Sexual Health Flashcards
what is the presentation of chlamydia?
what is the incubation period of it?
caused by Chlamydia trachomatis (obligate intracellular, gram negative bacterium)
7-21 days
most are asymptomatic
dysuria or discharge
intermenstrual or postcoital bleeding
can cause an ascending infection (acute salpingitis or PID)
what is the life cycle of chlamydia?
1) elementary bodies (infectious particles which are released when infected cells rupture, attach to sperm and endocervical cells)
2) reticulate bodies (replicating intracytoplasmic form of chlamydia)
what is the treatment of chlamydia?
what is the contact tracing?
PO doxycycline 100mg bd for seven days
or single dose oral azithromycin 1g stat
contact tracing: 4w for symptomatic male, 6m asymptomatic male, 6m asymptomatic female
what investigations are used to diagnose chlamydia?
NAAT testing
urine: first void urine sample
swabs (LVS, endocervical)
what type of bacterium is gonorrhoea? what is it’s incubation period? what are the symptoms?
gram negative diplococcus
2-5 days
green/yellow discharge within 2 weeks of infection, dysuria, intermenstrual bleeding
what are the complications of gonorrhoea?
strictures
salpingitis
epididymitis
disseminated gonococcal infection (triad of tenosynovitis, migratory polyarthritis, dermatitis)
what is the management of gonorrhoea?
ceftriaxone 1g IM
if ceftriaxone is refused =
PO cefixime 400mg + 2g azithromycin PO
diagnose using NAAT
How does infection with Candida albicans present?
Cottage cheese (thick white) discharge
Vulvitis
Itch
what is the management of thrush (candida albicans)
clotrimazole pessary 500mg stat
OR
fluconazole 150mg PO
what is the presentation of trichomonas vaginalis?
offensive, yellow/green, frothy discharge
vulvovaginitis
strawberry cervix
what is the treatment for trichomonas?
what is trichomonas associated with?
metronidazole 2g PO
low birth weight, PPROM and preterm birth
What is the look back period for gonorrhoea?
symptomatic males: 2 weeks
asymptomatic males: 3m
all females: 6m
how does bacterial vaginosis present?
what are the investigations?
(Gardnerella vaginalis)
offensive fishy grey/colourless thin discharge
do a microscopy to look for ‘clue cells’, a swab and culture
what is the treatment for bacterial vaginosis?
metronidazole 2g
how does primary HSV present?
multiple painful genital blisters
lymphadenopathy
urinary retention
may present with severe gingivostomatitis or cold sores
discharge has a pH <4.5
what is the management of a primary HSV infection?
genital herpes: PO aciclovir 400mg 3x daily, 7 days
saline baths
if gingivostomatitis: oral aciclovir, chlorhexidine mouthwash
pregnant? = first attack of herpes in pregnancy >28w = elective caesarean at term
recurrent herpes? = prophylactic aciclovir at 36w
blisters are HIGHLY CONTAGIOUS and wait until symptoms pass/10-21 days to have sex
how does primary, secondary, and tertiary syphilis present?
Treponema pallidum
incubation period 9-90 days
primary = painless chancre at the site of sexual contact
secondary = 6-10w after infection. fevers, lymphadenopathy, rash on palms, trunk, legs, soles. buccal ‘snail tracks’. condylomata lata
tertiary = gummas, ascending aortic aneurysms, tabes dorsalis, Argyll-Robertson pupil
what are the features of congenital syphilis?
blunted upper incisor teeth keratitis saber shins saddle nose deafness
what are the investigations of syphilis?
cardiolipin tests (becomes negative after treatment) treponemal specific antibody tests
what is the management of syphilis?
1) IM benzathine penicillin OR doxycycline
what strains of HPV cause genital warts?
6 and 11
how do genital warts present?
what is the treatment?
also known as condylomata accuminata
small fleshy painless lumps
topical podophyllotoxin or imiquimod
what are the most common organisms in epididymo-orchitis?
how do you treat it?
E coli is the most common organism in older adults or those with BPH
N. gonorrhoea, C. trachomatis are the most likely cause in younger men
ceftriaxone 500mg IM + doxycycline 100mg
