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REGUB > L23: Sexually Transmitted Infections > Flashcards

L23: Sexually Transmitted Infections Flashcards

1
Q

List the 4 stages of syphilis

A
  1. Primary
  2. Secondary
  3. Latent (early or late)
  4. Tertiary
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2
Q

What is the incubation period of syphilis?

A

3 to 90 days

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3
Q

What is the typical presentation of primary syphilis?

A
  • chancre (painless ulcer) @ site of inoculation typically

- regional lymphadenopathy

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4
Q

What is the typical presentation of secondary syphilis?

A
  • multisystem illness
  • occurs 2-12 weeks after primary
  • lymphadenopathy
  • skin lesions/rashes
  • sore throat
  • fever
  • condyloma lata (flat growths)
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5
Q

What time frame is considered EARLY latent syphilis?

A

less than 2 years since infection

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6
Q

What time frame is considered LATE latent syphilis?

A

more than 2 years since infection

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7
Q

What are some of the possible presentations of tertiary syphilis?

A
  • aortitis
  • meningitis
  • spinal cord lesions
  • neuropsychiatric lesions
  • gummatous syphilis
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8
Q

How is congential syphilis acquired?

A

occurs in neonates via transplacental transmission

– mother usually has untreated primary/secondary syphilis

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9
Q

What time frame is considered early congenital syphilis?

A

evident less than 2 years of age

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10
Q

What time frame is considered late congenital syphilis?

A

evident greater than 2 years of age

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11
Q

What are the symptoms of early congenital syphilis?

A
  • hepatomegaly
  • rhinitis
  • rash
  • lymphadenopathy
  • skeletal abnormalities
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12
Q

What are the symptoms of late congenital syphilis?

A
  • facial features
  • keratitis
  • hearing loss
  • Hutchinson teeth
  • bowing of the shins
  • intellectual disabilities
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13
Q

What is the mainstay investigation for diagnosis of syphilis?

A

Serology (specific and non-specific tests)

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14
Q

What investigation/test will be done if a neurosyphilis is suspected?

A

Serology of CSF

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15
Q

What is the treatment for early syphilis?

A

1 dose of IM penicillin

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16
Q

What is the treatment for late syphilis?

A

1 weekly dose of IM penicillin for 3 weeks

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17
Q

What is the treatment for neurosyphilis?

A

IV/IM penicillin for 10-14 days

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18
Q

If a patient with syphilis is allergic to penicillin, what antibiotic may be given?

A

doxycycline

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19
Q

What is the Jarisch Herxheimer reaction? What is it associated with?

A

the reaction occurs within 24 hours of antibiotic treatment of spirochete infections, including syphilis

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20
Q

What is the typical presentation of neisseria gonorrhea infection in a male?

A
  • mostly asymptomatic
  • urethritis (dysuria, purulent discharge, increased frequency)
  • epididymitis
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21
Q

What is the typical presentation of a neisseria gonorrhea infection in a female?

A
  • mostly asymptomatic
  • cervicitis (discharge, pain w/ sex, asymptomatic)
  • pelvic inflammatory disease (PID) - abdominal pain, infertility
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22
Q

What is the typical presentation of a neisseria gonorrhea infection in a neonate that acquired it from their mother?

A

opthalmia neonatorum (muculent discharge from eyes)

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23
Q

What is the mainstay test for diagnosing a neisseria gonorrhea infection?

A

NAAT - nucleic acid amplification testing [from swabs of the affected areas]

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24
Q

How does neisseria gonorrhea present on a gram stain?

A

gram negative

intracellular diplococci

25
Q

What type of agar plate does neisseria gonorrhea grow on?

A

NYC agar

26
Q

What is the principal treatment of neisseria gonorrhea? What is given if the patient has a beta-lactam allergy?

A

1 dose of IM Ceftriaxone

Alternatives:
Spectimonycin*
Azithromycin (need susceptibility)
Ciprofloxacin (need susceptibility)

27
Q

What do chlamydia trachomatis serovars D - K cause?

A

genital infection

28
Q

What do chlamydia trachomatis serovars A - C cause?

A

trachoma of the eye

29
Q

What is trachoma of the eye?

A

roughening of the surface of the inner eyelids - leads to pain and eventual blindness

30
Q

What do chlamydia trachomatis serovars L1 - L3 cause?

