Sexual Health Flashcards
Sx of chlamydia in women?
Abnormal vaginal discharge
Pelvic pain
Abnormal vaginal bleeding (intermenstrual or postcoital)
Painful sex (dyspareunia)
Painful urination (dysuria)
Examination findings of chlamydia in females?
Pelvic or abdominal tenderness
Cervical motion tenderness (cervical excitation)
Inflamed cervix (cervicitis)
Purulent discharge
Complications of chlamydia in pregnancy?
Preterm delivery
Premature rupture of membranes
Low birth weight
Postpartum endometritis
Neonatal infection (conjunctivitis and pneumonia)
What is trichomoniasis infection caused by?
Flagellated protozoan parasite
Sx of trichomoniasis infection?
Both females and males.
What colour is the discharge?
Females:
* Profuse, frothy, yellow discharge
* Vulval irritation
* Dyspareunia
* Strawberry cervix
Males:
* Non-gonococcal urethritis
Tx of trichomoniasis infx?
- Oral metronidazole
- Abstain from sexual activity 1 wk
What’s balanitis?
When head of penis (glans) becomes inflamed
What is chancroid typically caused by?
STI of genital skin caused by gram-negative bacillus Haemophilus ducreyi (H. ducreyi)
Sx of chancroid
- Painful genital lesion - may bleed on contact
- Painful lymphadenopathy a.k.a bubo - may rupture + discharge pus
Tx of chancroid
Abx:
Ceftriaxone
Azithromycin
What is Lymphogranuloma Venereum and what is it caused by?
LGV is a STI caused by L1, L2 or L3 serovars of chlamydia trachomatis.
MC - MSM
Sx of Lymphogranuloma Venereum?
- Painless genital ulcer
- Inguinal lymphadenopathy
- Proctitis - rectal pain + discharge
- Systemic sx - fever
Tx of Lymphogranuloma Venereum?
Abx:
Oral doxycycline
Oral erythromycin
Oral tetracycline
What are genital herpes caused by?
Caused by infx w/ HSV-1 or HSV-2
HSV-1 : Associated w/ oral herpes + MC cause of genital herpes
HSV-2 : Previously MC
Genital herpes sx
- Multiple painful genital ulcers
- Dysuria
- Vaginal/urethral discharge
- Crusting + healing of lesions
- Systemic sx - fever
Tx of genital herpes
Antivirals:
Aciclovir
Valaciclovir
What is syphilis and which bacteria causes it? How is it transmitted?
A STI caused by spirochete bacterium Treponema pallidum.
Transmission:
* Primarily transmitted through direct contact with syphilis sores or rash during vaginal, anal, or oral sex.
* Can also be transmitted from an infected mother to her unborn child, resulting in congenital syphilis.
Difference between primary, secondary and tertiary syphilis?
Primary = Occurs 3 wks post exposure. Highly contagious during this stage.
Secondary = Develops wks to mths and still highly contagious through skin membrane contact.
Tertiary = Occurs years to decades after initial infx if untreated. Less contagious but can cause severe health problems.
Sx present in the following:
1. Primary syphilis
2. Secondary syphilis (manifests 4-10 weeks post-primary infection)
3. Tertiary syphilis (may occur 20-40 years after primary infx in untreated patients)
4. Congenital syphilis
- Single painless lesion (chancre) - round and heals spontaneously within 3-8 wks + painless regional lymphadenopathy.
- Symmetrical maculopapular rash involving palms, soles and face + mucosal ulcers and lymphadenopathy + malaise, fever, hep and glomerulonephritis.
- Gummatous, CVD complications, neuro complications (i.e. dementia, paresis)
- Infant presents with rash on palms/feet soles, mucous patches/lesions in mouth/nose/genitals, fever, hepatosplenomegaly, anaemia, bone developmental abnormalities
Gummatous = a tusmor of gummy or rubbery consistency that is characteristic of the tertiary stage of syphilis
Ix for syphilis?
Dark field microscopy - samples from primary lesions or secondary rash but not oral lesions (false +ve)
PCR testing - oral lesions
Serological tests - treponemal tests (most sensitive for 2 or latent stages)
Tx of syphilis in:
1. Primary, secondary and early latent syphilis
2. Tertiary and late latent syphilis
3. Neurosyphilis
- Single dose IM penicillin G (benzathine benzylpenicillin)
- Longer course IM penicillin G for 2-3 weeks
- IV penicillin G for 10-14 days
What is a Jarisch-Herxheimer reaction?
On initial tx of syphilis this reaction may occur. This is an acute febrile illness which is self-resolving within 24 hours. Generally, patients can be reassured and given antipyretics for the fever.
What is trichomonas vaginalis?
Trichomoniasis is a sexually transmitted infection (STI) caused by the flagellated protozoan parasite, Trichomonas vaginalis.
Sx of trichomonas vaginalis
In women:
Profuse, frothy, yellow vaginal discharge
Vulval irritation
Dyspareunia
Rare ‘strawberry cervix’ sign may be observed in some cases
In men:
Non-gonococcal urethritis
