Sexual Health Flashcards

1
Q

Neisseria gonorrhoea

A

GN coffee bean shaped diplococci

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2
Q

GN coffee bean shaped diplococci

A

Neisseria gonorrhoea

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3
Q

PID symptoms in females

A

lower abdo pain, dyspareunia, fevers, vaginal discharge, IMB, PCB

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4
Q

lower abdo pain, dyspareunia, fevers, vaginal discharge, IMB, PCB are symptoms of

A

PID in females

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5
Q

PID causative organisms

A

Chlamydia trachomatis, Neisseria gonorrhoea (most common two), Gardnerella vaginalis, Haemophilus influenzae

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6
Q

Chlamydia trachomatis, Neisseria gonorrhoea (most common two), Gardnerella vaginalis, Haemophilus influenzae causes of

A

PID

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7
Q

Fitz-Hugh-Curtis S

A

complication of PID where infection tracks up to the liver from the pelvis, RUQ pain + perihepatitis, adhesions between liver capsule and abdo wall

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8
Q

complication of PID where infection tracks up to the liver from the pelvis, RUQ pain + perihepatitis, adhesions between liver capsule and abdo wall

A

Fitz-Hugh-Curtis S

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9
Q

Chlamydia trachomatis

A

GN intracellular coccoid/rod shaped pathogen

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10
Q

GN intracellular coccoid/rod shaped pathogen

A

Chlamydia trachomatis

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11
Q

condyloma acuminatum

A

benign genital warts

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12
Q

primary syphilis

A

2-3/52 post infection, painless, solitary, genital/perianal ulcer, may resolve spontaneously (can be multiple + painful)

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13
Q

painless genital ulcer, may resolve spontaneously

A

primary syphilis

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14
Q

secondary syphilis

A

4-8/52 post 1’ lesion, generalised illness, lymphadenopathy, diffuse macular papular rash (trunk + extremities, w/o sparing palms/soles, symmetrical, not itchy)

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15
Q

generalised illness, lymphadenopathy, diffuse macular papular rash (trunk + extremities, w/o sparing palms/soles)

A

secondary syphilis

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16
Q

tertiary syphilis

A

v rare, years post initial infection, granulomatous DZ, CVS DZ, neurological DZ

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17
Q

years post initial infection, granulomatous DZ, CVS DZ, neurological DZ

A

tertiary syphilis

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18
Q

trichomoniasis

A

Trichomonas vaginalis, frothy green discharge, pruitit, vaginitis, PCB, punctate haemorrhages (strawberry cervix)

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19
Q

frothy green discharge, pruitit, vaginitis, PCB, punctate haemorrhages (strawberry cervix)

A

trichomoniasis

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20
Q

candidiasis risk factors

A

DM, immunosuppression, recent ABx

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21
Q

DM, immunosuppression, recent ABx are risk factors of

A

candidiasis

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22
Q

vaginal discharge differentials

A

BV, gonorrhoea, chlamydia, candida, tricomonas

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23
Q

male urethral discharge differentials

A

gonorrhoea (2-5/7 incubation), chlamydia (1-3/52 incubation)

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24
Q

genital ulceration differentials

A

syphilis, herpes, Bechet’s S, LGV, chancroid

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25
Q

genital rash differentials

A

psoriasis, eczema, scabies

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26
Q

genital lesions differentials

A

lichen planus, lichen sclerosis, VIN, SCC, basal cell carcinoma, Paget’s DZ, malignant melanoma, Bartholin cyst/abscess, 2’ syphilis (condylomata lata), warts, molluscum contagiosum

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27
Q

dysuria differentials

A

chlamydia, gonorrhoea, UTI, non-specific urethritis

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28
Q

epididymitis

A

infection of the upper GU tract from an STI

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29
Q

infection of the upper GU tract from an STI

A

epidymitis

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30
Q

LGV

A

lymphogranuloma venereum = long term chronic infection of the lymphatic system, cause by Chlamydia trachomatis