A

lymphogranula venereum

31
Q

What are the symptoms of chlamydia trachomatis serovars D - K in females?

A

cervicitis (discharge, post-coital bleeding)

urethritis (dysuria, increased frequency)

pelvic inflammatory disease (abdominal or pelvic pain)

complications of pregnancy (PROM, pre-term delivery, transmission to baby)

32
Q

What is PROM? What is it a complication of?

A

premature rupture of membrane

– complication of chlamydia trachomatis serovars D - K

33
Q

What are the symptoms of chlamydia trachomatis serovars D - K in males?

A

urethritis (urethral discharge, dysuria)

acute epididymitis (unilateral testicular pain, tenderness, hydrocele, palpable swelling of epididymis)

proctitis (inflammation of rectum)

34
Q

What is inflammation of the proctitis?

A

inflammation of the lining of the rectum

35
Q

What is the mainstay test for diagnosing a chlamydia trachomatis infection?

A

NAAT (nucleic acid amplification testing) of swabs of infected areas

36
Q

What is the treatment of chlamydia trachomatis serovars D - K?

A

macrolide or doxycycline

37
Q

What is the treatment for chlamydia trachomatis serovars L1 - L3? What is the duration?

A

doxycycline for 21 days

38
Q

What is trichomoniasis?

A

a STI caused by the trichomonas vaginalis parasite

39
Q

What are the clinical features of trichomoniasis in females?

A
  • vaginal discharge
  • vulval itching
  • dysuria
  • associated with PROM and low birth weight
40
Q

What are the clinical features of trichomoniasis in males?

A
  • most asymptomatic

- urethritis

41
Q

What is the mainstay test for diagnosing a trichomoniasis infection?

A

NAAT (of vulvovaginal swab)

42
Q

What are the possible treatment options for trichomoniasis? [3]

A
  1. Metronidazole 2g stat
  2. Metronidazole 400mg BD [5 to 7 days]
  3. Tinidazole
43
Q

What is a chancroid? What is it caused by?

A

bacterial sexually transmitted disease caused by infection with Haemophilus ducreyi

44
Q

What is adenitis?

A

inflammation of a lymph gland

45
Q

What is the presentation of chancroid?

A
  • ulcer
  • inguinal lymphadenopathy
  • suppuration and adenitis
46
Q

What are the possible treatment options for chancroid? [2]

A
  1. Aspiration

2. Antibiotics (azithromycin, ceftriaxone, ciprofloxacin, erythromycin)

47
Q

What are the 4 possible antibiotics that may be given to treat chancroid?

A

Azithromycin
Ceftriaxone
Ciprofloxacin
Erythromycin

48
Q

Which viruses causes genital herpes?

A

Herpes Simplex Virus 1 or 2

49
Q

How does a primary infection of HSV 1 or HSV 2 typically present?

A
  • cold sores
  • fever
  • malaise
  • myalgia
  • inguinal adenitis

*more severe in females

50
Q

A HSV 1 or 2 infection can remain latent in which structure?

A

sacral nerve root ganglia

51
Q

Neonatal herpes simplex virus is mainly caused by which virus?

A

HSV 2

52
Q

What is the mainstay diagnostic test for genital herpes?

A

PCR on vesicular fluid

53
Q

What is the mainstay diagnostic test for herpes simplex encephalitis?

A

PCR on CSF

54
Q

What is the mainstay diagnostic test for neonatal HSV?

A
  • PCR of CSF and blood

- surface swabs for culture

55
Q

Which antivirals may be used for the treatment of a herpes simplex infection?

A

aciclovir
valaciclovir
famciclovir

56
Q

What virus is genital warts caused by? (general)

A

human papilloma virus (HPV)

57
Q

What is the most common type of HPV which causes genital warts?

A

HPV 6

58
Q

What are the treatment options for genital warts?

A
  1. Destruction:
    - Podophyllotoxin
    - Trichloroacetic Acid
  2. Immunologic Therapy:
    - Imiquimod
  3. Surgical Therapy:
    - Excision
    - cryotherapy/laser therapy
59
Q

What are the risk factors for HIV?

A
  • sexual contact
  • vertical transmission
  • contaminated needles
  • blood transfusion
  • tissue/organ donation
  • occupational exposure (e.g. sharps injuries)

REGUB (22 decks)

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