Sexually Transmitted Diseases Flashcards
What does poor sexual health lead to
- poor maternity outcomes
- pregnancies/ abortions
- psychological consequences
- HIV transmission
- STDs
- cancers
symptoms of chlamydia
mostly asymptomatic but may cause bleeding
pathophysiology of chlamydia
attaches to mucosal surface and induces a strong inflammatory response
Complications of chlamydia in male and female
M - epididymitis (inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm)
F - pelvic inflammatory disease (PID)
tests used to diagnose chlamydia
urine sample and vaginal/urethral swab
1st and 2nd line treatment for chlamydia
1st - doxycycline 100mg BD for 7 days
2nd - erythromycin 500mg BD for 10-14 days OR azithromycin 1g OD for 1 day then 500mg orally OD for 2 days
symptoms of gonorrhoea
less asymptomatic than chlamydia
sometimes bleeding and pain on urination
pathophysiology of gonorrhoea
attaches to mucosal surface and resists phagocytosis
complications of gonorrhoea in M and F
M - epididymitis (inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm)
F - Pelvic inflammatory disease and possibility to pass from mum to baby during birth
test to diagnose gonorrhoea
urine sample or urine/vaginal swab
1st and 2nd line treatment for gonorrhoea
1st - ceftriaxone 1g IM injection as a single dose
2nd - ciprofloxacin 500mg orally as single dose
pathophysiology of syphilis
helical structure of T. pallidum allows it to move through mucosal surface or enter breaks in skins
5 stages and symptoms of each for syphilis
- initial contact (2-10w)
- primary genital ulcer (painless) - primary syphilis (1-3m)
- swollen glands in neck, groin or armpits - secondary syphilis (2-6w)
- small skin growths, red rash and flu-like - latent syphilis (3-30y)
- infection lies dormant - tertiary syphilis
- meningitis, stroke, dementia, numbness
test to diagnose syphilis
blood sample
virology swab from active lesions - to exclude herpes simplex virus (HSV)
treatment of syphilis
initiated at GUM clinic
antibiotic used but is unlicensed for syphilis treatment in UK
Pathophysiology of genital warts
due to HPV types 6 and 11
replicates within basal cells of epithelium
symptoms of genital warts
genital swelling and warts which may appear over a year after initial infection
can cause pain when peeing/ bleeding
treatment for genital warts
no treatment
most disappear spontaneously within 6 months
patients can self-apply meds but this has significant failure/relapse rates so not recommended
- podophyllotoxin
- imiquimod
- sinecatechins
pathophysiology of genital herpes
due to HSV types 1 and 2
passes through direct skin-to-skin contact and exposure to infected saliva, semen, vaginal fluid or fluid from herpetic blisters
symptoms of genital herpes
discharge and pain on peeing malaise headache dysuria fever tender lymph nodes in groin painful ulcers in genital area
test to diagnose genital herpes
visual diagnosis
swab of lesion for viral culture
PCR test
1st and 2nd line treatment for genital herpes
1st - aciclovir 400mg x3/day for 5-10 days OR 200mg x5/day for 5-10 days
2nd - valaciclovir 500mg BD for 5-10 days OR famciclovir 250mg x3/day for 5-10 days
patients can also use self-care to relieve symptoms
name 3 screening programmes
National Chlamydia Screening Programme (NCSP) - free screening for young people (15-24y) available in range of settings (GP, GUM clinics, pharmacies and non-healthcare settings e.g. colleges)
National HPV Immunisation Programme - protects against 4 types of HPV (6, 11, 16 and 18)
Syphilis Action Plan - 4 aims: increase test frequency, partner notification, antenatal screening and sustain targeted health promotion