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finals > sexual health > Flashcards

sexual health Flashcards

1
Q

which organism causes syphilis

A

treponema pallidum

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2
Q

what are the tests for syphilis

A
  1. cardiolipin tests (e.g VDRL)

2. treponema antibody specific tests

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3
Q

what should the syphilis cardiolipin tests (VDRL) show after treatment

A

VDRL: negitive after treatment

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4
Q

what should the syphilis antibody tests show after treatment

A

remains positive after treatment

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5
Q

what can cause a falsely positive cardiolipin test

A

pregnancy
hiv
TB
malaria

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6
Q

what are the primary symptoms of syphilis

A
  1. chancre at site of contact

2. local painless lymphadenopathy

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7
Q

what are the secondary symptoms of syphilis

A
  1. rash: soles, palms, trunk
  2. systemic: rash, fevers, lymphadenopathy
  3. oral snail track ulcers
  4. condylomata lata - warts on genitals
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8
Q

what are the tertiary manifestations of syphilis

A 
gummas
ascending aortic aneurysm
tabes dorsalis - neurosyphilis - locomotor ataxia
syphilis dementia
argyll robertson pupil
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9
Q

what is the first line management of syphilis

A

IM benzathine penicillin

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10
Q

name 3 signs of tertiary syphilis

A

argyll robertson pupil
gummas
tabes dorsalis

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11
Q

name complications of syphilis

A

aortic aneurysms

neurosyphilis

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12
Q

what is the incubation period of treponema pallidum

A

9-90 days

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13
Q

name a reaction that commonly occurs following treatment of syphilis

A

Jarisch-herxheimer
- condition that happens a couple of hours after 1st antibiotic dose that mimics anaphylaxis
presents with fever, tachycardia and rash
but no wheeze or hypotension

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14
Q

what organism causes chlamydia

A

chlamydia trachomatis

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15
Q

symptoms of chlamydia

A

female: cervicitis (bleeding, funny discharge), dysuria
male: dysuria, urethral discharge
or asymptomatic
females more likely to be asymptomatic

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16
Q

tests for chlamydia

A

nuclear acid amplification test

females: vaginal / cervical swab
males: first void urine sample

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17
Q

what does chlamydia trachomatis look like under the microscope

A

gram negative
intracellular
can be rods or cocci

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18
Q

what is the first line treatment of chlamydia

A

doxycycline 100mg bd for 7 days

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19
Q

how would you treat a pregnant lady with chlamydia

A

azithromycin / amoxicillin

must explain the risk and benefits of treating and let the woman decide herself

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20
Q

name complications of chlamydia for both males and females

A

F; PID, infertility, increased ectopic pregnancy risk, preihepatitis
M: epididymoorchitis, proctitis, infertility

both: reactive arthritis

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21
Q

how does chlamydia screening happen

A

opportunistic screening for asymptomatic young people aged 15-25

advised to screen once a year or even more if changes partners

22
Q

what are the contact tracing rules for chlamydia / gonnorhoea

A

asymptomatic men and women: all sexual contacts from past 6 months

symptomatic man: all sexual contacts within the 4 weeks prior to symptom onset

23
Q

what is fitz-hugh-curtis syndrome

A

a complication of a chlamydia infection that spreads to the liver from PID causing inflammation and swelling of the tissue surrounding the liver and stomach

24
Q

when should chalmydia/gonnorhoea testing take place after sexual contact

A

2 weeks after sexual contact

25
Q

what does gonorrhoea look like under microscope

A

gram negative diplococci

26
Q

which organism causes gonorrhoea

A

neisseria gonorrhoae

27
Q

1st line treatment of gonorrhoea

A

IM ceftriaxone

28
Q

test for gonorrhoea

A

NAAT plus culture for sensitivities

29
Q

complications of gonorrhoea

A 
epididymitis
urethral strictures
PID
infertility
anal / oral disease
salpingitis
30
Q

what are the symptoms of disseminated gonorrhoea

A

tenosynovitis
migrating polyarthritis
dermatitis - usually vesicular or macuopapular
endocarditis
perihepatitis (fits-hugh-curtis syndrome)
septic arthritis (haematogenous spreading)

31
Q

green frothy discharge from vagina, strawberry cervix, vulvovaginitis

A

trichomonas vaginalis

32
Q

management of trichomonas

A

oral metronidazole

33
Q

what is seen on microscopy in trichomonas

A

motile trophzoites

34
Q

smelly, clear / white discharge

A

BV

35
Q

what organism overgrows in BV

A

gardenella vaginalis

36
Q

what is seen on testing for BV

A
  1. alkalotic pH >4.5

2. clue cells on microscopy

37
Q

management of BV

A

oral metronidazole

38
Q

complications of BV in pregnancy

A

preterm labour
low birth weight
late miscarriage

39
Q

HIV pathophys

A

HIV-1 (most common) enters body –> infects T lymphocytes and other immune cells –> gets into cell –> viral RNA made into DNA by reverse transcriptase –> DNA goes into cell nucleus –> replicates –> releases more virus –> lots of mutations along the way so hard to get rid of –> travels to local lymph nodes and infects the immune cells there –> travels round body

40
Q

HIV seroconversion symptoms

A

fever headache malaise flu like symptoms myalgia, rash, arthralgia, diarrhoea, mouth ulcers

41
Q

what do you use to monitor HIV / response to treatment

A

cd4 cell count

42
Q

what treatments are used in ART

A

2 x nuceloside reverse transcriptase inhibitors plus either 1 protease inhibitor or 1 non-nucleoside reverse transcriptase inhibitors

43
Q

when should ART be started

A

as soon as diagnosis comes positive

44
Q

how do you test / screen for HIV

A

HIV antibody testing
p24 antigen

both of the above should be used for screening
HIV viral load can also be used if confirmed

45
Q

what methods are used to do the HIV antibody testing

A

enzyme linked immune sorbent assay and western blot assay

46
Q

what are the expected results of HIV antibody testing within 1st 1-4 weeks

A

no antibodies found

47
Q

when will HIV antibodies become present on testing

A

between 4 weeks to 3 months

48
Q

when will p24 antigen become positive

A

when viral load raises between 1-4 weeks

49
Q

when is repeat HIV testing recommended

A

if both positive it should be repeated to confirm diagnosis

if both come back neg they should be invited back in 12 weeks to double check they aren’t pos

50
Q

how long after exposure to HIV are patients recommended to test

A

after 4 weeks

51
Q

HIV positive patient presents to A+E with SOB, massive heamoptysi, hypotensive, tachycardic and multiple purple plaques on the skin he’s had for 4 weeks.

what is the likely diagnosis

A

kaposi sarcoma (purple plaques) - a HIV associated cancer
can have respiratory and GI tract involvement
resp involvement can cause massive haemoptysis and pleural effusion

finals (18 decks)

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