoencephalopathy?
Begin CART
What are complications of Kaposi Sarcoma?
Pulmonary KS - life threatening
Oral KS
What do you do after 2w of toxoplasmosis treatment if minimal response?
Assume its primary CNS lymphoma
What is primary CNS lymphoma and how is it different to NHL?
Its NHL limited to brain
CT signs for toxoplasmosis vs. Primary CNS lymphoma
Toxoplasmosis - multiple ring lesions
Primary CNS - single homogenous lesion
Both have mass effect
