Infections Lecture 9: Sexually Transmitted Infections

Question 1

What are sexually transmitted diseases caused by bacteria

Answer 1

Chlamydia

Gonorrhoea

Syphalis

Question 2

What are sexually transmitted diseases caused by viruses

Answer 2

HIV

Hepatitis B/C

Herpes

Warts

Question 3

What are sexually transmitted diseases caused by parasites

Answer 3

Lice

trichiomoniaisis

Question 4

Describe the bacteria that causes chlamydia, the symptoms and how do you diagnose it

Answer 4

Chlamydia Trachomatis

Symptoms:
Often asymptomatic
Similar to gonorrhoea
Pain and burning on urination (discharge)

Diagnosis: DNA testing NAAT or ELISA

Question 5

How do you treat chlamydia that is an uncomplicated genital infection

Answer 5

Azithromycin single dose

Doxycycline for 7 days

Erythromycin for 14 days

Question 6

What are the complications that may arise from chlamydia and how do you treat it

Answer 6

Increased risk of contracting HIV

Development of pelvic inflammatory disease and infertility
- Doxycycline and metronidazole

Question 7

Describe the bacteria that causes gonorrhoea, transmission, and diagnosis how do you diagnose it

Answer 7

Neisseria Gonnorhoeae

Transmission: vaginal, anal or oral sex (childbirth)

Symptoms:
NAAT

Question 8

What are the symptoms of it gonorrhoea

Answer 8

Many are asymptomatic and similar to chlamydia
Dysuria
Watery, yellow or green vaginal discharge
White yellow, green penile discharge
Abdomen pain during or after sex
Bleeding in men

Question 9

How do you treat uncomplicated genital infection of gonorrhoea

Answer 9

Azithromycin: 1g orally and Ceftriaxone 500mg both as single dose

Question 10

What are the complications that can develop from gonorrhoea

Answer 10

Disseminates can be life threatening:
(gonococcal meningitis)

Need admitting and higher dose

I/M or I/V cephalosporins for a week

lead to pelvic inflammatory disease

Question 11

What causes pelvic inflammatory disease, transmission and risk factors

Answer 11

bacteria from vagina and cervix spreading to pelvic

Usually gonorrhoea, chlamydia can be multiple

Transmission: STIs, multiple sexual partners
bacterial vaginosis: increases risk

Question 12

What are symptoms of pelvic inflammatory disease

Answer 12

Asymptomatic
Lower abdominal pain
Fever
Vaginal discharge 
Painful urination and/or sex
Irregular bleeding in menstruation

Question 13

How do you diagnose pelvic inflammatory disease

Answer 13

Pelvic Exam

Laparoscopy

PUS in fallopian tubes

CT and others

Microbial analysis to detect pathogens

Question 14

How do you treat uncomplicated genital infection of pelvic inflammatory disease

Answer 14

Culture for gonorrhoea and chlamydia

Treat with METRONIDAZOLE and ofloxacin

Gonorrhoea:
Metronidazole, Doxycycline and ceftriaxone (i/m)

Question 15

What are the complications that may arise from pelvic inflammatory disease

Answer 15

Scarring leads to infertility

Ectopic pregnancy

Chronic pelvic pain

Abcesses

Question 16

What is the cause of syphillus and symptoms

Answer 16

Treponema Pallidum

Symptoms:
Asymptomatic

Primary- early in infection (painless sores)

Secondary- hair loss and flu like symptoms

Tertiary- paralysis, blindness, other conditions

Question 17

What are the treatment options of syphilis

Answer 17

Single dose of benzathine benzylpenicillin i/m

Alternative: doxycycline or erthyromycin

Question 18

What are the causes of genital warts and the symptoms

Answer 18

Human papiolla virus (HPV)
HPV 6-11

By examination of warts
DNA test to see what HPV type it is

Question 19

How do you treat genital warts

Answer 19

Many cleared by immune system

Creams and freezing

Vaccines 
Cervarix (HPV 16 and 18 for cervical cancer) 

Gardasil (HPV 16, 18 and 6, 11)

Question 20

What are the causes of genital herpes

Answer 20

HSV usually HSV-2 (human papiolla virus)

HSV-1 causes cold sores, oral herpes

Question 21

How do you treat genital herpes

Answer 21

Acyclovir
Valaciclovir
Famciclovir

Question 22

What causes hepatitis B, symptoms and diagnosis

Answer 22

HBV, orthohepadnavirus

Symptoms:
Nausea 
vomiting 
Loss of appetite
Flu like symptoms
Jaundice- asymptomatic

Diagnosis: blood test

Question 23

How do you treat hepatitis B

Answer 23

Entecavir
Adefovir
Tenofovir

Question 24

What causes hepatitis C, how is it transmitted, diagnosed and symptoms

Answer 24

HCV- hepatitis C virus

Transmitted: IV drug use, STI

Diagnosis: ELISA or PCR blood testing

Symptoms:
Often asymptomatic
Fatigue, nausea, decrease appetite, weight loss, muscle and joint pain

Question 25

How do you treat hepatitis C

Answer 25

IFNalpha and ribavirin

Question 26

how do you treat the majority of strains of HCV

Answer 26

daclatasvir + sofosbuvir and ribavirin

either one of the first two

Question 27

What causes trichomoniasis and its symptoms

Answer 27

Trichomonas Vaginalis

Women: 
Vaginal discharge
thick, thin, frothy yellow green
FISHY smell
Soreness, itchiness, swelling
tummy pain, discomfort on urination or sex

Men: 
Thin, white discharge
Pain on urination or ejaculation
Increased frequency
Soreness, redness, swelling

Question 28

How do you diagnose and treat trichomoniasis

Answer 28

Diagnosis:
Examination, testing of vaginal swab or urine (men)

Treatment:
Metronidazole:
200mg THREE times a day for 7 days
400-500mg TWICE daily for 5-7 days

Question 29

How do you treat pubic lice

Answer 29

Permethrin