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Kofi: Pure Clinical Sem 3 > Repro: STI and PID > Flashcards

Repro: STI and PID Flashcards

1
Q

Which factors affect transmission of genital infections?

A
  • Age
  • Ehtnicity
  • Socioeconomic status
  • Age at first sexual intercourse
  • Number of partners
  • Sexual orientation
  • Condom use
  • Menstrual cycle
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2
Q

What are the general considerations made during diagnosis of STI?

A
  • Could be symptomatic or asymptomatic
  • Sexual history and physical examinations are essential
  • Diagnostic samples need to be collected from the correct sites
  • Every effort should be made to isolate/diagnose the offending organism
  • Prompt treatment and partner notification
  • Advice, counselling and education of the patient and contacts
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3
Q

What are the general principles of STI treatment?

A
  • Treatment (antibiotics, antiviral, topical creams)
  • Co-infections are common so screen for other STIs
  • Contact tracing
  • STI prevention
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4
Q

What causes chlamydia and what are the microbial features of it?

A
  • Chlamydia trachomatis

- Obligate intra-cellular bacterium

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5
Q

What are the symptoms of chlamydia in males?

A
  • Urethritis
  • Dysuria
  • Epididymitis
  • Proctitis
  • Prostatitis
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6
Q

What are the symptoms of chlamydia in females?

A
  • Mostly asymptomatic
  • Increased discharge
  • Post coital and intermenstrual bleeds
  • Dyspareunia
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7
Q

Apart from the genital tract, which regions can chlamydia trachomatis affect?

A
  • Ocular inoculation that manifest as conjunctivitis

- Pharyngeal infection which is usually asymptomatic

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8
Q

What test are used to diagnose chlamydia in men?

A
  • First catch urine NAAT
  • Urethral swabs (less acceptable)
  • Rectal and pharyngeal NAAT for extragenial sampling
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9
Q

What is used to treat chlamydia?

A
  • Doxycycline or Azithromycin 1st line

- Erythromycin or Ofloxacin 2nd line

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10
Q

What is the cause of gonorrhoea and what are the microbiological features of it?

A

Neisseria Gonorrhoeae

-Gram negative intracellular diploccus

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11
Q

What are the primary sites of infection for neisseria Gonorrhoeae?

A

-Urethra, Endocervix, Rectum, Pharynx, and Conjunctiva

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12
Q

What are the main symptoms of Gonorrhoea in men?

A
  • Urethral discharge
  • Dysuria
  • Anal discharge
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13
Q

What are the main symptoms of gonorhea in women?

A
  • Asymptomatic in women in most cases
  • Altered discharge
  • Lower abdominal pain
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14
Q

Which investigations are undertaken in the diagnosis of Gonorhea?

A
  • Microscopy of gram stained genital specimen in men more than women
  • NAATS
  • Cultures for confirmatory identification and antimicrobial testing
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15
Q

What is used in the treatment of gonorrhoea?

A
  • Intramuscular Ceftriaxone plus oral azithromycin
  • Spectinomycin as alternative in penicillin allergy
  • Test of cure
  • Partner Notification
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16
Q

Why is azithromycin used in combination with ceftriaxone?

A
  • Shown to boost action of ceftriaxone
  • Decreases chances of developing resistance to ceftriaxone
  • People how have an STI have an increased change of co-infections. Azithromycin covers clamydia as a co-infection
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17
Q

What is the cause of herpes?

A

Herpes Simplex Virus

HSV 1 - oral-labial herpes
HSV 2 - primary, non-primary or recurrent infection

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18
Q

What are the symptoms of Herpes?

A
  • Painful ulceration
  • Dysuria
  • Vaginal discharge
  • Can be asymptomatic
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19
Q

What are the systemic features of Herpes?

A
  • Fever

- Myalgia

20
Q

What is used to diagnose HSV?

A
  • Virus detection of vesicle fluid or ulcer base

- Type specific Serology

21
Q

What is the treatment for Herpes?

A
  • General advice
  • Aciclovir
  • Suppresive treatment for recurrent HSV
22
Q

What is the recommendation give to patient with primary herpes in pregnancy?

A

-Caesarian section recommended

23
Q

What is the organism that causes syphilis and what are its microbial features?

A
  • Treponema pallium

- Spirochete bacterium

24
Q

What is the pathophysiology of syphilis?

A

1 - Painless ulcer
2 - Rash, mucosal lesion, multi system involvement

Latent- symptom-free for years

3 - Up to 40 years after initial infection (neurosyphillis, parenchymous, cardiovascular syphillis, Gummas)

25
Q

What is trichomanas vaginalis?

