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Medicine > (ID)- STIs > Flashcards

(ID)- STIs Flashcards

1
Q

What is chancroid?

A

Infection of genital skin caused by Haemophilus ducreyi

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2
Q

How does chancroid present?

A

Painful and potentially necrotic genital lesion which can bleed on contact

Associated with painful lymphadenopathy (bubo) which can rupture and discharge pus

4-10 days after exposure to bacterium

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3
Q

How is chancroid diagnosed?

A

Culture (often difficult and time-consuming)
PCR (can be performed on genital ulcer specimens)

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4
Q

Where are people affected by chancroid?

A

Tropical and subtropical regions
Poor living conditions
Sexual behaviour

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5
Q

What are some differential diagnoses for chancroid?

A

Herpes Simplex Virus
- Multiple, small, vesicular lesions that become ulcers
- Systemic symptoms

Syphilis
- Painless ulcer (chancre)
- Generalised non-tender lymphadenopathy

Lympogranuloma Venerum
- Small painless ulcer or papule
- Followed by painful inguinal lymphadenopathy (bubo)

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6
Q

How is chancroid managed?

A

Ceftriaxone
Azithromycin
Ciprofloxacin

Analgeisa
Incision and drainage of buboes

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7
Q

What causes chlamydia?

A

Chlamyida trachomatis

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8
Q

Who is affected by chlamydia?

A

Most common bacterial STI
Young adults between 15-24

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9
Q

How does chlamydia present?

A

Urethral discharge
Dysuria in men
Intermenstrual bleeding
Vaginal discharge
Anal infections may manifest as dicharge or anorectal discomfort

Many cases, especially infection remains asymptomatic

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10
Q

What can happen to neonates that are exposed to chlamydia during birth?

A

Pneumonia
Conjuctivitis

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11
Q

How is chlamydia diagnosed?

A

NAATs on vaginal swabs for women
Urine or urethral swabs on men

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12
Q

How is chlamydia treated?

A

7 day course of oral doxycycline

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13
Q

What are some differential diagnoses for chlamydia?

A

Gonorrhoea
- Asymptomatic
- Urethral discharge
- Dysuria
- Intermenstrual or postcoital bleeding
- Lower abdominal pain

Trichomoniasis
- Pruritis
- Dysuria
- Discharge in men and women

Genital herpes
- Painful vesicular lesions
- Dysuria
- Flu-like symptoms

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14
Q

What are some complications of chlamydia?

A

If left untreated

  • PID
  • Epididymitis
  • Reactive arthritis
  • Conjunctivitis and pneumonia in neonates
  • Increased risk of acquiring or transmitting HIV
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15
Q

What causes genital herpes?

A

HSV-1 and HSV-2

Clinically indistinguishable

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16
Q

How do patients present with genital herpes?

A

May be asymptomatic or
- Multiple painful genital ulcers
- Dysuria
- Discharge vaginal or urethral
- Crusting and healing of lesions
- Systemic symptoms

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17
Q

How is genital herpes diagnosed?

A

Swab from the base of the ulcer using NAATs

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18
Q

What are the differentials of herpes?

A

Syphillis
Chancroid
Lymphogranula venereum

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19
Q

What investigations are used for herpes?

A

Clinical history
Swab from ulcer base and NAATs

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20
Q

How is herpes treated?

A

5 days after symptom onset
Aciclovir
Valaciclovir
Aciclovir
Famciclovir

Topical lidocaine for symptom relief

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21
Q

How is herpes managed during pregnancy?

A

Referral to GUM clinic
Informing women that neonatals risk is low even with lesions present

Supportive treatment with saline bathing and paracetamol is sufficient

22
Q

What is vulvovaginal candidiasis?

A

Fungal infection caused by Candida Albicans

23
Q

How does vulvovaginal candidiasis present in women?

A

Itching
White curdy discharge
Burning sensation
Sour milk odour
Dyspareunia

24
Q

How does genital candidiasis present in men?

A

Soreness, pruritis, redness
Dry, red-glazed plaques and papules

25
Q

What are the risk factors for vulvovaginal candidiasis?

