Sexually Transmitted Infections Flashcards
define bacterial vaginosis
a bacterial overgrowth of gardenerella vaginalis leading to vaginal discharge with an associated fishy odour
diagnostic criteria of bacterial vaginosis
Amstel criteria - 3/4 must be present to confirm diagnosis
criteria of Amstel criteria for bacterial vaginosis
vaginal pH >4.5
homogenous grey discharge
whiff test- 10% potassium hydroxide produces fishy odour
clue cells present on wet mount
management of bacterial vaginosis
oral metronidzaole (400mg 2XD for 5-7days) or clindamycin
management of bacterial vaginosis in pregnancy
oral metronidzaole (400mg 2XD for 5-7 days) or intravaginal gel (1XD for 5 days)
risks associated with bacterial vaginosis in pregnancy
preterm rupture of membranes
premature labour
define genital chlamydia infection
an infection caused by chlamydia trachomatis bacterium
clinical features of chlamydia
can be asymptomatic but can present with:
urethral discharge and dysuria in men
dysuria, intermenstrual bleeds and vaginal discharge in women
investigations of chlamydia
endo-cervical swab for NAAT
urine and urethral swab for NAAT
management of chlamydia
doxycycline BD for 7 days OR azithromycin 1g single dose
define genital candidiasis
an infection caused by candida albicans
risk factors of genital candidiasis
pregnancy
antibiotics
immunosuppression
clinical features of genital candidiasis in women
itching thick white curdly discharge sour milk odour dysuria superficial dyspareunia (painful intercourse)
clinical features of genital candidiasis in men
soreness
pruritis
redness
management of genital candidiasis
intravaginal antifungal cream/pessary
oral antifungal
examples of intravaginal antifungal creams/pessarys
clotrimazole
econazole
miconazole
fenticonazole
examples of oral antifungals
fluconazole
itraconazole
management of genital candidiasis in pregnancy
clotrimazole
miconazole
define molluscum conatgiosum
an infection caused by the poxvirus that is transmitted via skin-skin contact
clinical features of molluscum contagiosum
small and smooth pearly coloured papules with central area of umbilication
management of molluscum contagiosum
can clear spontaneously after 3mnths
cryotherapy
define gonorrhoea
a STI caused by Neisseria gonorrhoea - a gram -ve diplococci
clinical features of gonorrhoea in men
mucopurulent or purulent discharge dysuria anal discharge perianal/anal pain pruritus pharyngeal infection
clinical features of gonorrhoea in women
increase or altered vaginal discharge (mucopurulent)
lower abdominal pain
contact-induced bleeds
dysuria
investigation of gonorrhoea
nucleic acid amplification test (NAAT) via vulvovaginal swab or first-pass urine sample
management of gonorrhoea
ceftriaxone (500mg IM) or oral azithromycin (1g)
define trichomoniasis
a sexually transmitted infection caused by flagellated protozoan trichomonas vaginalis
clinical features of trichomoniasis
can be asymptomatic but if symptomatic:
women
- frothy yellow discharge
- vulval itching
- dysuria
- offensive odor
- lower abdominal discomfort
men
- dysuria
- uretheral discharge
investigations of trichomoniasis
NAAT for T.vaginalis and other STIs via high vaginal swab or urethral swab or first-void urine
management of trichomoniasis
avoidance of sexual intercourse for 1wk following treatment oral metronidazole (2g single dose or 400-500mg 2XD for 5-7 days)
define genital herpes
an infection with herpes simplex virus (HSV-1 or HSV-2) that causes oral, genital and ocular ulcers
most common cause of genital herpes
HSV-2
clinical features of first episode of genital herpes
multiple painful blisters that develop into erosions and ulcers vaginal or urethral discharge local oedema tingling/neuropathic pain fever headache dysuria malaise
investigations of genital herpes
viral culture of site swabs
PCR or NAAT of ulcer base
supportive management of genital herpes
saline bathing
oral analgesics
topical lidocaine
increase fluid intake
medical management of genital herpes
aciclovir (400mg 3XD for 5 days)
valciclovir (500mg 2XD for 5 days)
medical management of genital herpes in pregnancy
oral aciclovir (400mg 3XD)
