L5 - STIs Flashcards
What are the risk factors for STIs?
Age
sexual partners
sex tourism
MSM (PrEP)
What is caused by gonococcal and non-gonococcal sexual disease?
Urethritis
Cervicitis
Proctitis
What is Gonorrhoea caused by?
Neisseria gonorrhoeae
What are symptoms of gonorrhoeae
Discharge
Burning sensation
scrotal pain
anal itching
sore throat
What are the non-genital complications of gonorrhoea?
arthritis-dermatitis syndrome
meningitis/osteomyelitis/sepsis
Salpingitis
PID
Ectopic pregnancy
Sterility
what are symptoms of gonorrhoea in men?
Orhcitis
Epididymitis
sterility - rare as other symptoms are obvious
How does gonorrhoea adhere?
Type IV pili
Opa protein - makes adherence tight
What does induction of PMNLs do?
induces localised information
What can N. gonorrhoea resist the activity of?
PMNLs
complement pathway
Why is urine sample not useful for women for STIs?
Usually result in cervicitis not urethritis
cervical swab instead
What is NAAT?
Nucleic Acid Amplification Technology
What is super gonorrhoea?
potentially untreatable
What is the current treatment for gonorrhoea?
high dose ceftriaxone
What are non-gonococcal STIs caused by?
Chlamydia trachomatis
What is the sex bias of chlamydia?
men - 50% asymptomatic
women - 80% asymptomatic
Chlamydia pathogenesis?
Elementary bodies bind to cell surface
T3SS - injects invasion effectors & early effectors
What is the main test used for chlamydia?
NAAT
What is the treatment of chlamydia?
DOXYCYCLINE - 100mh 2x day for 7 DAYS
AZITHROMYCIN
Which chlamydia treatment has fewer complications?
azithromycin - one single dose, easily monitored in clinic
What is the “new chlamydia”
missed on diagnostic testing
MYCOPLASMA GENITALIUM
treat - moxifloxacin
What diseases cause genital ulcerations?
Syphilis
Chancroid
L. venereum
Donovanosis
What are the 3 stages of syphilis?
Primary - chancre
Secondary - rash, condylomata lata
Tertiary - Gumma, meningovascular lesions - madness
How is syphilis diagnosed?
serology methods
What are treponemal antibodies?
remain positive for life
What are non-treponemal antibodies?
decline following treatment
How is syphilis treated?
Benzathine/procaine penicillin
What are tropical genital ulcerations?
common in AIDS patients in developing countries
What is L. venereum caused by?
severs L1, L2, L3 of C. trachomatis
infection of lymph nodes
What is chancroid caused by?
Haemophilus ducreyi
What is donovanosis caused by?
Klebsiella inguinale
What is bacterial vaginosis?
reduction in dormant lactobacilli in vagina - increases in other microbes e.g. Bacteroides spp.
How is bacterial vaginosis?
Clue cells
whiff test