A

Pregnancy
Antibiotic use
Immunosuppression

26
Q

How is vulvovaginal candidasis investigated?

A

Only for unclear cases

Microscopy and culture

27
Q

How is vulvovaginal candidiasis managed?

A

Oral
Fluconazol
Itraconazole

Intravaginal
Clotrimazole pessary

Vulval
Topical clotrimazol cream

28
Q

What causes genital warts?

A

HPV 6 and HPV 11

29
Q

How do genital warts present?

A

Painless
Keratinised or non-keratinised in areas that undergo trauma during sex

30
Q

How are genital warts diagnosed?

A

Clinical diagnosis

Biopsy may be performed in some cases

31
Q

How are genital warts managed?

A

Podophyllotoxin - antiviral that destroys wart tissue

Cryotherapy
Trichloroacetic acid

High likelihood of recurrence after treatment

32
Q

What is molluscum contagiosum?

A

Viral skin infection caused by Molloscum Contagiosum virus

33
Q

How does molluscum contagiosum present?

A

Small pearly papules
Central umbilication

Can occur anywhere, commonly on genitals

34
Q

How is molluscum contagiosum diagnosed?

A

Visual inspection
Full STI screen advised

35
Q

How is molluscum contagiosum managed?

A

Resolves spontaneously in 18 months

Cryotherapy

36
Q

What causes gonorrhoea?

A

Neisseria gonorrhoeae

37
Q

What are the symptoms of gonorrhoea?

A

Genital discharge
Dysuria
Tender inguinal nodes in men
Abnormal bleeding in women

Extragenital complications
Pharyngitis
Rectal pain and discharged
Disseminated infection

38
Q

How is gonorrhoea disagnosed?

A

NAAT with culture

Presence of monomorphic gram-negative diplococci with polymorphonuclear leukocytes

39
Q

How is gonorrhoea treated?

A

Ceftriaxone

40
Q

What can gonorrhoea lead to if untreated?

A

Infertility due to PID
Infertility due to epididymitis
Increased susceptibility to HIV

41
Q

What causes syphilis?

A

Treponema pallidum

42
Q

How is syphilis transmitted?

A

Direct contact with syphilis sores of rash during sex

Vertical transmission

43
Q

What are the signs of primary syphilis?

A

Single painless lesion (Chancre), round with indurated bases heals in 3-8 weeks

44
Q

What are the signs of secondary syphilis?

A

Symmetrical maculopapular rash, involving palms, soles and face

4-10weeks after primary infection

Some patients may get hepatitis, glomerulonephritis and neurological complications

45
Q

What are the signs of tertiary syphilis?

A

20-40 years after primary infection in untreated patients

Gummatous disease
CV complications
Neurological complications

46
Q

What are the signs of congenital syphilis?

A

Rash on palms/soles of feet
Mucuous patches/lesions in mouth/nose/genitals
Hepatosplenomegaly
Saber shins
Seizures
Developmental delay

47
Q

How is syphilis investigated?

A

Serological testing
Dark-field microscopy
CSF examination (tertiary syphilis for CNS involvement)

48
Q

How is syphilis managed?

A

Primary, secondary and early latent
IM penicilin G (benzylpenicillin)

Tertiary and late latent
IM penicillin G for 2-3 weeks

Neurosyphilis
IV penicillin G for 10-14 days
Doxycyclin if allergic

49
Q

What is trichomoniasis?

A

STI caused by flagellated protozoan Trichomonas vaginalis

50
Q

What are the signs and symptoms of trichomoniasis?

A

Profuse, frothy yellow vaginal discharge
Vulval irritation
Dyspareunia in women
Urethritis in men
Strawberry cerix

51
Q

What investigations are used to confirm trichomoniasis?

A

Microscopy and culture of causative organism

52
Q

What is the management of trichomoniasis?

A

Oral mentronidazole 5-7 weeks
Abstrain from sexual activity for at least 1 week or until patient and partners have completed treatment
Screening
Contact tracing

Medicine (111 decks)

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