New FunMed PBL Flashcards
Important questions in sexual health check?
When you last had sex What protection you used Symptoms Why you think you have an infection Who the sexual partner was
Ways for testing for STIs
Blood test
Urine test
Genital exam
Vaginal, anal, urethral swabs
Common STIs
Chlamydia Gonorrhoea Syphilis Herpes HIV
Barrier contraception
Prevent contact of sperm and egg to prevent fertilisation Male condoms Female condom Cervical cap Diaphragm
Hormonal contraception
Combined - oestrogen and progesterone Progesterone only Thicken cervical mucous Endometrial atrophy Inhibit ovulation
Contact tracing
Important in reducing risk of further transmission
Done anonymously
Does not require patient consent as within public interest
How you can be prosecuted for reckless HIV tranmission
The person you had sex with didn't know you had HIV You knew you had HIV at the time You understood how HIV was transmitted You did't use a condom You transmitted HIV to the person
Define stigma
Negative label that may change the way you view yourself or others view you and can lead to discrimination
Define enacted stigma
Discrimination due to a condition that causes suffering
Define felt/anticipated stigma
Fear that discrimination might occur that might lead to the person avoiding situations where the discrimination might occur
Reasons for HIV being a stigmatised condition
Life threatening
Perceived as contagious and threatening
Lack of understanding about the disease
Association with specific lifestyle behaviours
How does HIV kills cells?
Induced apoptosis
Which cells does HIV target?
CD4 cells
How can HIV be transmitted?
Blood, semen, vaginal fluid, pre-ejaculate, breast milk
HIV diagnosis methods
Blood antibody test -monoclonal antibody test for antibodies against HIV -may take up to 3 months to become positive HIV p24 antigen testing -detects viral antigen -may show positive before antibody test HIV RNA test -measures HIV is plasma by PCR
How long before HIV can show up on a test?
4 weeks earliest
3 months latest
How to conceive as a HIV positive woman
Ensure low viral load
Keep taking anti-retrovirals
Check for other STIs and potential opportunistic infections
Time cycle so you only have to have unprotected sex once
HIV negative partner can take PrEP
Consider insemination
Preventing mother-to-child transmission
HIV tested for in early pregnancy for women who may be unaware they are infected
ARVs taken throughout pregnancy
Caesarian section to reduce chance of transvaginal transmission
No breast feeding
Baby given zidovudine monotherapy for 4 weeks after birth
Zidovudine class
NRTI
Precautions for relationships
Inform partner before any genital contact Always use condoms Adhere to ARVs Regular HIV tests for your partner Read up of PrEP and PoEP
Bacteria that causes chlamydia
Chlamydia trachomatis
Gram negative
Symptoms of chlamydia
Pain urinating
Unusual discharge from the vagina, penis or anus
Pain and swelling in testicles
Bleeding during or after sex or between periods
Transmission of chlamydia
Through unprotected vaginal, anal or oral sex
Treatment of chlamydia
Azithromycin - macrolide antibiotic
Targets 50s ribosome to prevent translocation
Prevention of chlamydia
Condoms
Not sharing sex toys
Complications of chlamydia
Pelvic inflammatory disease
Can lead to fertility problems and ectopic pregnancies
Conjunctivitis for babies born to chlamydia positive mothers
Reactive arthritis
Diagnosis of chlamydia
Men = urine sample
Women = swab of affected area
Nucleic acid amplification tests used to identify presence of bacteria
Reasons for flu like symptoms
Seroconversion phase of infection
Seroconversion phase
Usually occurs 2-6 weeks after infection
When the body develops antibodies against HIV
Large amounts of virus being produced
CD4 cells used for this replication so number rapidly falls while viral load increases
Seeding of lymphoid organs
Leads to flu like symptoms
Most infectious at this point
Symptoms include fever, swollen glands, sore throat, rash, muscle and join pain, headache
Immune system begins to respond and CD4 count increases again slightly
Clinical latency phase
Virus can lay dormant for up to 10 years ARVs keep virus in this phase HIV still replicating in this phase but more slowly Patients appear asymptotic Can still transmit HIV at this stage
Symptomatic phase - AIDS
Individuals become open to opportunistic infections and HIV related malignancies
Opportunistic infections
Candidiasis TB Cytomegalovirus Cryptosporidium Herpes viruses Haemophilus Pneumococcus Salmonella
Tests important for monitoring the progress of the virus
CD4 count -normal range 450-1200cells/mm3 -most useful indicator of immune status -can help show effects of ARVs Viral load -measures HIV is plasma -high load correlated with increased disease progression -can monitor ARV success -can show risk of transmission
Why are HIV patients more at risk of infections?
Defective cell mediated immunity problems dealing with intracellular organisms
Reduced antibody production
When can STIs be disclosed to other doctors?
For direct purpose of treatment
To prevent transmission
Type of nucleic acid in HIV
Single stranded positive RNA
Retrovirus
