L10 - STIs Flashcards
RISK GROUPS FOR STIS
i) who can get an STI?
ii) name six factors that increase a persons risk of dev an STI
iii) living in what type of area may increase risk of STIs? (2)
i) anyone
ii) young age (<20yrs), frequent partner change, sexual orientation, ethnicity, use of non barrier contraception
iii) inner city or deprived areas
STIs IN YOUNG PEOPLE
i) what is early age at first intercourse associated with?
ii) give five behavioural factors that make young people more vulnerable to STI acquisition?
iii) what is sexual competence?
iv) what age group have the highest rate of new STI diagnoses per year?
v) give four vulnerabilities assoc with early intercourse
i) early age at first intercourse assoc wih poor subsequent sexual health
ii) higher numbers of sexual partners, more concurrent partners, yet to develop skills around condoms/safe sex, more risk taking behaviour, poor contraception awareness
iii) sexual competence - younger you are at first intercourse the less competent you are to negotiate all the above factors
iv) 20-24yrs
v) leaving home/not living with parents before 16yrs, leaving school early, family disrup/disadv, lack of nuturing relationships, main source of sexual info not school or parents
PORN
i) what % of teenagers view porn regularly?
ii) give four negative aspects of porn
i) 58%
ii) unrealistic, lack of boundaries, ethical issues eg exploitation of women, lack of condom use
SEXUAL ORIENTATION
i) what type of STIs are gay/bisexual men more likely to be diagnosed with compared to other men? what further increases this risk?
ii) which two STIs are diagnosed majority in MSM?
iii) when does the gonnorea peak span in men? which group are most responsible for this?
iv) which STI is much more prevalent in men than women?
i) bacterial STIs - increased risk if HIV positive
ii) gonnorhoea and syphylis
iii) gonnorhea peaks in 30-40s - mostly responsible are GBM
iv) syphyllis is much more prevalent in men than women
ETHNICITY
i) which three groups have higher rates of chlamidya, gonnorhea and trichomoniasis?
ii) what is a core group? give four characterstics of a core group
iii) what is needed in relation to core groups?
i) black african, black carribean and black other
ii) core group = more at risk subgroup of the population w high turnover
- highly sexual individuals, high prevalence of infec, reservoirs of infec, high freq of transmission
iii) control at a population level - screen and treat
FEMALE GENITAL EXAM
i) label A-M
ii) what is used as a lubricant in a speculum exam?
iii) which area is palpated first?
iv) when may a bimanual examination be indicated?
i) A - mons pubis, B - clitoral hood, C - clitoris, D - vestibule,
E - anus, F - labia majoraa, G - labia menora, H - urethral opening, I - hymen, J - vagina, K - bartholins gland, L - post fourchette, M - perineum
ii) use water
iii) palpate inguinal region then inspect skin folds
iv) pelvic pain
MALE GENITAL EXAMINATION
i) which area is inspected first? then which area?
ii) how should testes feel? what would be felt if they were abnormal?
iii) which three areas should be carefully inspected as pre dispose to warts?
iv) label diagram
i) first inspect pubic area/inguinal region then scrotum/perianal
ii) testes should feel smooth egg shape
- abnormal = small gritty lumps
iii) carefully inspect coronal sulcus, frenulum and meatus
iv) S - shaft, F - foreskin, COS - coronal sulcus, G - glans penis, M - meatus, FR - frenulum, GC - glans corona
GENITAL PRESENTATION
i) are pearly penile papules pathological?
ii) which spots may be found on the foreskin and are a normal skin struc?
iii) which glands may be enlarged aand look like warts?
iv) name two other conditions presenting with genital signs
v) which fungal infection can arise in sweaty skin folds?
i) no
ii) fordyce spots
iii) sebaceous glands
iv) malignant melanoma and psoriasis
v) tinea cruris
BACTERIAL VS VIRAL STIS
i) name three bacterial STIs and one protazoal
ii) give five characteristics of bacterial/protazoal
iii) name four viral STIs
iv) give five characteristics of viral
i) bacterial - chlamidya, gonnorhea and syphylis
protazoa - TV
ii) florid (red), early presentation, rapid dx, effective/curative treatment, reservoirs can be controlled
iii) herpes, warts, HIV, hepatitis
iv) many unaware of infection, delayed dx, diagnostic tests can be unreliable, symptomatic tx only, life long, expanding reservoirs
CHLAMIDYA/GONNORHEA
i) give two symptoms of gonnorhea/chlamidya?
ii) what is seen on gram staining of gonnorhea?
i) profuse purulent discharge and dysuria
ii) gram negative diplococci
SYPHILIS
i) how can primary syphylis present? are there more signs or more symptoms?
ii) what organism causes it? how long does it take to heal without treatment?
iii) which two main areas does secondary syphylis present on? what is this due to?
iv) give four accompanying signs/symptoms of secondary syphylis?
v) what can it progress to if not treated?
i) presents with big painless ulcers
- lots of signs, not many symptoms
ii) caused by spirochetes
- can heal in 1-3 weeks without tx
iii) secondary syphilis presents on palms and soles of feet (so does HIV)
- due to systemic dissemination of spirochete
iv) flu like illness, mouth ulcers (snail track), condylomata lata (white grey lumps in moist areas), arthritis
v) can progress to tertiary syphilis
TRICHOMONAS VAGINALIS
i) what is the caustive organism?
ii) give two key signs strongly suggestive of TV
iii) what is seen in microscopy?
iv) which treatment does it respond well to
i) single cell protazoa parasite
ii) frothy discharge and strawberry cervix
iii) motile organism
iv) responds well to metronidazole
GENITAL WARTS
i) are they common?
ii) which two types of HPV cause warts?
iii) what effect has administering HPV vaccine to women had on a) heterosexual men b) MSM
i) yes
ii) 6 and 11 cause 90% cases
iii) giving women HPV vaccine has also caused decrease in heterosexual men but MSM has remained constant
MOLLUSCUM CONTAGIOSUM
i) what is it?
ii) which group of people is it common in?
iii) what test may need to be done if it is widespread espec above neck?
i) small spots on skin
ii) children (not STI)
iii) HIV test - suggests immunocompromised
HERPES SIMPLEX TYPE 1 AND 2
i) how does it enter the body? then where does it travel? where does it reside?
ii) what is the most common symptom? what does this cause?
iii) what three things may be seen in prodome (before onset of skin symptoms)? what can be taken to prevent tthe virus at this point?
iv) what is an early sign? what is a later sign? give another sign
v) when are severe systemic symptoms more common? give two examples
vi) after how many days does it usually heal?
vii) which type causes cold sores?
i) enters body through skin then travels along nerves to reside latent in the nerve root ganglia
ii) most common symptom is blistering/ulceration which causes dysuria
iii) prodrome > pain, pins and needles, paraesthesia
- can take high dose aciclovir to clear the virus
iv) blistering is early sign and ulceration is seen later
- also see painful inguinal lymphadenopathy
v) systemic symptoms more common in first occurence eg fever and myalgia
vi) usually heals in 5-14 days
vii) type I causes cold sores
