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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
what does gonorrhoea look like under microscope
gram negative diplococci
26
which organism causes gonorrhoea
neisseria gonorrhoae
27
1st line treatment of gonorrhoea
IM ceftriaxone
28
test for gonorrhoea
NAAT plus culture for sensitivities
29
complications of gonorrhoea
``` epididymitis urethral strictures PID infertility anal / oral disease salpingitis ```
30
what are the symptoms of disseminated gonorrhoea
tenosynovitis migrating polyarthritis dermatitis - usually vesicular or macuopapular endocarditis perihepatitis (fits-hugh-curtis syndrome) septic arthritis (haematogenous spreading)
31
green frothy discharge from vagina, strawberry cervix, vulvovaginitis
trichomonas vaginalis
32
management of trichomonas
oral metronidazole
33
what is seen on microscopy in trichomonas
motile trophzoites
34
smelly, clear / white discharge
BV
35
what organism overgrows in BV
gardenella vaginalis
36
what is seen on testing for BV
1. alkalotic pH >4.5 | 2. clue cells on microscopy
37
management of BV
oral metronidazole
38
complications of BV in pregnancy
preterm labour low birth weight late miscarriage
39
HIV pathophys
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
HIV seroconversion symptoms
fever headache malaise flu like symptoms myalgia, rash, arthralgia, diarrhoea, mouth ulcers
41
what do you use to monitor HIV / response to treatment
cd4 cell count
42
what treatments are used in ART
2 x nuceloside reverse transcriptase inhibitors plus either 1 protease inhibitor or 1 non-nucleoside reverse transcriptase inhibitors
43
when should ART be started
as soon as diagnosis comes positive
44
how do you test / screen for HIV
HIV antibody testing p24 antigen both of the above should be used for screening HIV viral load can also be used if confirmed
45
what methods are used to do the HIV antibody testing
enzyme linked immune sorbent assay and western blot assay
46
what are the expected results of HIV antibody testing within 1st 1-4 weeks
no antibodies found
47
when will HIV antibodies become present on testing
between 4 weeks to 3 months
48
when will p24 antigen become positive
when viral load raises between 1-4 weeks
49
when is repeat HIV testing recommended
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
how long after exposure to HIV are patients recommended to test
after 4 weeks
51
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
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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