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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
What is trichomanas vaginalis?
Infection but flagellated Protozoa Treated with metranidazole
26
Scabies can spread sexually. True/False
True. It can affect the genitalia and spread. Treatment is permethrin
27
What are anogenital warts?
- Benign lesion caused by the HPV virus | - More than 100 HPV types
28
Which HPV types commonly cause genital warts?
Types 6 or 11
29
What are the features of anogenital warts?
-Benign, painless, epithelial or mucosal outgrowths Found at Penis, Vulva, Vagina, Urethra, Cervix, Perianal skin
30
Which strains of HPV are high risk oncogenic?
HPV 16 | HPV 18
31
What is used in the diagnosis of Anogenital warts?
-Biopsy in atypical lesion or non-response treatment
32
What are the treatment measures for anogenital warts?
- No treatment - Topical application - Physical ablation - HPV vaccination
33
What is bacterial vaginosis?
Common cause of abnormal (fishy) discharge in women of childbearing age. - Gardnerella vaginalis - Treated with metronidazole
34
What is vulvovaginal candidiasis?
- 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
What is pelvic inflammatory disease?
- Result of infection ascending the endocervix | - Causes endometriosis, salpingitis, parametrises, oophoritis, tubo-ovarian abscess and/or pelvic peritonitis.
36
What is the pathophysiology of pelvic inflammatory disease?
- 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
What is endometritis?
Inflammation of the endometrial lining
38
What is salpingitis?
- 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
What are complications of salpingitis?
-Abscess can form which can spread around the ovaries or within the tube
40
What is the aetiology of pelvic inflammatory disease?
-Sexually transmitted disease Example organisms - Chlamydia trachomatis - Neisseria Gonorrhoea
41
What are the clinical symptoms of Pelvic inflammatory diseases?
- Pyrexia - Pain - Lower abdominal pain - Deep dyspareunia - Abnormal vaginal/ cervical discharge - Abnormal vaginal bleeding - Sexual history - STI - Contraceptive history
42
What is found on examination in patient with pelvic inflammatory diseases?
-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
What are investigations undertaken in patients suspected with pelvic inflammatory diseases?
- 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
What are drugs used to treat PIDs?
- Ceftriaxone - Docycline - Metranidazole
45
How are PIDs managed?
- 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
What are complications of PIDs?
- 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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