Sexually Transmitted Disease Flashcards
define a sexually transmitted disease
disorder of a structure or function caused by a sexually transmitted pathogen
what is a sexually transmitted infection?
an infection by a pathogen which is sexually transmissible (unlikely to be transmitted by sexual means)
what is a sexually transmitted microbe?
a virus/bacteria or protozoan that is spread by sexual contact
what organism causes gonorrhoea?
Neisseria gonorrhoeae
what is the male presentation of gonorrhoea?
> asymptomatic (10%) (rectal and pharyngeal)
dysuria
thick profuse yellow discharge
what is the female presentation of gonorrhoea?
> dysuria
vaginal discharge
bleeding: intermenstrual and post coital
what complications can arise form gonorrhoea in men?
> epididymitis
what complications can arise form gonorrhoea in women?
> pelvic inflammatory disease
> Bartholin’s abscess
what complications can arise form gonorrhoea in men and women?
> acute mono-arthritis (elbow and shoulder)
> disseminated gonococcal infection (skin lesions of pustular halo)
what treatment is there for gonorrhoea?
> antibiotics according to sensitivities > blind: azithromycin 1g or ceftriaxone 500mg > follow up - test for cure at 2 weeks - test for reinfection at 3 months
how is gonorrhoea diagnosed?
> nucleic acid amplification (urine/swab)
gram stained smear
culture (checks sensitivity)
what causes chlamydia?
chlamydia trachomatis
what are the symptoms for chlamydia in men?
> dysuria
slight watery discharge
conjunctivitis
asymptomatic (70%)
what are the symptoms for chlamydia in women?
> asymptomatic (80%) > dysuria > vaginal discharge > bleeding (intermenstrual and post coital) > conjunctivitis
what complications can occur from chlamydia in men?
> epididymitis
what complications can occur from chlamydia in women?
> pelvic pain
pelvic inflammatory disease (ectopic pregnancy)
infertility
what complications can occur in both men and women from chlamydia?
> cervicitis
urethritis
reactive arthritis (reiters syndrome)
how is chlamydia diagnosed?
> first void urine in men
swab (cervix, urethra, rectum)
NAAT test
what is the management of chlamydia?
> azithromycin 1g
doxycycline 100mg for 1 week (rectal infection)
follow up at 3 -12 months for reinfection
what causes herpes STI?
herpes simplex one and two
how does herpes present?
> 80% have no symptoms > burning/itching then blistering then tender ulceration > tender inguinal lymphadenopathy > flu like symptoms > dysuria > neurological pain (back, pelvis, legs)
what complications can occur in herpes infection?
> autonomic neuropathy (urinary retention)
secondary infection
neonatal infection
HSV2 is an important cofactor in the transmission of what?
HIV
what is the incubation period of herpes?
5 days to months
how is herpes diagnosed?
> clinically
> PCR of lesion swab
what is the management for herpes?
> ACICLOVIR for primary outbreak
- 400g twice a day frequent occurrence
- 1.2g daily until symptoms have gone in in frequent occurrence
lidocaine ointment
what causes syphilis?
treponema pallidum
how does primary syphilis present?
local ulcer
how does secondary syphilis present?
> rash
mucosal ulceration
neuro symptoms
patchy alopecia
describe the early latent stage of syphilis
no symptoms but less than 2 years since infected
describe late latent stage of syphilis
no symptoms but more than 2 years since infected
how does tertiary syphilis present?
> neurological symptoms
gummatous skin lesions
cardiovascular symptoms
what is the incubation period in syphilis?
9-90 days
how is early syphilis managed?
> benzathine penicillin 2.4 Mu once
> doxycycline 100mg 2 times a day for 2 weeks
how is syphilis diagnosed?
> PCR sample from ulcer
clinical signs
serology
what complications can arise from syphilis?
> congenital syphilis
> neurosyphilis (cranial nerve palsies, aortal involvement, cardiac involvement)
what are the symptoms of trichomonas vaginalis?
> asymptomatic in men
vulvulitis
frothy, foul and profuse vaginal discharge
in what group is trichomonas vaginalis more common?
middle aged women
what complications can trichomonas vaginalis lead to?
> miscarriage
> preterm labour
how is trichomonas vaginalis diagnosed?
> PCR of vaginal swab
> microscopy of preparation of vaginal discharge
how is trichomonas vaginalis managed?
metronidazole 2g single dose or 400mg twice a day for 5 days
how do angiogenital warts present?
> cauliflower lumps
> perianal/intra-uthral bleeding/itching
what causes angogenital warts?
human papilloma virus types 6-11
what percentage of people infected with HPV get warts?
20%
what complications can arise from angogenital warts
neonatal laryngeal papillomatosis
how are angiogenital warts diagnosed?
> clinically
> biopsy (if unusual, to exclude intra-epithelial neoplasia)
how are angioigenital warts managed?
> podophylootoxin
imiquimod
cryotherapy
diathermy or scissor removal if bulky
