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HD 2 > Sexually Transmitted Diseases > Flashcards

Sexually Transmitted Diseases Flashcards

1
Q

What is the most common STI?

A

Chlamydia

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2
Q

What STI are Black African men and women particularly over-represented for?

A

Chlamydia

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3
Q

What bacteria causes chlamydia?

A

Chlamydia trachomatis

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4
Q

What do serovars D-K (chlamydia) cause in males, females and neonates?

A

Males - urethritis, epipdidymitis, prostatitis
Females - cervicitis, PID, Fitz-Hugh Curtis
Neonate - conjunctivitis and pneumonia

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5
Q

What do serovars L1-3 (chlamydia) cause?

A

Lymphogranuloma venereum

Buboes, proctitis

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6
Q

What are the complications of chlamydia? (2)

A

Reactive arthritis

Infertility

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7
Q

How is chlamydia treated? (2)

A

Azithromycin

Doxycycline

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8
Q

What causes genital warts?

A

Human Papilloma Virus

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9
Q

How many % of genital warts are asymptomatic?

A

90%

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10
Q

What HPV sub-types are associated with carcinoma?

A

16, 18, 31, 33

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11
Q

How are genital warts managed? (3)

A

Topical podophyllotoxon
Imiquimod
Cryotherapy

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12
Q

What bacteria causes gonorrhoea?

A

Neisseria gonorrhoea

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13
Q

What does gonorrhoea cause in males, females and neonates?

A

Males – urethritis, proctitis, sore throat, epididymitis, prostatitis
Females – cervicitis, PID, Peri-hepatitis, septic abortion
Neonates – Conjunctivitis

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14
Q

How is gonorrhoea treated?

A

Ceftriaxone

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15
Q

What are the complications of gonorrhoea? (4)

A

Septic arthritis, blindness, infertility, septicaemia

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16
Q

Herpes simplex virus 1 and 2 - what does each one cause?

A

HSV-1 oral

HSV-2 genital

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17
Q

How is herpes managed? (3)

A

Aciclovir
Famciclovir
Valaciclovir

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18
Q

What bacteria causes syphilis?

A

Treponema pallidum

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19
Q

What are the different stages of syphilis? (5)

A 
Primary
Secondary
Latent
Tertiary
Congenital
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20
Q

How is syphilis treated?

A

Penicillin

Doxycycline

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21
Q

How does primary syphilis present?

A

Chancre (usually single, painless)
Lymphadenopathy
Very infectious

22
Q

Is serology positive or negative in primary syphilis?

A

May be negative

23
Q

Is serology positive or negative in secondary syphilis?

A

Positive

24
Q

How does secondary syphilis present?

A

Very infectious
Rash, fever, lymphadenopathy
Condyloma lata (wart-like lesions on genitals)

25
Q

Is the incidence or prevalence of HIV decreasing?

A

Decreasing incidence (increasing prevalence)

26
Q

How many adults and children are living with HIV?

How many in the UK?

A

36.9 million

91,500

27
Q

What other medical conditions might lead to healthcare professionals to test the patient for HIV?

A

TB

Lymphoma

28
Q

What are the symptoms of a primary HIV 1 infection?

A 
Headache
Lymphadenopathy
Pharyngitis
Nausea
Rash
Myalgias
Fever, fatigue, weight loss, night sweats
Oral/genital ulceration
29
Q

Primary HIV 1 infection is said to be a ____ illness.

A

Seroconversion

30
Q

How many % patients develop symptoms within 2-6 weeks of HIV infection?

A

75%

31
Q

Why does HIV have a wide differential diagnosis?

A

It presents as a non-specific, glandular fever/flu-like illness.

32
Q

During primary HIV infection, what can be said about the viral replication? What about the CD4 count?

A

Increased

Decreased

33
Q

During primary HIV infection, the patient may be HIV antibody negative. Why is this?

A

HIV antibody can take up to 3 months to become positive

34
Q

What antigen is tested for in HIV?

A

P24 antigen (positive in primary infection)

35
Q

Primary infection of HIV is a time of high or low risk of transmission?

A

High

36
Q

How does HIV cause disease?

A

HIV infects CD4+ T-cells (T-helper cells), macrophages and dendritic cells. Acute (primary) HIV infection leads to massive loss of CD4+ cells. Chronic HIV infection is associated with on-going loss of CD4+ cells, decline in immune system.

37
Q

What is the direct effect of HIV? (3)

A

Wasting, diarrhoea, neurological problems

38
Q

What are the types of opportunistic infections caused by HIV?

A

Viral, fungal, bacterial, mycobacterial and parasitic infections

39
Q

What are the malignancies caused by HIV? (3)

A

Kaposi’s sarcoma, lymphoma, carcinoma (cervix)

40
Q

What happens as the CD4 count falls?

A

Risk of HIV-related disease increases (some OIs only occur at low CD4 counts)

41
Q

What happens if the CD4 count is >500?

A

Low risk of HIV-related disease

42
Q

What happens if the CD4 count is 350-500?

A

Symptomatic HIV

43
Q

What happens if the CD4 count is <200 or <100?

A

Gut infections, CMV, toxoplasmosis etc

44
Q

How does anti-retroviral therapy aim to do?

A

Suppression HIV replication, causing CD4 count recovery (“immune reconstitution”). This causes a long term reduced risk of morbidity and mortality.

45
Q

What does HAART stand for? How many classes of anti-retroviral drugs are currently available?

A

Highly Active Antiretroviral Therapy

6

46
Q

How do anti-retroviral drugs work?

A

Act during viral replication cycle to prevent production of new HIV particles

47
Q

What is combination anti-retroviral therapy?

A

3 drugs from at least 2 (of the 6) classes of drugs

48
Q

What are the six classes of anti-retroviral drugs?

A 
Nucleoside reverse transcriptase inhibitors (e.g zidovudine)
Non-NRTIs (e.g. nevirapine)
Protease inhibitors (e.g. indinavir)
Fusion inhibitors (enfuvirtide)
Integrase inhibitors (e.g. raltegravir)
Co-receptor antagonists (maraviroc)
49
Q

What are the short-term side effects of HAART?

A 
Nausea / vomiting / headache
Sleep disturbance (Non-NRTIs e.g. efavirenz)
50
Q

What are the long-term side effects of HAART?

A

Lipodystrophy (NRTIs and PIs)
Renal dysfunction (tenofovir - NRTI)
Peripheral neuropathy
Lactic acidosis

51
Q

How is HIV managed in pregnancy?

A

Early screening for HIV
Anti-retroviral therapy for mother and infant
Elective C section (vaginal delivery possible if undetectable HIV load)
No breastfeeding

52
Q

What is the risk of transmission from mother to child with HIV?

A

1% with management

HD 2 (25 decks)

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