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31
Q

Chlamydia strains

A

L1, L2, L3 = LGV

A-K = oculogenital chlamydia

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32
Q

contraception options

A

COCP, POP, IUD, IUS, implant, injection, withdrawal method, ovulation method, cap, diaphragm, condom, femadom, patch, ring

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33
Q

PID complications

A

chronic pain, infertility

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34
Q

chronic pain, infertility are complications of

A

PID

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35
Q

PID O/E

A

lower abdo pain, adenexal tenderness, cervical excitation, fever, dyspareunia, discharge

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36
Q

lower abdo pain, adenexal tenderness, cervical excitation, fever, dyspareunia, discharge O/E are indicative of

A

PID

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37
Q

PID DD

A

apendicitis, ectopic pregnancy, UTI, ovarical cyst torsion/rupture, endometriosis, IBS

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38
Q

PID investigations

A

pregnancy test, gonorrhoea + chlamydia NAATS, WCC, ESR, CRP, laproscopy, TVUS

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39
Q

PID management

A

analgesia, protected sex, ABx, partner notification

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40
Q

IUD

A

spermicidal + prevents implantation, effective immediately, periods heavier, longer, more painful, 2/1000 perforation, ectopic, infection, expulsion

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41
Q

spermicidal + prevents implantation, effective immediately, periods heavier, longer, more painful, 2/1000 perforation, ectopic, infection, expulsion

A

IUD

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42
Q

IUS

A

prevents endometrial thickening, effective after 7/7, periods lighter, 2/1000 perforation, ectopic, infection, expulsion

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43
Q

prevents endometrial thickening, effective after 7/7, periods lighter, 2/1000 perforation, ectopic, infection, expulsion

A

IUS

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44
Q

chlamydia investigations

A

urine/swab NAATS (nucleic acid amplification test)

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45
Q

chlamydia management

A
  1. azithromycin single dose
  2. doxycycline 7/7
    pregnancy use: azithromycin, erythromycin, amoxicillin
    partner notification (1/52 partners if symptomatic male, 6/12 of partners if asymptomatic or female)
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46
Q

chlamydia presentation

A

often asymptomatic, discharge, bleeding, dysuria, epididymoorchitis

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47
Q

chlamydia complications

A

epididymitis, PID, endometriosis, ectopic pregnancies, infertility, reactive arthritis, perihepatitis (Fitz-Hugh-Curtis S)

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48
Q

chlamydia screening

A

opportunistic e.g. freshers’ week, registering with a GP

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49
Q

urine/swab NAATS (nucleic acid amplification test)

A

chlamydia/gonorrhoea

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50
Q
  1. azithromycin single dose
  2. doxycycline 7/7
    pregnancy use: azithromycin, erythromycin, amoxicillin
    partner notification (1/52 partners if symptomat ic male, 6/12 of partners if asymptomatic or female)
A

chlamydia management

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51
Q

epididymitis, PID, endometriosis, ectopic pregnancies, infertility, reactive arthritis, perihepatitis (Fitz-Hugh-Curtis S)

A

chlamydia complications

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52
Q

opportunistic e.g. freshers’ week, registering with a GP

A

chlamydia screening

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53
Q

gonorrhoea presentation

A

discharge, dysuria

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54
Q

gonorrhoea complications

A

urethral strictures, epididymitis, salpingitis, PID, infertility, disseminated gonococcal infection, gonococcal arthritis, perihepatitis

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55
Q

DIG disseminated gonococcal infection

A

tenosynovitis, migratory polyarthritis, dermatitis, later complications: septic arthritis, endocarditis, perihepatitis

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56
Q

tenosynovitis

A

inflammation of the fluid filled sheath surrounding tendons

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57
Q

inflammation of the fluid filled sheath surrounding tendons

A

tenosynovitis

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58
Q

tenosynovitis, migratory polyarthritis, dermatitis, later complications: septic arthritis, endocarditis, perihepatitis

