Sexually transmitted diseases

Question 1

What diseases present in the throat?

Answer 1

chlamydia, gonorrhea, syphilis

Question 2

What disease present in the mouth?

Answer 2

herpes, HIV, HPV

Question 3

What does chlamydia infect?

Answer 3

Infects mucosal epithelium

Question 4

What is the incubation period for chlamydia?

Answer 4

1 - 4 weeks

Question 5

What is the % of people who dont show any symptoms for chlamydia?

Answer 5

M >50%

F >70%

Question 6

What happens if chlamydia infects the uterus and fallopian tubes?

Answer 6

Leads to pelvic inflammatory disease (PID)

Question 7

What is the % of people who get PID following endocervical injection?

Answer 7

17%

Question 8

What does PID cause?

Answer 8

Infertility or ectopic pregnancies

Question 9

What measures have been put in place to reduce % of people not knowing they have chlamydia?

Answer 9

National screening programme for 15 - 24 yr old to be screened every year

Question 10

How does Gonorrhoea present?

Answer 10

Purulent discharge, accompanied by inflammation
15% M asymptomatic
50% F asymptomatic

Question 11

What diagnostic test is used to detect gonnorhoea?

Answer 11

NAAT - nucleic acid amplification test

Question 12

What areas are swabbed for diagnostic testing of gonorrhea?

Answer 12

M - urine, throat, rectum

F - vaginal, endocervical

Question 13

What treatment is there for gonorrhea?

Answer 13

Antibiotics but no sex for 7 days after starting them
Tracing of partners
Ceftiaxone, Ciproflaxin, azithromycin
Antimicrobial resistant so need dual therapy

Question 14

What treatment is there for Chlamydia?

Answer 14

Antibiotics - Doxycylcine, azithromycin

Question 15

What are the 3 main causes of genital ulceration?

Answer 15

Herpes simplex virus
Primary syphilis
Non sexually transmitted infection

Question 16

How many types of genital herpes?

Answer 16

2 types : HSV 1 and HSV 2

Question 17

What is the incubation period for genital herpes?

Answer 17

2 days - several weeks

Question 18

How does herpes present?

Answer 18

Flu like symptoms
Vesicles burst to form ulcers which then crust and heal and then asymptomatic shedding occurs once healed
Dysuria
Latent infection in spinal nerve root ganglia

Question 19

How is herpes diagnosed?

Answer 19

Swabs

Question 20

What is the treatment for herpes?

Answer 20

Acyclovir 5 - 10 days

Question 21

How easy it herpes to transmit?

Answer 21

Transmission without lesions is small but not 0

20 - 60% have the virus

Question 22

What causes syphilis?

Answer 22

Spriochaete bacterium called Treponema pallidum

Question 23

Where is syphilis common?

Answer 23

MSM
Africa
Sex workers

Question 24

What is the incubation period for syphilis?

Answer 24

9-90 days

Question 25

How long is the primary infection for syphilis?

Answer 25

9- 90 days

Question 26

How long is the secondary infection fr syphilis?

Answer 26

6 weeks - 6 months

Question 27

How does syphilis present?

Answer 27

Painless ulcer - can get it in the back of the throat

Question 28

What causes genital warts?

Answer 28

Human papilloma virus (>100 types)

Question 29

Where does genital warts present?

Answer 29

Hands, feet, genitals

Question 30

What is the incubation period for genital warts?

Answer 30

2 weeks - 8 months

Question 31

How are genital warts treated?

Answer 31

Cryotherapy | Topical creams

Question 32

How often does it reoccur?

Answer 32

Reoccurs in 25% and virus is cleared over time by the immune system

Question 33

What is the link with HPV and cervical cancer?

Answer 33

1% of those with high risk HPV develop cervical cancer

Question 34

Which types of HPV are associated with cancer?

Answer 34

HPV 16 and 18

Question 35

What is the link between inflammation and HIV?

Answer 35

Increased HIV load during inflammatory response

Question 36

Where is HIV prevalent?

Answer 36

Sub - Saharan Africa - more poverty and less education Europe (esp Eastern) - intravenous drugs UK - 25% unaware, MSM highest incidence

Question 37

How is HIV transmitted?

Answer 37

vaginal, anal, oral, blood, vertical transmission

Question 38

What cells does the virus infect?

Answer 38

CD4 T-helper cells

Question 39

Describe the progression of HIV?

Answer 39

Long latent period where virus and CD4 levels are stable | Eventually CD4 reduced and viral load increases

Question 40

What delays progression to AIDS?

Answer 40

Medication

Question 41

What is PEP?

Answer 41

Post exposure prophylaxis. 1 month HAART if needlestick/splash from high risk patient

Question 42

What is PEPSE?

Answer 42

post exposure prophylaxis after sexual exposure. 1 month course of HAART

Question 43

What are high risk fluids for HIV?

Answer 43

``` blood CSF breast milk peritoneal fluid amniotic fluid saliva ```

Question 44

What are low risk fluids for HIV?

Answer 44

vomit faeces urine