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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
What type of agar plate does neisseria gonorrhea grow on?
NYC agar
26
What is the principal treatment of neisseria gonorrhea? What is given if the patient has a beta-lactam allergy?
1 dose of IM Ceftriaxone Alternatives: Spectimonycin* Azithromycin (need susceptibility) Ciprofloxacin (need susceptibility)
27
What do chlamydia trachomatis serovars D - K cause?
genital infection
28
What do chlamydia trachomatis serovars A - C cause?
trachoma of the eye
29
What is trachoma of the eye?
roughening of the surface of the inner eyelids - leads to pain and eventual blindness
30
What do chlamydia trachomatis serovars L1 - L3 cause?
lymphogranula venereum
31
What are the symptoms of chlamydia trachomatis serovars D - K in females?
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
What is PROM? What is it a complication of?
premature rupture of membrane | -- complication of chlamydia trachomatis serovars D - K
33
What are the symptoms of chlamydia trachomatis serovars D - K in males?
urethritis (urethral discharge, dysuria) acute epididymitis (unilateral testicular pain, tenderness, hydrocele, palpable swelling of epididymis) proctitis (inflammation of rectum)
34
What is inflammation of the proctitis?
inflammation of the lining of the rectum
35
What is the mainstay test for diagnosing a chlamydia trachomatis infection?
NAAT (nucleic acid amplification testing) of swabs of infected areas
36
What is the treatment of chlamydia trachomatis serovars D - K?
macrolide or doxycycline
37
What is the treatment for chlamydia trachomatis serovars L1 - L3? What is the duration?
doxycycline for 21 days
38
What is trichomoniasis?
a STI caused by the trichomonas vaginalis parasite
39
What are the clinical features of trichomoniasis in females?
- vaginal discharge - vulval itching - dysuria - associated with PROM and low birth weight
40
What are the clinical features of trichomoniasis in males?
- most asymptomatic | - urethritis
41
What is the mainstay test for diagnosing a trichomoniasis infection?
NAAT (of vulvovaginal swab)
42
What are the possible treatment options for trichomoniasis? [3]
1. Metronidazole 2g stat 2. Metronidazole 400mg BD [5 to 7 days] 3. Tinidazole
43
What is a chancroid? What is it caused by?
bacterial sexually transmitted disease caused by infection with Haemophilus ducreyi
44
What is adenitis?
inflammation of a lymph gland
45
What is the presentation of chancroid?
- ulcer - inguinal lymphadenopathy - suppuration and adenitis
46
What are the possible treatment options for chancroid? [2]
1. Aspiration | 2. Antibiotics (azithromycin, ceftriaxone, ciprofloxacin, erythromycin)
47
What are the 4 possible antibiotics that may be given to treat chancroid?
Azithromycin Ceftriaxone Ciprofloxacin Erythromycin
48
Which viruses causes genital herpes?
Herpes Simplex Virus 1 or 2
49
How does a primary infection of HSV 1 or HSV 2 typically present?
- cold sores - fever - malaise - myalgia - inguinal adenitis *more severe in females
50
A HSV 1 or 2 infection can remain latent in which structure?
sacral nerve root ganglia
51
Neonatal herpes simplex virus is mainly caused by which virus?
HSV 2
52
What is the mainstay diagnostic test for genital herpes?
PCR on vesicular fluid
53
What is the mainstay diagnostic test for herpes simplex encephalitis?
PCR on CSF
54
What is the mainstay diagnostic test for neonatal HSV?
- PCR of CSF and blood | - surface swabs for culture
55
Which antivirals may be used for the treatment of a herpes simplex infection?
aciclovir valaciclovir famciclovir
56
What virus is genital warts caused by? (general)
human papilloma virus (HPV)
57
What is the most common type of HPV which causes genital warts?
HPV 6
58
What are the treatment options for genital warts?
1. Destruction: - Podophyllotoxin - Trichloroacetic Acid 2. Immunologic Therapy: - Imiquimod 3. Surgical Therapy: - Excision - cryotherapy/laser therapy
59
What are the risk factors for HIV?
- sexual contact - vertical transmission - contaminated needles - blood transfusion - tissue/organ donation - occupational exposure (e.g. sharps injuries)

REGUB (22 decks)

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