A

disseminated gonococcal infection

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59
Q

gonorrhoea management

A

ceftriaxone 500 mg IM single dose + azithromycin 1g PO single dose

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60
Q

ceftriaxone 500 mg IM single dose + azithromycin 1g PO single dose

A

gonorrhoea management

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61
Q

urethral strictures, epididymitis, salpingitis, PID, infertility, disseminated gonococcal infection, gonococcal arthritis, perihepatitis

A

gonorrhoea complications

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62
Q

causatie agent of syphilis

A

Treponema pallidum

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63
Q

transmission of Trepomena pallidum

A

sexually, ertically during pregnancy

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64
Q

description of ulcer in syphilis

A

macule to papule to ulcer, round, clean, indurated base, defined edges, heals w/i 3-10/52

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65
Q

in warm oppsed areas e.g. anus, labia the maculopapular rash of 2’ syphilis can

A

coalesce to form large fleshy masses - condyloma lata

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66
Q

if 2’ syphilis is left untreated

A

will resolve, may have recurrent episodes of 2’ syphilis

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67
Q

latent syphilis

A

when s/o has untreated syphilis w/o signs/symptoms

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68
Q

early stage latent syphilis

A

DZ present for <2 years

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69
Q

late stage latent syphilis

A

DZ present for >2 years

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70
Q

latent syphilis aka

A

3’ syphilis

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71
Q

neurosyphilis definition

A

10-20 years post-infection, asymptomatic, meningovascular/parenchymatous (general paresis + tabes dorsalis)

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72
Q

tabes dorsalis process

A

slow degeneration of dorsal column neural tracts, leading to loss of proprioception, vibration + discriminative touch

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73
Q

meningovascular syphilis presentation

A

early (part of 2’)/late (2-20 years post-infection) stages of syphilis, acute meningeal involvement (during 2’ syphilis), headache, papilloedema, Argyll Robertson pupils

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74
Q

Argyll Robertson pupil

A

sm, unequal pupils, react to accommodation, not to light (ARP = accommodation reflex present)

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75
Q

parenchymatous syphilis describes

A

general paresis, tabes dorsalis

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76
Q

early symptoms of general paresis

A

irritability, fatiguability, personality change, headaches, impaired memory, tremor

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77
Q

late symptoms of general paresis

A

lack of insight, depression/euphoria, confusion, disorientation, delusions, seizures, transient paralysis, aphasia

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78
Q

signs of general paresis

A

expressionless facies, tremor of lips/tongue/hands, dysarthria, impairment of handwriting, hyperreflexia, pupillary abnormalities, optic atrophy, convulsions, extensor plantar responses

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79
Q

tabes dorsalis symptoms

A

increasing ataxia, failing vision, sphincter disturbances, attacks of severe pain (lightening), paraesthesiae, deafness, ED

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80
Q

asymptomatic neurosyphilis

A

no neuro signs/symptoms, diagnosis based on serum/SCF

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81
Q

paraesthesiae

A

abnormal sensation, tingling/pricking, caused by P + damage of n

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82
Q

tabes dorsalis signs

A

Argyll Robertson pupil, absent refleces, Romberg’s sign, impaired vibration/proprioception/touch/pain sensation, optic atrophy, ocular palsies, Charcot’s joints

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83
Q

Romberg’s sign

A

close eyes, stand still, tests proprioception

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84
Q

Charcot’s joint

A

neuropathic arthropathy

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85
Q

CVS syphilis most commonly affects

A

large vessels, aorta

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86
Q

symptoms of CVS syphilis

A

are that of an aneurysm affecting the arch of the aorta putting P on mediastinal structures

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87
Q

gummata

A

3-12 years post infection, granulomatous lesions, painless, 3’ syphilis

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88
Q

diagnosing syphilis

A

NAATs, PCR, dark ground microscopy (1’ + 2’), serology (RPR, EIA), CSF, radiology

89
Q

syphilis Hx

A

previous syphilis screening/diagnosis/treatment

90
Q

serum RPR for syphilis

A

non-specific, becomes +ve 3-5/52 post-infection, quantitative assessment of stage + DZ activity (i.e. response to treatment), false +ves in acute infecion (HSV, measles, mumps, AI DZ, RA)

