sexually transmitted infections

Question 1

some consequences of STIs

Answer 1

Infertility
* Ectopic pregnancy
* Cervical cancer
* Pelvic inflammatory disease (PID)
* Congenital infections
* Adverse pregnancy outcomes
* Death of infants and adults

Question 2

some common STI symptoms

Answer 2

fever
chills
headache
muscle aches
sore throat
swollen lymph nodes
rashes
fatigue
night sweats
mouth ulcers

Question 3

some differences between UTIs and STDs

Answer 3

some occurences that are unlikely in UTIs but likely/happen in STDs ;
vaginal/urethral/abdominal or rectal discharges
genital rash/sores/blisters
genital itch
spotting( light vaginal bleeding that occurs outside of your regular menstrual cycle)
painful intercourse
vaginal or rectal pain

there is no blood in urine in STDs but there is in UTIs
no cloudy or smelly urine in STDS or it is unlikely, but there is in UTIs

note that fever is less common in STDs but still occur

Question 4

name some common STIs

Answer 4

syphillis
trichomoniasis
gonorrhea
HPV (human papilloma virus )
Hepatitis B
Chlamydia
HHV-8 (human herpes virus 8)
HIV
herpes

Question 5

the most common sti in the UK

Answer 5

chlamydia

Question 6

chlamydia is mostly symptomatic, true or false

Answer 6

false it is asymptomatic in most cases

mostly affects women

Question 7

some symptoms of chlamydia in women

Answer 7

Increased vaginal or cervical
discharge – this can be purulent
(containing pus)

• Deep pain during sex
• Bleeding after sex
• Intermenstrual bleeding
• Dysuria

Question 8

some chlamydia symptoms in men

Answer 8

Dysuria
* Urethral discharge
* Pain in the testicles

Question 9

the NCSP, what it stands for, and what it is aimed at and any other important thing you know about it

Answer 9

National Chlamydia Screening Programme

Aimed at sexually active people under 25, to reduce the cases of untreated chlamydia

It’s recommended that these individuals get screened annually if they have any risk factors, such as new or multiple sexual partners.

Chlamydia is typically diagnosed through urine samples or swabs from the cervix, urethra, or throat (depending on sexual behavior).

The urine test (for both men and women) is the most common method of screening, as it is less invasive.

usually targets ages 16-24
results come back in 2 wks

Question 10

first line treatment for chlamydia and the initial dose

precaution to be taken when taking this drug

Answer 10

doxycycline

Initially 200 mg daily in 1–2 divided doses for 1 day, then 100 mg daily. can only use for 7 days

no sexual activity while taking the treatment

this is a tetracycline antibiotic

dose from bnf(Initially 200 mg daily in 1–2 divided doses for 1 day, then 100 mg daily.)

Question 11

second line treatment for chlamydia and the initial dose

precaution to be taken when taking this drug

Answer 11

Azithromycin

• 1g single dose(1 day), then 500mg daily
  for two more days
• No sexual activity for seven days
  after treatment

this is a macrolide antibiotic

Question 12

genital warts are caused by?
describe their appearance

Answer 12

HPV

The warts tend to be small and soft, but can link to look like cauliflower-like lumps

Question 13

which areas are affected by genital warts

Answer 13

anywhere in the anogenital region

Question 14

genital warts are painful true or false

Answer 14

false, they are usually painless

Question 15

treatments for genital warts

Answer 15

Suggested treatments are
* Imiquimod cream (Aldara®)
* Podophyllotoxin cream (Warticon®)

HPV vaccination

for topical treatments, The patient would be shown by the prescriber where all the warts are, so they can be sure they are treating all of them

Question 16

does HPV cause only warts?

Answer 16

no, it can also cause cancer

Question 17

gonnorhea symptoms in women

there is a lot of antibiotic resistance in gonorrhea

Answer 17

Increased vaginal discharge

• Lower abdominal pain
• Dysuria – with no change in
  frequency
• Pain during sex
• Intermenstrual bleeding

in 50% of women it can be asymptomatic

Question 18

some gonorrhea symptoms in men

Answer 18

Purulent urethral discharge

Dysuria – with no change in
frequency

in 10% of men can be asymtomatic, meaning its mostly symptomatic in men , compared to women

Question 19

usual first line treatment for gonorrhea

Answer 19

Ceftriaxone 500mg , administered as IM injection – single dose

note that gono is generally managed in secondary care, and that contact tracing is important in gono, just as in chlamydia

Question 20

contact tracing

Answer 20

Contact tracing is a public health method that identifies and isolates people who may have been exposed to an infectious disease. The goal is to stop the spread of the disease by breaking the chain of transmission

Question 21

syphilis is not very common but in which scenario is syphilis more prevalent?

Answer 21

More prevalent in men who have sex with men (MSM)

GAY

Question 22

how many stages of syphilis are there, and describe them

Answer 22

3

Primary: Presents as a single ulcer (chancre) in the anogenital region. Usually develops 14-21 days after infection. Can be 0.3-3cm in size

Secondary: Presents as a non-itchy rash – often involving the palms of the hands and the soles of the feet.Wart -like lesions, Fever, headache, and malaise

Tertiary: Rarely seen – due to effective antibiotics being used as treatment

Question 23

first line syphilis treatment

usual dose of this drug?

Answer 23

benzathine benzylpenicillin (BPG). it is a long acting treatment. note that this is unlicensed for syphilis in the uk

2.4 Mega Unit IM injection – single dose

The benzathine component makes it a long acting treatment

Question 24

Trichomoniasis symptoms in women

note this condition is usually asymptomatic in half of women, and in 15-50% of men

Answer 24

Changes to vaginal discharge, classically frothy and yellow-green(in TCM) and can be thinner or thicker than
usual. Can also become more or less than usual

Vulvovaginal itching or soreness

Vaginal odour

Dysuria

Men usually present as partners of infected women

Question 25

Trichomoniasis symptoms in men

Answer 25

Urethral discharge
* Dysuria
* Balanitis
* Urethritis

Balanitis is a condition that causes inflammation of the glans penis and foreskin

Question 26

Trichomoniasis first line treatment and the usual dose(s)

Answer 26

Metronidazole
200 mg 3 times a day for 7 days, alternatively 400–500 mg twice daily for 5–7 days

can also opt for 2 g for as a single dose.

Metronidazole is an antimicrobial drug with high activity against anaerobic bacteria and protozoa.