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Sexually Transmitted Infections Flashcards

1
Q

What are the main presentations of STIs?

A

vaginal or urethral discharge, genital lesion, dermatalogical presentation, generalised presentation (syphilis) or PID

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2
Q

What are the diagnostic tools for STIs?

A

microscopy, culture, serology, PCR

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3
Q

What is the urethral discharge for neisseria gonorrhoea?

A

thick, creamy and painful

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4
Q

What is the gram stain of neisseria gonorrhoea?

A

intracellular gram negative diplococci - characteristic gram stain of neutrophils packed with organisms

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5
Q

Where does neisseria gonorrhoea adhere to?

A

the columnar epithelial cells that line the urethra and cervix - as cells become more squamous in the cervix with age you’re less likely to be infected

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6
Q

What is the incubation period of neisseria gonorrhoea?

A

2-7 days

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7
Q

How commonly is neisseria gonorrhoea asymptomatic in females?

A

80%

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8
Q

Why is there increasing antibiotic resitance of neisseria gonorrhoea?

A

because it can exchange genetic material with other non pathogenic neisseria that are commensals

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9
Q

Where can neisseria gonorrhoea disseminate to?

A

arthritis, maculopapular rash, meningitis, endocarditis, epididymitis and peri-hepatitis

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10
Q

How can gonorrhoea cause infertility?

A

if it results in PID and causes tubule scarring

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11
Q

What is the presentation of PID?

A

pelvic tenderness, discharge, fever, palpation of cervix induces pain and can see fluid abscess on imaging

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12
Q

What is neonatal gonococcal opthalmia?

A

babies born to a mother with gonorrhoea get a purulent conjunctivitis in the first week of life which can lead to scarring of the cornea and blindness

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13
Q

What is the treatment for neonatal gonococcal opthalmia?

A

cefotaxime for 7 days and regular eye irrigation + treat mother and contacts

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14
Q

Why is PCR a good diagnostic test?

A

because it only requires a 10mL first void urine sample compared to a urethral swab which is more unpleasant

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15
Q

What is the selective media for culture of neisseria gonorrhoea?

A

thayer-martin agar - contains colistin to inhibit gram negatives, vancomycin to inhibit gram positives and nyastatin to inhibit the yeast

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16
Q

What is the disadvantage of PCR as a test for gonorrhoea?

A

cant get antibiotic resistance results

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17
Q

What is the treatment for neisseria gonorrhoea?

A

ceftriaxone (beta lactam) and azithromycin (macrolide) - using two different mechanisms delays resistance and azithromycin is also used to treat chlamydia which is useful because coinfection is common

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18
Q

How do you prevent gonorrhoea?

A

barrier contraception and contact tracing

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19
Q

What type of organism of chlamydia trachomatis?

A

an obligate intracellular parasite - a gram negative bacteria

20
Q

Where does chlamydia trachomatis adhere to?

A

the columnar epithelium

21
Q

Which serovars of chlamydia trachomatis cause genital infections?

A

D-K

22
Q

Describe the life cycle of chlamydia trachomatis

A

elementary bodies (the infectious form of the organism) enter cells and form reticulate bodies which replicate and eventually rupture the cell to release the infectious elementary bodies which are in the body secretions

23
Q

What does chlamydia cause in women?

A

cervicitis, endometritis, discharge, dysuria, irregular bleeding, can cause PID - although it is very commonly asymptomatic

24
Q

What does chlamydia cause in men?

A

urethritis - dysuria, meatal erythema, clear urethral discharge, testicular pain, prostatitis

25
Q

What is lymphogranuloma venereum?

A

an infection caused by a different serotype of chlamydia which starts off as an ulcerative genital lesion which then spreads to lymph nodes

26
Q

What are the symptoms of neonatal chlamydia?

A

conjunctivitis that is thin and sometimes haemmorhagic from 2-28 days and pneumonia with a staccato cough at 2-8 weeks

27
Q

What is the treatment for chlamydia?

A

azithromycin or doxycycline

28
Q

What type of organism is trichomonas vaginalis?

A

a flagellated protozoon

29
Q

What are the symptoms of trichomonas vaginialis (if its not asymptomatic)?

A

frothy, green-yellow vaginal discharge, more alkaline pH in the vagina, cervical erythema and friability, pruritus, dysuria, abdominal pain

30
Q

Why does a trichomonas vaginalis infection put you at risk of HIV?

A

because of the genital inflammation it causes

31
Q

What are the laboratory tests for trichomonas vaginalis?

A

wet prep microscopy to look for the motility, PCR and can sometimes be seen on pap smear

32
Q

What is the treatment for trichomonas vaginalis?

A

metronidazole or tinidazole

33
Q

What does treponema pallidum cause?

A

syphilis

34
Q

What is the classic presentation of syphilis?

A

3 stages - primary stage of an ulcer (shanka) 2-3 weeks after exposure which then heals, followed by a secondary stage of a rash, lymphadenopathy, abdominal pain and allopetia, followed by an early latent phase (where still infectious) and a late latent phase (where less infectious) and then a tertiary phase which involves a gumma (growth) particulary in joints, aorta or brain

35
Q

Why is microscopy of syphilis difficult?

A

because the sample has to be taken from the primary shanka and the organisms are very thin so difficult to visualise

36
Q

What are the two types of serological tests for syphilis?

A

non treponemal and treponemal tests

37
Q

What is the use of non treponemal tests?

A

look for active disease by looking for biomarkers released in infection - useful for screening and monitoring therapy

38
Q

What is the use of treponemal tests?

A

looks for the actual antigen - they become postive earlier and are positive for life so can be used for antenatal screening and then followed up with a non treponemal test

39
Q

What type of organism is mycoplasma genitalium?

A

a molecute - no cell wall - flask shaped

40
Q

Why is mycoplasma genitalium not widely tested?

A

because its difficult to culture and the NAAT arent widely available

41
Q

What does mycoplasma genitalium cause in men?

A

urethritis

42
Q

What does mycoplasma genitalium cause in women?

A

cervicitis, acute endometritis, PID

43
Q

How long does mycoplasma genitalium persist for?

A

3-6 months

44
Q

What is mycoplasma genitalium associated with?

A

preterm labour and HIV transmission

45
Q

What is the treatment of mycosplasma genitalium?

A

azithromycin but has high failure rates so may need to use moxifloxacin

46
Q

What type of organism is treponema pallidum?

A

spirochaete bacterium - gram negative

Reproduction (21 decks)

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