91
Q

serum EIA for syphilis

A

specific, become +ve early in DZ course (2-4/52 post infection), false +ve in yaws

92
Q

suspected neurosyphilis investigations

A

LP, neuro examination

93
Q

treatment of syphilis

A

penicillin (benzylpenicillin), doxycycline in PenA

94
Q

syphilis management

A

early: contact tracing (previous 3-6/12)

95
Q

T. pallidum is a

A

spirochaete bacterium

96
Q

CVS syphilis causes

A

aortic regurgitation, angina, aortic aneurysm, 10-40 years post-infection

97
Q

1’ syphilis presentation in HIV

A

larger, painful, multiple ulcers

98
Q

2’ syphilis presentation in HIV

A

genital ulcers (slow healing of 1’ ulcers), higher titres of RPR

99
Q

Treponema pallidum causes

A

syphilis

100
Q

macule to papule to ulcer, round, clean, indurated base, defined edges, heals w/i 3-10/52 describes

A

ulcer in syphilis

101
Q

when s/o has untreated syphilis w/o signs/symptoms

A

latent syphilis

102
Q

3’ syphilis aka

A

latent syphilis

103
Q

10-20 years post-infection, asymptomatic, meningovascular/parenchymatous (general paresis + tabes dorsalis) describes

A

neurosyphilis

104
Q

slow degeneration of dorsal column neural tracts, leading to loss of proprioception, vibration + discriminative touch

A

tabes dorsalis

105
Q

early (part of 2’)/late (2-20 years post-infection) stages of syphilis, acute meningeal involvement (during 2’ syphilis), headache, papilloedema, Argyll Robertson pupils

A

meningovascular syphilis

106
Q

sm, unequal pupils, react to accommodation, not to light

A

Argyll Robertson pupil

107
Q

no neuro signs/symptoms, diagnosis based on serum/SCF

A

asymptomatic neurosyphilis

108
Q

close eyes, stand still, tests proprioception

A

Romberg’s test

109
Q

neuropathic arthropathy

A

Charcot’s

110
Q

3-12 years post infection, granulomatous lesions, painless

A

gummata, 3’ syphilis

111
Q

HSV-1 vs HSV-2 in genital herpes

A

HSV-1 is the most common causative agent of 1st episode herpes, HSV-2 is more likely to manifest as recurernt DZ

112
Q

HSV incubation period

A

5-14/7, although 1st episode of visible ulcer may be aftert this (not symptomatic at every flare)

113
Q

progression of a herpes ulcer

A

vesicular to ulcer

114
Q

herpes presentation

A

painful genital ulcer(s), local tender lymphadenopathy, m aches, headache, malaise, photophobia

115
Q

duration of a herpes episode

A

3/52

116
Q

local complications of herpes

A

superinfection of lesions (strep/staph), adhesion formation, vaginal candida, dysuria, urinary retention

117
Q

distant complications of herpes

A

myalgia, dissemination (to neonate in pregnancy), autoinnoculation to distant sites, erythema multiforme

118
Q

neuro complications of herpes

A

headache, encephalitis, radiculitis, transverse myelitis, AI neuropathy

119
Q

psychological complications of herpes

A

anxiety, depression

120
Q

risk factors for f recurrence of herpes

A

HSV-2 infection, no previous infection with ither HSV type, male > female, 1st year following infection, symptomatic acquisition episode, prolonged acquisition episode, immunocompromised

121
Q

herpes diagnosis

A

PCR, culture, Ag detection

122
Q

management of first episode herpes

A

PO antiviral: aciclovir, famciclovir, valaciclovir 5-10/7, PO analgesia

123
Q

management of herpes recurrences

A

may not require treatment, short course antiviral during prodrome, continuous antivirals (valaciclovir), counselling

124
Q

counselling in HSV infection

A

source of infection, duration of illness, natural course of illness (risk of asymptomatic shedding), future treatment options, reducing transmission, pregnancy (inform + prevent new acquisition), partner notification

