REPRO 9 Flashcards
candida does everyone get symp
30% of females are colonised with small number of candida and are asymptomatic
what can cause candida
recent antibiotic therapy high oestrogen levels (pregnancy) poorly controlled DM immunocomp decreased CD4 steroids
symp of candida
intensely itchy white discharge
cottage cheese
budding - hyphae under microsopcy
candida albicans
treatment of candida
topical clotrimazole 500mg pessary and dotrimazole 1% cream
or
fluconazole 150mg PO stat and cream
bacteria vagninosis is caused by what
gradinella vaginalis
what are the symp in BV
asymp in 50%
thin water dc
fishy smell
BV features
ph >4.5
clue cells
treatment of BV
metronidazole 400mg BD for 7d
or
2g stat
prostatitis symptoms
UTI symptoms
lower abdominal pain
pain and tender prostate on examination
ix in prostatitis
G+C STI in <35s
MSU for culture and staining
FPU for STIs
treatment of prostatitis
if high cdiff risk
ciprofloxacin 500mg BD for 28 days
if high CDiff infection then erimethoprim 200mg BD for 28 days
syphilis is caused by what which does not what
treponema pallidum
which does not stain with gram stain
trensmission of syphilis
sexual contact, transplacental/birth, parental
primary syphilis symp
rx
primary chancre at site of sexual contact 90% genital. painless. non tender local LD
heals without treatment
secondary syphilis
snail track ulcers buccal. fever. LD. rash including soles and palms. flu like symptoms. patchy alopecia. condylomatala.
tertiary syphilis
granulomatous lesions of skin and bones. ascending aortic aneurysms. paralysis.
late syphilis
CVS/neuro cx
investigations - demonstrate of exudate from lesion
dark field microscopy or swab of lesion for PCR
to see how active the disease is and to monitor it
what serology
what happens after rx
VDRL, RPR, IgM
should become negative after rx
specific serology to confirm dx
TPPA, INNILIA, FTAAS, IgG
stays positive for life
in tayside what
if positive IgG/IgM then IgM, ELISA, VDRL, TPPA
treatment of syphilis
2.4 MUB penicillin IM 2 in early and 3 in late
follow up in syphilis
RPR should be negative or serofast titres should decreased by fourfold in 3-6 months in early
what is the jarich-hexheimer reaction
fever, rash, tachy after first dose of ABs
release of endotoxins after bacterial death
ghonnorhea micro
gram neg intracellular diplococcus which is easily phagocytksed by polymorphs and can’t survive outside the body
where gonnorhoea
mucous membranes: genitourinary, rectum, pharynx
symptoms of G in males
asymp <10%
yellow/green dc
dysuria
symptoms of G in females
asymp in 50%
increased or change in dc
dysuria
plevic pain
ix for G
NAATS/PCR
males FPU females HVS
rectal/throat/eye swab for culture
complications of gon
endometriosis, PID, infertility, ectopic pregnancy, prostattitis
treatment of gon and follow up
ceftriaxone 500mg IM and aziathoprine 1g stat PO
ceftriaxone 400mg PO
test of cure in all px
what is the commonest STI
chlamydia
does chlamydia stain with gram stain and if no why
no
no peptidoglycan in walls
C A-C
not sexually transmitted. trachoma - eye infection
C D-K
genital
C L1-L3
lymphogranulomatoma venerum. can mimic crohns. MSM
PID and chlamydia link
PID increases the risk of chlamydia by 10
female chlamydia symptoms
70% asymp
post coital or inter menstrual bleeding
lower abd pain
dyparuria
male chlamydia symptoms
50% asymp urethreal dc dysuria urethritis epididmo-orchitis
ix for chlamydia
NAATS/PCR
males FPU
females HVS/VVS
msm - rectal swab
complications of chlamydia
PID, fitz Hugh curtis Syndrome, tubal damage, chronic pelvic pan, reiters, ectopic, endometriosis
tranmission to neonate chlamydia
17% conjunctivitis
20% pneumonian
treatment of chlmaydia
if rectal
azithromycin 1g stat
doxy 100mg BD for 7 days
bad thing about NAATS/PCR
have to wait 5 weeks to do test of cure as will detect dead organisms
