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CP > Pathogenesis of HIV and the major sexually Transmitted Infections > Flashcards

Pathogenesis of HIV and the major sexually Transmitted Infections Flashcards

1
Q

What is the definition of STI?

A

Sexually transmitted infection

infetions which are transmitted person to person by sexual contact

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2
Q

What is the definition of STD?

A

Sexually transmitted infection

evidence of disease i.e. signs and symptoms present

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3
Q

How are STI caused specifically via sexual contact?

A

mucous membrane contact

exchange of body fluids

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4
Q

What are 3 common concepts of STI’s?

A

risk of transmissions = number of sexual partners - increased risk with use of non barrier/no contraception
Patients with one STD likely to have other STD’s
Tracing of people who may have come into contact with infected person is important

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5
Q

What kind of an organism is Neisseria gonorrhoeae?

A

gram negative

diplococcus - in pairs

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6
Q

Where does gonorrhoeae multiply and therefore how does the body destroy it?

A

intra-cellularly

therefore destroyed via phagocytosis by neutrophils

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7
Q

How does gonorrhoeae attach to mucosal epithelial cells?

A

pili on the surface

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8
Q

Where does gonorrhoeae present at in the body?

A

GU tract
rectum
oropharynx

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9
Q

What are the symptoms of gonorrhoeae?

A

urethral discharge

dysuria

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10
Q

What are the complications of gonorrhoeae? (inc in pregnancy)

A

epididymitis
prostitis
barthonilitis - inflammation of Bartholin’s glands in the vagina
salpingitis - inflammation of the fallopian tubes
PID
peritonitis
Fitz-Hugh-Curtis Syndrome (perihepatitis)
Diseminated Gonococcal Infection - spread of infection to the rest of the body e.g. Conjuctivitis
Pregnancy: spontaneous abortion, premature labour

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11
Q

What is the treatment for gonorrhoeae?

A

B-lactams e.g. BenzylPenicillin

Cephalosporins e.g. cefixime

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12
Q

What two pathogens cause non gonococcal urethritis?

A

chlamydia trachomatis

Ureaplasma urealyticum

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13
Q

How is gonorrhoeae, syphilis, HIV and chlamydia diagnoised?

A

Nucleic acid amplification test (NAAT)

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14
Q

What is the treatment for non gonococcal urethritis?

A

Doxycycline

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15
Q

What are the symptoms of chlamydia?

A 
dysuria
frequency
urgency
discharge
abnormal bleeding e.g. after sex, between periods
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16
Q

What are the complications of chlamydia?

A

PID
Epididymitis
Conjuctiva (inc neonates)
Reiters syndrome

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17
Q

What is Reiters syndrome?

A

Arthritis
Conjuctivitis
Urethritis
Skin lesions

18
Q

What is the treatment for chlamydia?

A

Azithromycin

Doxyclycline

19
Q

What is the treatment for HPV warts?

A 
Burn
Freeze
Cut
Imiquimod - immune response modifier
Salicylic acid
Liquid nitrogen
20
Q

What are the signs and symptoms of genital herpes?

A 
pain
itching
dysuria
vaginal/urethral discharge
ulcers
21
Q

What is the treatment of genital herpes?

A

aciclovir

22
Q

What are the complications of genital herpes?

A

dissemination
meningitis
encephalitis
sacral nerve parasthesiae which causes urinary retention

23
Q

What organism causes syphilis?

A

Treponema pallidium

24
Q

Where does treponema pallidium penetrate and travel round the body?

A

penetrates intact mucous membranes

disseminates within days via lymphatics/bloodstream

25
Q

What is obliterative endarteritis and what infection is it associated with?

A

inflammation of the intima or inner lining of an artery
results in an occlusion of the lumen of the artery
Syphilis

26
Q

What do the 3 stages of syphilis involve?

A

1) Painless lesion
2) Redness. Rash, wart like lesions on genitalia, mucous patches, lymphadenopathy, headache, fever, malaise, weight loss
3) serious CNS symptoms e.g. hemiplegia, seizures,
CV symptoms - aortic regurgitation, saccular aneurysm Other: granulomatous reactions

27
Q

What is the treatment for syphilis?

A

penicillin based

28
Q

What is Jarish-Herxheimer reaction?

A 
commonest in secondary stage of syphilis
fevers
chills
myalgia
hypersensitivity reaction - organism lysis
NOTE: feels worse with penicillin
29
Q

What pathogen causes trichomoniasis?

A

trichomonas vaginalis

protazoa

30
Q

What are the symptoms of trichomoniasis?

A

green frothy vaginal discharge

mucosal inflammation

31
Q

What is the treatment for trichomoniasis?

A

metronidazole

32
Q

What is bacterial vaginosis (BV)?

A

Caused by reduced vaginal lactobacilli

increased Gardnerella vaginalis and anaerobes

33
Q

How is HIV transmitted?

A

Sexual - genital/colonic mucosa
Exposure to other infected fluids e.g. blood/blood products
Mother to infant

34
Q

Why do opportunistic infections occur in those with HIV?

A

loss of CD4 T cells

Reporting of stage based on CD4 count

35
Q

For more HIV questions see…

A

Antivirals

36
Q

What has been implemented to prevent STI’s?

A 
Referral to GUM clinics
Free barrier contraception
Chlamydia screening
Universal HIV screening for those with STI's
Encouraging contact tracing
Vaccinations e.g. HPV
37
Q

What 2 organisms can cause PID?

A

N.gonorrhoea

C.trachomatis

38
Q

How is trichomoniasis diagnoised?

A

Vaginal swab - microscopy and culture

39
Q

What is the treatment for bacterial vaginosis?

A

Metronidazole

40
Q

What are the symptoms of bacterial vaginosis?

A

watery, fishy odoured discharge

CP (50 decks)

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