125
Q

genital herpes in pregnancy first episode

A

PO/IV aciclovir, planned vaginal delivery, daily suppressive aciclovir from 36/40, greatest risk if episode occurs in 3rd trimester (offer c/s)

126
Q

genital herpes in pregnancy recurrent episodes

A

no threat to foetus, avoid foetal scalp monitoring, consider c/s if active at EDD

127
Q

neonatal herpes acquisition

A

contact with infected maternal genital tract, noscomisal, community acquired

128
Q

neonatal herpes types

A

local, encephalitis, disseminated (potentially fatal)

129
Q

painful genital ulcer(s), local tender lymphadenopathy, m aches, headache, malaise, photophobia describes the presentation of

A

genital herpes

130
Q

superinfection of lesions (strep/staph), adhesion formation, vaginal candida, dysuria, urinary retention are

A

local complications of herpes

131
Q

HSV-2 infection, no previous infection with ither HSV type, male > female, 1st year following infection, symptomatic acquisition episode, prolonged acquisition episode, immunocompromised are risk factors for

A

recurent herpes

132
Q

PO antiviral: aciclovir, famciclovir, valaciclovir 5-10/7, PO analgesia is the managment for

A

first episode genital herpes

133
Q

may not require treatment, short course antiviral during prodrome, continuous antivirals, counselling is the management for

A

recurrent episode genital herpes

134
Q

active outbreak of herpes in pregnancy increases transmission of

A

HIV

135
Q

HPV is a risk factor for

A

cervical ca, vulval ca, vaginal ca, penile ca, anal ca

136
Q

low risk HPV strains

A

6, 11 associated with genital warts

137
Q

high risk HPV strains

A

16, 18 (cervical ca)

138
Q

genital warts presentation

A

asymptomatic, pruitis, irritation, single vs multiple

139
Q

genital warts diagnosis

A

clinical examination, biopsy in uncertain situations

140
Q

when to biopsy a genital wart

A

pigmented, indurated, fixed, unresponsive to treatment, persistent ulceration, persistent bleeding

141
Q

types of genital wart

A

condylomata acuminata, smooth papules, flat papules, keratotic warts

142
Q

condylomata acuminata

A

cauliflower-like appearance, skin coloured, pink, hyperpigmented, non-keratinised on mucosal surfaces, may be keratotic on skin

143
Q

smooth papules

A

usually dome shaped, skin coloured

144
Q

flat papules

A

macular/slightly raised, flesh coloured, smooth surface, > common on internal structures e.g. cervix, but also on external genitalia

145
Q

keratotic warts

A

thick, horny layer, resembles common warts/seborrheic keratosis

146
Q

genital wart DD

A

molluscum contagiosum, condylomata lata (syphilis), seborrheic keratosis, lichen planus, fibroepithelial polyp, adenoma, melanocytic naevus, neoplastic lesion, pearly penile papules/coronal papilae, fordyce spots, vestibular papillae (micropapillomatosis labialis), skin tags (acrochordons)

147
Q

genital wart management

A

education on transmission, stop smoking (may help HPV clearance), treatment is aesthetic > viral clearance/infectivity, chemical applications, cryotherapy, excision, electrosurgery, laser, counselling

148
Q

genital wart investigations

A

STI screen, contact tracing

149
Q

two types of HPV vaccine available

A

Gardasil (HPV-6, 11, 16 + 18), Cervarix (HPV-16 + 18)

150
Q

HPV-6 + 11

A

are low risk strains causing benign genital warts

151
Q

HPV-16 +18

A

are high risk strains contributing to cervical + other genital cancers

152
Q

cauliflower-like appearance, skin coloured, pink, hyperpigmented, non-keratinised on mucosal surfaces, may be keratotic on skin

A

condylomata acuminata

153
Q

usually dome shaped, skin coloured

A

smooth papules

154
Q

macular/slightly raised, flesh coloured, smooth surface, > common on internal structures e.g. cervix, but also on external genitalia

