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Case 7: HIV > Medical Microbiology: STI > Flashcards

Medical Microbiology: STI Flashcards

1
Q

What STI are curable

A

Bacterial is treatable while viral is incurable & can recur

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2
Q

What is the link between STI & HIV

A

Increase likelihood of transmission & acquisition
Transmission:
HIV shedding by bleeding during intercourse & increased viral load in fluids
Acquisitions:
Disrupt mucosal barrier integrity & increase immune cells

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3
Q

Define syndromic management

A

Treatment is given to deal w/ symptoms & most common organisms causing a syndrome w/o knowing the causative agent

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4
Q

3 advantages of syndromic management

A

Cost effective (avoid lab diagnostic)
Treat mixed infections
Treatment @ 1st treatment & not lost due to follow up

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5
Q

3 disadvantages of syndromic management

A

Antibiotics overuse
Under treat resistant infection
Asymptomatic infections not identified & remain a reservoir to infect other

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6
Q

What 3 syndromes does Neisseria Gonorrhoea cause

A

VDS
MUS
LAP

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7
Q

What is the management of Neisseria Gonorrhoea

A

Ceftriazone & azithromycin

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8
Q

What is the clinical features of Neisseria Gonorrhoea

A

Female: asymptomatic w/ gonococcal cervicitis & conjunctivitis
Male: purulent discharge & painful & conjunctivitis
Children: conjunctivitis

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9
Q

What does Neisseria Gonorrhoea look like

A

Gram negative diplococci that is bean shaped neutrophils that is fastidious

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10
Q

Where does Neisseria Gonorrhoea cause infection

A

Mucosal columnar epithelium
Cervix, urethra, ano-genital, conjunctiva & oropharynx
Can disseminate to joints

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11
Q

What 4 syndromes does Chlamydia trachomatis cause

A

VDS
MUS
GUS
LAP

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12
Q

What is the treatment for Chlamydia trachomatis

A

Azithromycin

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13
Q

What is the clinical features of Chlamydia trachomatis

A

Mucopurulent discharge, small sores (LGV) & unnoticed w/ inguinal bulboes

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14
Q

What 2 syndromes does Trichomons vaginalis cause

A

VDS
LAP
a protozoal parasite

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15
Q

What treatment is used for Trichomons vaginalis

A

Metronidazole

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16
Q

What is the clinical features of Trichomons vaginalis

A

Green frothy discharge w/ fishy odour & ithing

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17
Q

What syndrome does Bacterial vaginosis cause

A

VDS

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18
Q

What treatment is used for Bacterial vaginosis

A

Metronidazole

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19
Q

What is the clinical features of Bacterial vaginosis

A

Grey discharge w/ unpleasant smell w/ imbalance to normal bacteria flora dysbiosis

20
Q

What syndrome does Candida Albicans cause

A

VDS

21
Q

What is the treatment for Candida Albicans

A

Clotrimazole

22
Q

What is the clinical features of Candida Albicans

A

Cheese like discharge & itch w/o smell

23
Q

What syndrome does Treponema pallidum cause

A

GUS - syphilis

24
Q

What is the treatment of Treponema pallidum

A

Benzathine penicillin

25
Q

What is the clinical features of Treponema pallidum

A

Painless chancres if primary + rash if secondary

26
Q

What syndrome does Herpes Simplex cause

A

GUS

27
Q

What is the treatment of Herpes simplex virus

A

Acyclovir

28
Q

What is the clinical features of Herpes simplex virus

A

Blisters w/ tingling/itch
W/ advanced HIV granulomatous w/ red base

29
Q

What syndrome does Haemophilus ducreyi cause

A

GUS

30
Q

What is the treatment of Haemophilus ducreyi

A

Azithromycin

31
Q

What is the clinical features of Haemophilus ducreyi

A

Chancroid ulcer (deep, bleeding & painful)
Associated w/ inguinal buboes

32
Q

Clinical features of vaginal discharge syndrome

A

Abnormal vaginal discharge
Burning on urination
Pain/itch vagina

33
Q

Clinical features of male urethral syndrome

A

Urethral discharge
Burning on urination

34
Q

Clinical features of genital ulcerations- syphilis

A

Single painless ulcer
Painless non-suppurating lymph nodes

35
Q

Clinical features of genital ulcerations- chancroid

A

Painful ulcer
Painful lymphadenopathy (may suppurate)

36
Q

Clinical features of genital ulcerations- granuloma inguinale

A

Raised granulomatous ulcer
Lymph not involved

37
Q

Clinical features of genital ulcerations- genital herpes (4)

A

Painful vesicular lesions
Rapidly ulcerated
Tender lymph nodes
Recurrent ulcers
Neonatal herpes

38
Q

Clinical features of genital ulcerations- lymphogranuloma venerium (LGV)

A

Transient papule/ulcer followed by suppuration lymphadenopathy
Late complications- strictures & fistula

39
Q

What do you do if genital ulcer do not improve after 7 days

A

Change treatment to azithromycin

40
Q

What is the causes of genital warts

A

HPV 6, 11,16 & 18 (16 & 18 - Ca)

41
Q

Is genital warts preventable

A

Yes w/ a vaccine

42
Q

What is the lab diagnosis for VDS for vagina & cervix

A

Vagina: KOH/WHIFF test, pH, wet prep, culture & gram staining
Cervix: gram stain, molecular test, Ag detection & culture

43
Q

What is the lab diagnosis for MUS

A

Specimen: urine or endo-urethral swab
Microscope: gram stain, wet smear & direct Ag test
Molecular test: swab or urine

44
Q

What is the 2 complications w/ MUS

A

Epididymis: scrotal swelling
Urethral stricture: infertility

45
Q

What is the 5 complications w/ VDS

A

Pelvic inflammatory disease w/ LAP
Damage to fallopian tube causing infertility or ectopic pregnancy
Problem in pregnancy like preterm labour or rupture of membranes
Spread to baby causing neonatal conjunctivitis & respiratory infection
Increase risk of HIV transmission

46
Q

Why is STI persistent (give 8 reasons)

A

Sexual partner:
Not treated (re-infected )
More than one partner (similar or different infections)
New partner (new infection)

Persistent infection:
Poor compliance
Aetiology not covered by treatment
Suboptimal efficacy
Vomiting after treatment

Antimicrobial resistance causing treatment failure

Case 7: HIV (6 decks)

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