Session 6 Flashcards
Why has there been a large increase in the incidence of STIs?
Increased transmission Increased GUM attendance Increased awareness Improved diagnostic methods Increased use of screening programmes
What are some of the morbidities associated with STIs?
Pelvic Inflammatory Disease Impaired fertility Reproductive tract cancers Risk of Blood Borne Virus infection Risk of congenital infection of neonate
What are the specific risk groups for STIs?
Young
Minority
Low Socio-economic status
Poor education
How can you treat STIs?
Antibiotics Antivirals Screen for other STIs as co-infections are common Contact tracing Advise abstinence
What are some of the viruses that cause STIs?
HPV
BBV
What are some of the bacteria that cause STIs?
Chlamydia trachomatis (Obligate intracellular bacterium) Neisseria gonorrhoeae Treponema pallidum (Syphillis)
What are some of the fungi that cause STIs?
Candida species
Ureaplasma urealyticum
Myoplasma horminis
What are some of the protozoa that cause STIs?
Trichomonas vaginalis (Underecognised in the UK)
What are some of the arthropods that cause STIs?
Scabies mite
Public louse
What are some examples of Genital tract infections?
Ulcers Warts Urethritis Vulvo vaginalis Prostatitis Epididymitis
What are the symptoms of Urethritis?
Discharge
Dysuria
Frequency
What does the Human Papillomavirus cause?
Genital warts
Benign epithelial/mucosal outgrowths
Cervical/anogenital cancer
What does the Herpes simplex virus cause?
Extensive painful genital ulceration
How do you treat Herpes?
Smear and swab of vesicle fluid and/or ulcer base
Treat with aciclovir (Antiviral that is only activated by cells that have the virus)
What does Chlamydia trachomatis cause?
Non specific genital chlamydial infections
Inflammation of areas of the tract
Conjuctivitis if inoculated into the eye
How do you treat Chlamydia?
Doxycycline or azithromycin
What is Neisseria gonorrhoeae?
A gram negative intracellular diplococcus
What does Neisseria gonorrhoeae cause in males?
Urethritis
Proctitis
Prostatitis
Epidymitis
What does Neisseria gonorrhoeae cause in females?
Endocervitis Urethritis PID Asymptomatic If disseminated can cause bacteraemia or skin/joint lesions
How do you diagnose and treat Neusseria gonorrhoeae?
Smear & culture
Intramuscular injection of ceftriaxone (Ciprofloxacin used to be used, but now resistance is too common)
What is Trichomonas vaginalis?
Flagellated protozoan whihc causes Trichomonas vaginitis
What are the symptoms of Trichomonas vaginitis?
Thin, frothy offensive discharge
Irritation
Dysuria
Vaginal inflammation
How do you diagnose Trichomonas vaginalis?
Vaginal wet preparation and or culture enhancement
How do you treat Trichomonas vaginitis?
Metronidazole (Also treats c. diff and other anaerobes or protozoa)
What are the 4 stages of Syphillis?
Caused by Treponema pallidum 1 = Indurated, painless ulcer 2 = 6-8 weeks later, fever rash mucosal lesions lymphadenopathy LATENT - Symptom free 3 = Chronic granulomatous lesions 4 = CVS & CNS pathology
How do you diagnose and treat syphillis?
Serology, dark field microscopy
Treat with penicillin
What are some examples of Non sexually transmitted GTIs?
Vulvo vaginal candidiasis (Younger people) Bacterial vaginosis (Middle aged people0
What causes Vulvo vaginal candidiasis?
Candida species such as albicans
What are the risk factors for Vulvo vaginal candidiasis?
Antibiotics Oral contraceptives Pregnancy Obesity Diabetes
How do you diagnose and treat Vulvo vaginal candidiasis?
Vaginal smear and culture
Topical azoles or nystatin
Oral fluconazole
What causes Bacterial vaginosis?
Pertubed normal flora eg Gardnerella
What is the symptoms of Bacterial vaginosis?
Offensive fishy discharge
How do you diagnose and treat Bacterial vaginosis?
KOH whiff test
Decreased lactobacilli
pH >5
Treat with metronidazole