A

flat papules

155
Q

thick, horny layer, resembles common warts/seborrheic keratosis

A

keratotic warts

156
Q

factors contributing to increased risk of HIV transmission

A

viral load, coexisting STIs, type of sexual activity, f of sexual activity, breach in mucosal barrier, genital HSV (increases HIV shedding + susceptibility to infection)

157
Q

protective factors of HIV transmission

A

condons, male circumcision

158
Q

mother to child transmission rates

A

1/3 w/o intervention, 10% in utero, 50% delivery related, 40% breastfeeding

159
Q

prevention + control of HIV

A

surveillance, provision of testing, counselling, education, screening blood donors, heat treatment of blood products, antiretroviral treatment, infant feeding counselling, needle exchanges, STI detection/treatment, male circumcision, family planning/contraception

160
Q

HIV in pregnancy at delivery c/s vs vaginal delivery

A

vaginal delivery (w/o instrumentation) is safe in women who have an undetectable viral load, c/s is recommended in those with a detectable VL

161
Q

breastfeeding for mothers with HIV

A

not recommended, unless it is unsafe (risk vs benifit) for the baby to be by an alternative method

162
Q

primary HIV infection presentation

A

subclinical, fever, malaise, myalgia, lymphadenopathy, pharyngitis, rash, ?transient aseptic meningoencephalitis

163
Q

ELIZA detects Abs which are produced

A

2-6/52 post infection, some people undergo delayed seroconversion + require repeat testing at 3/12

164
Q

VL post HIV infection

A

initially v high, rapidy decline w/i days/weeks, then a plateau

165
Q

high VL is associated with a low

A

CD4 count + quicker progression to symptomatic DZ

166
Q

most common physical feature of chronic HIV

A

persistent lymphadenopathy (cervical/axillary)

167
Q

non-specific features of declining CD-4 count

A

fevers, night sweats, diarrhoea, weight loss

168
Q

skin conditions associated with immunosuppression

A

seborrhoeic dermatitis, folliculitis, impetigo, tinea infections

169
Q

oral mucosa conditions associated with immunosuppression

A

oral candidiasis, oral hairy leucoplakia, HZV, recurrent oral/anogenital HSV

170
Q

AIDS

A

1 or more indicator conditions, in absence of other immunodeficiency, CD4 <200 cells/mm2

171
Q

AIDS defining DZs

A

TB, pneumocustis, cerebral toxoplasmosis, 1’ cerebral lymphoma, cryptococcal meningitis, progressive multifocal leucoencephalopathy, Kaposi’s sarcoma, persistent cryptosporidiosis, NHL, cervical ca, CMV retinitis

172
Q

pneumocystis jiroveci presentation

A

malaise, fatigue, weight loss, dry cough, SOB, fever, retrosternal chest pain, desaturate on exertion

173
Q

pneumocystis jiroveci CXR

A

?N, bx fine infiltrates (perihilar)

174
Q

pneumocystis jiroveci diagnosis

A

cytology of induced sputum, fibre optic bronchoscopy + bronchioalveolar lavage

175
Q

management of pneumocystis jiroveci

A

high dose co-trimoxazole, steroids in severe DZ

176
Q

complication of pneumocystis jiroveci

A

pneumothorax (exclude in PTs with clincal deterioration)

177
Q

lymphadenopathy, night sweats, fevers, weight loss think

A

TB

178
Q

oropharyngeal candidiasis presentation

A

dysphagia, retrosternal discomfort

179
Q

oropharyngeal candidiasis diagnosis

A

biopsy/culture at endoscopy

180
Q

oropharyngeal candidiasis treatment

A

fluconazole + itraconazole

181
Q

oral hairy leukoplakia is caused by

A

EBV

182
Q

oral hairy leukoplakia presentation

A

white lesions on the lateral border of the tongue

183
Q

cerebral toxoplasmosis DD

A

1’ cerebral lymphoma, cerebral abscess

184
Q

AIDS-related dementia

A

memory loss, apathy, impaired concentration, hyperreflexia, hypertonia, frontal signs

