Repro: Infections Of The Genital Tract Flashcards
What is the difference between an STI and a STD?
STI: symptomatic and asymptomatic cases
STD: symptomatic cases only
What are some implications of STIs?
- pelvic inflammatory disease
- infertility
- reproductive tract cancers (eg papilloma virus)
- transmission to fetus / neonate
What is the management for STIs?
Important to test for other STIs - if they have the risk factors for one they have risk for all
Contact tracing - patients and public health
Treatment preferable a single dose or short
Advise on safe sex
What are the 2 classes of human papilloma virus?
Low risk types (HPV 6&11):
Benign, painless epithelial or mucosal growths
Usually resolve spontaneously
High risk types (HPV16):
Oncogenic - associated with cervical and anal cancer
What is the treatment for HPV?
None - 70% of cases resolve in 1yr, 90% in 2yrs
What are the symptoms of chlamydia trachomatis in males, females and neonates?
Males: urethritis, epididymitis, prostatitis, inflammation of anal area
Females: urethritis, cervicitis, salpingitis, perihepatitis (mostly asymptomatic)
Neonates: conjunctivitis, pneumonia
How is chlamydia trachomatis diagnosed?
Endocervical and urethra swab: then do NAAT (nucleic acid amplification test)
Or 1st void urine (an also detect gonorrhoea from the same specimen)
What is the treatment for chlamydia trachomatis?
Adults:
Doxycycline or azithromycin (can be given as one large dose)
Children:
Erthyromycin (to preserve bone density)
What are the symptoms of herpes simplex virus?
Extensively painful genital ulceration, dysuria, inguinal lymphadenopathy , fever
How is herpes simplex virus diagnosed?
PCR of the vesicle fluid or the ulcer base
How is herpes simplex virus treated?
Aciclovir (can be given orally or IV)
Can be used for prophylaxis for frequent recurrence - the virus can lie latent in the dorsal root ganglia
What is the classification of neisseria gonorrhoea?
Its a gram negative intracelular diplococcus - looks exactly the same as neisseria meningitis
What are the symptoms of gonorrhoea in males and females?
Males: purulent discharge, urethritis, epididymitis, prostatitis, proctitis, pharyngitis, testis pain
Females: asymptomatic, endocervicitis, urethritis, PID
How is neisseria gonorrhoea diagnosed?
Swab from urethra, cervix, throat or rectum - gram stain
Can do NAAT on the urine
What is the treatment for neisseria gonorrhea?
Im ceftriaxone, as it has increasing resistance to other agents
Which STI does treponema pallidum cause?
Syphilis
Who is at higher risk of syphilis?
Men and MSM
What are the different stages of syphilis?
1: painless ulcer called a chancre
2: 6-8 weeks later, fever rash, mucosal lesions in the mouth, lymphadenopathy
Then there are some latent years
3: Neurosyphilis, cardiovascular syphilis
(These are severe complications)
How is treponema pallidum detected?
It cannot be grown
Therefore have to undergo serology - initial screening with EIA antibody
How is treponema pallidum treated?
Treated with penicillin then followed up
What can cause inguinal lymphadenopathy?
LGV (lymphogranuloma venereum) - clamydia serotypes 1 2 3
Get a raised bump and access in the groin area
What does trichomonas vaginalis cause?
Irritation, dysuria, vaginal inflammation
Alongside a thin, froth, offensive discharge
How is trichomonas vaginalis diagnosed and treated =?
Diagnosed with a vaginal wet preparation and culture enhancement
Treated with metronidazole
What are some risk factors for vaginal candida infection?
- antibiotics
- oral contraceptives
- pregnancy
- obesity
- steroids
- diabetes
