Sexually Transmitted Infections Flashcards
What are the top 3 most common STIs?
1) Chlamydia Trachomatis,
2) Human Papilloma Virus,
3) Neisseria Gonnorhoeae
What are the risk factors for getting an STI?
- Young age,
- Failure to use barrier contraceptives,
- Non-regular sexual relationships,
- Men who have sex with men,
- IV drug use,
- African origin,
- Social deprivation,
- Sex workers,
- Poor access to advice and treatment of STIs
What are some determinants of risky sexual behaviour?
Individual factors - low self-esteem, lack of skills, lack of knowledge of unsafe sex.
- External influences - peer pressure, attitudes and prejudices of society.
- Service provision - accessibility of sexual health services and/or lack of resources such as condoms
What are three basic microbial testing for STIs?
1) NAAT - used for chlamydia and n.gonnorhoea and herpes.
2) Microscopy, culture and sensitivity -used for N.gonorrhoeae, candidam bacterial vaginosis and trichomonas,
3) Blood tests - syphilis, HIV and hepatitis
What are the female and male symptoms of chlamydia trachomatis
female - Vaginal or anal discharfe, post-coital bleeding, abdo tenderness, pelvic tenderness, infertility, reactive arthritis, proctitis, pharyngitis and perihepatitis.
Male - Urethral/anal discharge, epididymal tenderness, prostatitis, reactive arthritis, proctitis, pharyngitis and perihepatitis.
What are some of the complications of a chlamydia infection?
- Pelvic inflammatory disease (associated with infertility, ectopic pregnancies and chronic pelvic pain)
- Sexually acquired reactive arthritis (SARA) (urethritis, arthritis and conjunctivitis)
- Epididymo-orchitis,
- Peri-hepatitis
What are some of the chlamydia investigations?
Women - Vulvo-vaginal swab (self taken)
Men - First catch urine
Extra genital sites - rectal and pharyngeal.
How is chlamydia treated?
Doxycycline 100mg twice daily for 7 days whilst avoiding sexual contact and notify partner
What is lymphogranuloma venerum?
It is caused by one of the three invasive serovars of chlamydia trachomatis. It presents with a solitary genital lesion, proctitis and lymphadenopathy. Treatment if doxycycline
Describe features of the neisseria gonorrhoea infection
Gram negative bacteria that infections the epithelial cells of the mucous membrane of GU tract or rectum. Resulting in the development of localised infection with production of pus
What are the symptoms of gonorrhoea in men and women?
Females - Dysuria, rectal infection, salpingitis, PID, pharyngeal infection, post-coital bleeding and septic arthritis.
Males - Urethral discharge, anal discharge (with/without pain and bleeding)
- Epididymal tenderness, pharyngeal infection and septic arthritis
What are some of the investigations for Gonorrhoea?
- Light microscopy,
- NAAT,
- For men its First catch urine,
- For women its a vulvo-vaginal swab,
- For men who have sex with men take a rectal and pharyngeal sample
What is the treatment for gonorrhoea?
Ceftriaxone 1g IM or ciprofloxacin 500mg orally however there is increasing resistance to antibiotics but most respond to ceftriaxone. Parner needs notified and tested
How does a candida albicans (thrush) infection present?
Itch, vulval pain, superficial dyspareunia and curd like vaginal discharge.
How is thrush diagnosed and treated?
Diagnosis - clinical and microscopy.
Treatment - Topical clotrimazole
What are the stages of a treponema pallidum infection (syphilis)
Primary - Hard genital or oral ulcer at site of infection.
Secondary - Red maculopapular rash anywhere plus pale moist papules in urogenital region and mouth.
Tertiary - Degeneration of NS, aneurysms and granulomatous lesions in liver, skin and bones.
How is syphilis diagnosed?
- From lesions or infected lymph nodes early on.
- Dark field microscopy,
- Direct fluorescent antibody (DFE) test,
- EIA for immunoglobin
What is the treatment for syphilis?
Early syphilis - Benzathine penicillin (single dose).
- Late latent, cardiovascular and gummatous syphilis -Benzathine penicillin for 3 weeks
What does the human papilloma virus cause?
- Urogenital warts,
- Cervical cancer,
- Laryngeal papillomas,
- Common, flat and plantar warts
How can the HPV be diagnosed and treated?
Virus can be seen on colposcopy.
Treatment - Podophyllum, cryo, laser and surgery
What are some prevention mechanisms for HPV?
Killed HPV vaccines which are given to girls aged 12-13, and MSM under age 45
Describe the two types of herpes simplex virus?
HSV-1 which usually affects the oral region and causes cold sores.
HVS-2 which is associated with genital infection
How does the primary genital herpes infectoin present?
Flu-like symptoms, tingling neuropathic pain in genital area, extensive bilateral crops of painful blisters in genital area, tender lymph nodes, local oedema, vaginal/urethral discharge
What is the treatment of primary infection genital herpes
- Saline bathing,
- Local anasthetics,
- Aciclovir
What is recurrant genital herpes
Occurs following primary infection as the virus can become latent in local sensory ganglia. Therefore there is periodic reactivation.
How can you diagnose HSV?
- Clinical appearance,
- Viral culture,
- NAAT of a swab from base of ulcer,
- Serology
