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PMP-201 > Infections - STIs > Flashcards

Infections - STIs Flashcards

1
Q

How can STis occur?

A

skin on skin contact or exchange of bodily fluids during insertive vaginal or anal sex

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2
Q

Epidemiology - Chlamydia + gonorrhoea

A

most common worldwide
rate at its highest 15-19 and 20-24

gonorrhoea is the second most common bacteria sexually TI

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3
Q

Epidemiology - Syphilis + Herpes simplex

A

Syphilis - ^ in recent years

Herpes; 6% of all diagnosed STIs

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4
Q

Uncomplicated Genital Chlamydia

A

causes inflammation of urethra in men and cervis/ urethra in women

asymptomatic in - 70% women
50% - men

Trachomatis - cause

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5
Q

What is the assessment for chlamydia?

A

samples for nucleic acid amplifications tests (NAATs)

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6
Q

Chlamydia test WOMAN

A

a vulvo-vaginal or endocervical swab

first urine sample can be collected

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7
Q

Chlamydia test MEN

A

A FCU specimen of choice
urethral swab is an alt.

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8
Q

Symptoms of chlamydia in women

A

heavier periods

abdomen/ pelvic pain

vaginal discharge

irregular periods

bleeding between periods

pain during urination

pain and bleeding during and after sex

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9
Q

Symptoms of chlamydia MEN

A

pain during urination

pain in testicles

swelling in testicles

swelling of testicles

burning or itching of urethra

white/ watery or cloudy discharge from penis

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10
Q

Tests for chlamydia are recommended if a sexually active person has the following symptoms and signs

A

In women: post-coital or intermenstrual bleeding, increased or purulent vaginal discharge, mucopurulent cervical discharge, deep dyspareunia, dysuria, pelvic pain and tenderness, an inflamed or friable cervix.

In men: dysuria, urethral discharge, urethral discomfort, epididymo-orchitis or reactive arthritis

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11
Q

Complications of chlamydia LEAD TO&raquo_space;>

A

Pelvic inflammatory disease (PID)
Epididymo-orchitis
Lymphogranuloma venereum (LGV)
Sexually acquired reactive arthritis (SARA)
Perihepatitis
Adverse outcome in pregnancy
Conjunctivitis
Anxiety and psychological distress

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12
Q

How should I manage a person with suspected or confirmed chlamydia?

A

confirmed > refer to genito-urinary medicine (GUM) clinic > manage in GUM clinic ( if poss) / manage in primary care (not poss) > offer written info, advice to treat partner, treat, investigations, arrange follow up, refer if poss

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13
Q

Management of chlamydia: non-pregnant adults and children over age of 13 years:

A

1st line: doxycycline 100mg bd for 7 days

if contraindicated or not tolerated = azithromycin 1g orally as a single dose fro 1 day > 500mg orally OD for 2 days

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14
Q

Managment for pregnant women

A

Azithromycin, 1g orally for 1 day > 500mg orally OD for 2 days

Erythromycin 500mg qds daily for 7 days or erythromycin 500mg bd for 14 days

or

amoxicillin 500mng tds for 7 days

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15
Q

Gonorrhoea - cause?

A

Gram- negative neisseria gonorrhoeae

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16
Q

What does gonorrhoea affect?

A

mucous membranes of urethra, endocervix, rectum, pharynx and conjunctiva

17
Q

How is gonorrhoea transmitted?

A

direct inculation of secretions from one mucous membrane to another

infection of eye most commonoly results from autoinoculation

Gonococcol infection among infants > exposure to infected cervical exudates at birth

18
Q

Symptoms of gonorrhoea WOMEN

A

vaginal discharge

burning/painful urination

bleeding between periods

19
Q

Symptoms of gonorrhoea MEN

A

penile discharge

burning urination

testicular swelling

20
Q

Assessment of gonorrhoea:

A

nucleic acid amplification tests (NAATs) or by culture

21
Q

What specimens get tested fro culture = gonorrhoea?

