Repro 6 Flashcards
What is the difference between an STI and an STD?
STIs can be symptomatic or asymptomatic
STDs are only symptomatic cases
Give an example of an intestinal pathogen that can be sexually transmitted
Salmonella
Shigella
Giardia
Give some examples of the common STDs and their associated organism
Genital warts - Papillomaviruses
Urethritis - Chlamydia
Genital Herpes - Herpes Simplex
Describe a specific group that is at risk of STIs
Young people
Low socio-economic status groups
List some risk factors associated with STIs
Young age at first sexual encounter
High number of sexual partners
Sexual Orientation
Unsafe sexual activity
Describe some causes of the increase in incidence of STIs
Changing sexual/social behaviours Increasing density & mobility of population INcrease in visits to GUM clinics Greater awareness Imporved screening
Why are STIs a burden to sufferers?
Can be chronic/relapsing
Stigma
Can lead to further pathology
Possible transmission to foetus
What do patients STIs with STIs commonly present with?
Ulcers
Vesicles
Warts
Urethral discharge/pain
How is HPV diagnosed?
BIopsy + genome analysis, “hybrid capture”
How is HPV treated?
No intervention - 90% spontaneosu resolution within 2yrs
Otherwise surgery
How is HPV screened?
Cervical Pap smear
Cervical swab
How is Chlamydia trachomatis diagnosed?
Endocervical and urethral swabs
Conjunctival swab in neonates
How is Chlamydia trachomatis treated?
Doxycycline or azithromycin
Erythromycin in children
What are the symptoms of Primary genital herpes?
Extensive, painful genital ulceration
Dysuria
Ingunal lymphadenopathy
Fever
How is Herpes diagnosed?
PCR or vesivelfluid and/or ulcer base
How is Herpes treated?
Aciclovir
Herpes preventative measures?
Aciclovir prophylaxis for recurrent infections or barrier contraception
What is Neisseria gonorrhoeae?
Gram negative intracellular diplococcus
What are the male symptoms of Gonorrhoea?
Urethritis, epididymitis, prostatitis, pharyngitis
What are the symptoms of Gonorrhoea?
Can be asymptomatic
Endocervicitis
Urethritis
PID (subsequent infertility)
How is Gonorrhoea diagnosed?
Swab - urethra, cervix, throat or urine
Gram stain
How is Gonorrhoea treated?
Ceftriaxone
What is Treponema pallidum?
Spirochaete, aetiological agent of syphilis (most cases men and MSM)
What are the symtpms, in order of development, of shyphilis?
Painless ulcer
Fever, rash, lymphadenopathy
Neurosyphilis (insanity)
Treatment of Treponema pallidum (syphilis)?
Penicillin
What is Pelvic Inflammatory disease (PID)?
The result of infection ascending from the endocervix to cause inflammation
What areas are inflamed in PID?
Endometrium Fallopian tubes (salpingitis) Ovaries (oophoritis) Pelvic peritoneum
Other than inflammation, what can PID cause?
Tubo-ovarian abscess
What is the epidemiology of PID?
Sexually active women
Peaks 20-30y/o
Incidence in primary care ~280 per 100,000py
What are the risk factors for PID?
Young age Unsafe sex Multiple partners low socio-economic class IUCD
What are the clinical features of PID?
Fever
Lower abdo pain
Vaginal/carvical discharge
List some differential diagnoses for PID
Ectopic pregnancy
Endometriosis
UTI
IBS/Appendicitis
Describe the management of PID
Analgesia, rest, manage sepsis
Severe cases use IV antibiotics, surgery if no response
Describe the antibiotic treatment therapy for PID
Ceftriaxone, doxycycline, metronidazole
What is involved in surgical management of PID?
Laparoscopy/laparotomy
List some possible complications of PID
Ectopic pregnancy
Infertility
Chronic pelvic pain
Reiter syndrome (disseminated chlamydia)
