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Reproduction and sexual health > Microbiology of GU tract & STIs > Flashcards

Microbiology of GU tract & STIs Flashcards

1
Q

List microorganisms that cause STIs

A

Bacteria: Chlamydia trachomatis, neisseria gonorrhoea, mycoplasma genitalium, treponema pallidum
Viral: HSV, HPV, HIV
Parasites: trichonomas vaginalis, phthirus pubis, scabies

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2
Q

Can you become immune after having an STI

A

NO, reinfection becomes more common

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3
Q

STIs travel in groups, true or false

A

TRUE, test for one test for all

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4
Q

What is the predominant microorganism in normal vaginal flora

A

Lactobacillus - Gm +ve bacilli

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5
Q

What other microorganisms may or may not be present in normal vaginal flora

A

Group B strep
Candida
Strep viridans group

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6
Q

What is vaginal thrush/candidiasis caused by

A

Candida albicans fungus

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7
Q

Is vaginal thrush an STI

A

NO

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8
Q

What are predisposing factors to developing vaginal thrush

A

Recent antibiotic therapy
Poorly controlled diabetes mellitus
High oestrogen levels - some contraceptives
Immunocompromised patients

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9
Q

What are features of vaginal thrush

A

Intensely white itchy discharge

Diagnosed clinically or with a high vaginal swab

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10
Q

Treatment of vaginal thrush

A

Topical clotrimazole cream

PO fluconazole

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11
Q

Can you get candida albicans infection in males

A

Yes, as candida balanitis

It is far less common

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12
Q

What causes gonorrhoea

A

Neisseria Gonorrhoea = Gm -ve intracellular diplococcus

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13
Q

Which is less common, chlamydia or gonorrhoea

A

Gonorrhoea

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14
Q

Where can gonorrhoea infect

A

Urethra, endocervix, rectum, throat, eyes

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15
Q

What discharge occurs in gonorrhoea

A

PURULENT (pus) discharge

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16
Q

Neisseria gonorrhoea is a fastidious organism, what does this mean

A

Fastidious = dies easily if not in ideal conditions

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17
Q

what tests can look for gonorrhoea

A

Microscopy –> Gm- intracellular diplococci
Culture –> allows determination of antibiotic sensitivities
Nucleic Acid Amplification Test (NAAT) –> picks up genetic material

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18
Q

What is the treatment of gonorrhoea

A

IM ceftriaxone 1g

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19
Q

What samples are used for NAAT

A

Males - 1st void urine sample

Females - self taken vaginal swab

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20
Q

What causes Chlamydia

A

Chlamydia trachomatis = behaves like a gram negative
HAS NO GRAM STAIN
because of no peptidoglycan wall

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21
Q

Chlamydia is the most common STI in the UK, true or false

A

TRUE

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22
Q

Chlamydia is an obligate intracellular bacteria, what does this mean

A

It only grows inside the cell, cannot grow outside of the cell

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23
Q

Where can chlamydia infect

A

urethra, rectum, endocervix, throat, eyes

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24
Q

what are the serological groupings of chlamydia

A

Serovars A-C: trachoma eye infection
Seovars D-K: genital infection
Serovars L1-3: lymphogranuolma venereum (LGV)

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25
Q

What is LGV and what condition can it mimic

A

Lymphogranuloma venereum is a tropical disease common in MSM
It is clinically similar to Crohns disease

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26
Q

What is the treatment of Chlamydia

A

1st - PO doxycycline
2nd - PO azithromycin
3rd - PO erythromycin

27
Q

How do you test for Chlamydia

A

NAAT - can test for at the same time as gonorrhoea

28
Q

What are the disadvantages of NAAT

A

Cannot perform antimicrobial susceptibility testing

high risk of false positives in gonorrhoea

29
Q

What is trichonomas vaginalis / trichomoniasis and what is its management

A

A trophozoite parasite
Presents with vaginal discharge and irritation / urethritis
Tx: PO metronidazole

30
Q

What is bacterial vaginosis (BV)

A

Disturbance in the normal vaginal flora

Not caused by just 1 bug

31
Q

Is BV an STI

A

No, but it can co-exist with STIs

32
Q

What does BV present with

A

Fishy smelling thin homogenous vaginal discharge, may contain bubbles

33
Q

Describe features of BV

A

+ve Whiff test from volatile amines
Absence of lactobacilli and presence of coccobacilli clumps as their replacement
Clue cells = vaginal epithelial cells coated with coccobacilli clumps

34
Q

What are the 3 main features of BV

A

disturbed microbiome
loss of vaginal acidity
normal cellular protection has changed

35
Q

Treatment of BV

A

PO metronidazole 7 days
NB - high relapse rate
No benefit in treating male sexual partner

36
Q

What causes syphilis

A

Treponema pallidum

NO GRAM STAIN

37
Q

Treponema pallidum can be cultured, true or false

A

FALSE, treponema pallidum cannot be cultured

38
Q

How do you test for syphilis

A 
Dark ground microscopy 
PCR 
serological testing 
IgM 
VDLR / RPR
39
Q

What are the 4 stages of syphilis

A

Primary - chancre
Secondary - can manifest in anyway
Latent - no symptoms, but continues to grow
Tertiary - CVS or neurosyphilis

40
Q

What are VDRL and RPR useful for

A

Useful for monitoring the disease response to therapy and can be used to see whether disease has been cured

41
Q

Which antibiotic is syphilis very sensitive to

A

Penicillin
Tx: IM long lasting penicillin preparations
Anything else is inferior
Would even consider desensitising if patient is penicillin allergic

42
Q

What causes genital herpes

A

Herpes simplex 1 + 2

virus containing double stranded DNA

43
Q

Symptoms of genital herpes

A

painful multiple small vesicles that are easily deroofed

44
Q

what is the test for genital herpes

A

viral swab of deroofed blister for PCR

45
Q

Management of genital herpes

A

Aciclovir and pain killers

46
Q

what is the incubation period of chlamydia

A

14 days

47
Q

what is Fitz-Hugh-Curtis syndrome

A

perihepatitis associated with PID

48
Q

what is the incubation period of gonorrhoea

A

2-5 days

49
Q

how long do you wait to do the test of cure in gonorrhoea

A

2 weeks from site where they had a positive swab

50
Q

in genital herpes, what is meant by primary infection

A

never been exposed to herpes before

51
Q

in genital herpes, what is meant by non-primary first episode

A

been exposed before, but this is the first symptomatic presentation

52
Q

what is the incubation period for primary infection of HSV

A

3-6 days

53
Q

which has a better prognosis, HSV 1 or 2

A

HSV 1

54
Q

what is the most common viral STI in the UK

A

HPV

55
Q

what do HPV 1+2 cause

A

warts on hands and feet

56
Q

What do HPV 6+11 cause

A

genital warts

57
Q

what do HPV 16+18 cause

A

cervical cancer

58
Q

what is the incubation of HPV

A

3 weeks to 9 months

59
Q

what is the management of genital warts

A

podopyhyllotoxin
imiquimod
cryotherapy

60
Q

what is the appearance of treponema pallidum

A

spirochete

61
Q

what is the incubation period of primary syphilis

A

9-90 days

62
Q

what is a chancre

A

painless ulceration at site of inoculation

63
Q

what is the incubation period of secondary syphilis

A

6 weeks - 6 months

Reproduction and sexual health (46 decks)

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