A

urethral, endocervical, neovaginal, anorectal and phatyngeal swabs

22
Q

How should I manage a person with suspected gonorrhoea?

A

confirm > refer to GUM > (if poss) manage in GUM clinic / (not poss) manage in primary care > prescribe AB, screening for other STIs and HIV, patient-led partner notification, info, follow up

23
Q

Antibiotic choices for the treatment of gonorrhoea:
uncomplicated

A

antimicrobial susceptibility KNOWN:
cipofloxacin 500mg orally as single do

antimicrobial susceptibility UNKNOWN: Caftriaxone 1g intramuscular (IM) injection as a single dose

24
Q

Antibiotic choices for the treatment of gonorrhoea: people with allergy/ needle phobia or comntraindications:

A

Gentamicin 240mg Im as single dose plus azithromycin 2g orally

OR
cefixime 400mg orally as single dose plus azithromycin 2g orally

25
Q

Antibiotic choices for the treatment of gonorrhoea: people with penicillin allergy

A

cefriaxone and cefixime suitabkle treatment options unless history of hypersensitivity e.g. to a beta-lactam antibacterial agent

26
Q

Antibiotic choices for the treatment of gonorrhoea: pregnant or breastfeeding

A

ceftriaxone 1g Im injection as a single dose

azithromycin 2g as single oral dose

DO NOT prescribe CRIPOFLOXACIN

27
Q

Prognosis
- gonorrhoea

A

most solve spontaneously

28
Q

Complications of untreated gonorrhoea

A

men ; epididymo-orchitis, prostatitis, infertility, urethral structure, infection of mullerian or cowper glands

women ; PID, pregnancy complications

29
Q

Syphilis - caused by:

A

spirochete bacterium Treponema pallidum

30
Q

Untreated syphilis: persist for years > what stages?

A

early syphilis; 3 stages
primary, secondary and early latent syphilis

Late syphilis; 2 stages
Late latent syphilis and tertiary syphilis

31
Q

Complications syphilis:

A

Neurosyphilis
Cardiovascular syphilis
Gummatous syphilis
Adverse outcomes in pregnancy.
Facilitation of HIV transmission.

32
Q

symptoms of syphilis:

A

chancres (sores)

hair loss

swollen lymph nodes

sore throat

rash

33
Q

Assessment
of syphilis

A

suspect if:
Genital lesion(s) - Chancre
Associated regional lymphadenopathy
A non-pruritic maculopapular rash
Moist wart-like lesions (condylomata lata)
Patchy lesions on the oral mucosa (‘snail tract’ lesions).
Generalized lymphadenopathy.
Unexplained neurological or ophthalmological symptoms.

34
Q

How should I manage a person with suspected syphilis?

A

confirm > refer to GUM > (poss) manage in GUM clinic / (not poss) primary care > explain conditions + risk factors, discuss prevention, discuss GUM and screening for other STIs

35
Q

syphillis treatment with Benzathine benzylpenicillin: LATE stage (latent seropositive)

A

2.4 million units once weekly for 3 weeks

35
Q

syphilis Treatment with Benzathine benzylpenicillin
adult - PRIMARY / SECONDARY STAGE

A

2.4 million units as single dose

36
Q

how to prevent syphilis?

A

use condom
complete treatment if you and your partner have it

do not share sex toys
do not share needles if you inject drugs

37
Q

MCQ: When untreated, whichONEof the following sexually transmitted infections (STIs) can cause neurological damage, blindness and cardiovascular disease?

A

Chlamydia

38
Q

MCQ: Destie is a 32 year-old pregnant woman. She underwent screening for STIs but she has no symptoms of infection. However, her first pass urine is positive for Chlamydia trachomatis on NAAT. Which of these treatment options would you recommend?

A

Azithromycin, 1 g orally for 1 day, then 500 mg orally once daily for 2 days

PMP-201 (34 decks)

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