A

Infection but flagellated Protozoa

Treated with metranidazole

26
Q

Scabies can spread sexually. True/False

A

True. It can affect the genitalia and spread. Treatment is permethrin

27
Q

What are anogenital warts?

A
  • Benign lesion caused by the HPV virus

- More than 100 HPV types

28
Q

Which HPV types commonly cause genital warts?

A

Types 6 or 11

29
Q

What are the features of anogenital warts?

A

-Benign, painless, epithelial or mucosal outgrowths

Found at Penis, Vulva, Vagina, Urethra, Cervix, Perianal skin

30
Q

Which strains of HPV are high risk oncogenic?

A

HPV 16

HPV 18

31
Q

What is used in the diagnosis of Anogenital warts?

A

-Biopsy in atypical lesion or non-response treatment

32
Q

What are the treatment measures for anogenital warts?

A
  • No treatment
  • Topical application
  • Physical ablation
  • HPV vaccination
33
Q

What is bacterial vaginosis?

A

Common cause of abnormal (fishy) discharge in women of childbearing age.

  • Gardnerella vaginalis
  • Treated with metronidazole
34
Q

What is vulvovaginal candidiasis?

A
  • Caused by Candida albicans or non albicans candida species
  • Vaginal discharge typically curdy and non offensive, Vulval itch, Soreness, Dyspareunia

Treatment: Topical and oral azoles

35
Q

What is pelvic inflammatory disease?

A
  • Result of infection ascending the endocervix

- Causes endometriosis, salpingitis, parametrises, oophoritis, tubo-ovarian abscess and/or pelvic peritonitis.

36
Q

What is the pathophysiology of pelvic inflammatory disease?

A
  • Ascending infection from endocervix and vagina
  • Infecgtion causes inflammation
  • Inflammationc causes damage which lead to damaged tubal epithelium and adhesion can then form
  • Some recovery of the tubal epithelium does occur
37
Q

What is endometritis?

A

Inflammation of the endometrial lining

38
Q

What is salpingitis?

A
  • Inflammation of the Fallopian tube
  • Neutrophils and macrophages invade and this form and inflammatory exudate
  • The tubes become filled with pus
  • Formation of adhesions and fibrin blocks the tubes
39
Q

What are complications of salpingitis?

A

-Abscess can form which can spread around the ovaries or within the tube

40
Q

What is the aetiology of pelvic inflammatory disease?

A

-Sexually transmitted disease

Example organisms

  • Chlamydia trachomatis
  • Neisseria Gonorrhoea
41
Q

What are the clinical symptoms of Pelvic inflammatory diseases?

A
  • Pyrexia
  • Pain
  • Lower abdominal pain
  • Deep dyspareunia
  • Abnormal vaginal/ cervical discharge
  • Abnormal vaginal bleeding
  • Sexual history
  • STI
  • Contraceptive history
42
Q

What is found on examination in patient with pelvic inflammatory diseases?

A

-Fever
-Lower abdominal tenderness (usually bilateral)
-Bimanual examination
of adnexal tenderness with or without a mass
-Cervical motion tenderness
-Speculum examination
-Lower genital infection
-Purulent cervical discharges
-Cervicitis

43
Q

What are investigations undertaken in patients suspected with pelvic inflammatory diseases?

A
  • Diagnostic laparoscopy is gold standard (Can also perform adhesiolysis and drain abscesses)
  • Urinary and/or serum pregnancy test
  • Endocervical and High vaginal swabs (absence of Clamydia trachomatis and Neisseria Gonorrhea doesnt exclude diagnosis)
  • Blood tests: WBC and CRP
  • Screening for other STIs including HIV
44
Q

What are drugs used to treat PIDs?

A
  • Ceftriaxone
  • Docycline
  • Metranidazole
45
Q

How are PIDs managed?

A
  • Low threshold for empirical treatment
  • Symptomatic management with analgesia and rest
  • Management of sepsis
  • Severe disease requires IV antibiotics and admission for observation and possible surgical intervention
  • Contact tracing for partners and full screening for women
46
Q

What are complications of PIDs?

A
  • Ectopic pregnancy
  • Infertility
  • Chronic pelvic pain
  • Fits-Hugh-Curtis syndrome
  • Reiter syndrome (disseminated chlamydial infection)

Kofi: Pure Clinical Sem 3 (44 decks)

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