185
Q

HIV retinopathy

A

benign, cotton wool spots w/o haemorrhages

186
Q

CMV retinitis

A

destructive, potentially blinding

187
Q

CMV retinitis presentation

A

floaters, blurring, loss of central vision, flashing lights, scotomas, ux (maybe bx)

188
Q

CMV retinitis fundoscopy

A

retinal pallor, multiple granular white dots, haemorrhages, starts in the periphery and spread to macula

189
Q

complications of CMV retinitis

A

retinal detachment, branch retinal a occlusion, cataract, persistent iritis

190
Q

management of CMV retinitis

A

IV ganciclovir

191
Q

Kaposi’s sarcoma causative agent

A

HHV-8 aka KSHV

192
Q

Kaposi’s sarcoma presentation

A

violaceous plaques, macules, papules, nodules, non-pigmented lesions may occur

193
Q

KS diagnosis

A

histology

194
Q

NHL in HIV+ PTs compared with HIV-

A

more advnaced, less responsive to cytotoxic treatment, extranodal DZ (CNS, BM, GIT)

195
Q

> 50% of AIDS related lymphomas are associated with

A

EBV/HHV-8/both

196
Q

cervical smear f in HIV+ women

A

annually

197
Q

HIV+ve PTs have an increased risk of which non-HIV related conditions

A

CVS, renal, liver DZ, neurocognitive impairment, non-AIDS ca

198
Q

HIV management

A

antiretrovirals

199
Q

types of antiretrovirals

A

NRTIs (nucleoside/nucleotide analogue reverse transcriptor inhibitors), NNRTIs (non-NRTIs), PI (protease inhibitors), entry inhibitors, fusion inhibitors, CCR5 antagonists, integrase inhibitors

200
Q

choice of antiretrovirals dependent on

A

PT choice, toxicity profile, pill burded, dosing schedule, likelihood of adherence, comorbidities, drug interactions

201
Q

objective of antiretroviral therapy

A

is to keep VL <5O copies/mL (undetectable)

202
Q

when to initiate antiretroviral therapy decision based upon

A

at diagnosis, clinical status, VL, benifit vs drug toxicity, PT choice

203
Q

problems with current antiretroviral therapies

A

drug resistance, long term drug toxicity

204
Q

immune reconstitutional S describes

A

restoration of immune function with subsequent worsening of opportunistic infections

205
Q

immune reconstitutional S occurs after

A

the initiation of antiretroviral therapy in PTs with low CD4

206
Q

immune reconstitutional S presentation

A

fever, worsening of opportunistic infections

207
Q

subclinical, fever, malaise, myalgia, lymphadenopathy, pharyngitis, rash, ?transient aseptic meningoencephalitis

A

1’ HIV infection presentation

208
Q

low CD4 count is associated with high

A

VL + quicker progression to symptomatic DZ

209
Q

malaise, fatigue, weight loss, dry cough, SOB, fever, retrosternal chest pain, desaturate on exertion

A

pneumocystis jiroveci

210
Q

high dose co-trimoxazole, steroids in severe DZ

A

pneumocystis jireoveci

211
Q

white lesions on the lateral border of the tongue

A

oral hairy leukoplakia

212
Q

benign, cotton wool spots w/o haemorrhages

A

HIV retinopathy

213
Q

floaters, blurring, loss of central vision, flashing lights, scotomas, ux (maybe bx)

A

CMV retinitis

214
Q

retinal pallor, multiple granular white dots, haemorrhages, starts in the periphery and spread to macula

A

CMV retinitis

215
Q

restoration of immune function with subsequent worsening of opportunistic infections

A

immune reconstitutional S

216
Q

progressive multifocal leukoencephalopathy is caused by

A

JC virus

217
Q

cerebral toxoplasmosis on CT

A

single/multiple, ring enhanced lesions, mass effect

218
Q

diarrhoea in HIV+ PTs most common causative agent

A

cryptosporidium

219
Q

other cause of diarrhoea in HIV

A

CMV, mycobacterium avium intracellulare, giardia