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Hannah's Reproductive > Sexually Transmitted Infections > Flashcards

Sexually Transmitted Infections Flashcards

1
Q

List the 4 routes of transmission for STIs

A

Oral-genital contact
Vaginal intercourse
Anal intercourse
Anilingus

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2
Q

List 5 STIs that can be spread by oral-genital contact

A 
Chlamydia
Gonorrhoea
HSV
Syphilis
HPV
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3
Q

List 5 STIs that can be spread by anilingus

A 
Amoeba
Cryptosporidia
Giardia
Shigella
HAV
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4
Q

What type of bacteria is N. gonorrhoeae?

A

Gram negative diplococci

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5
Q

What kind of cells does N. gonorrhoeae colonise?

A

Columnar epithelium

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6
Q

What is the incubation period of N. gonorrhoeae?

A

2-7 days (relatively short)

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7
Q

What are the symptoms of gonorrhoea in males?

A

Urethritis with a thick, creamy urethral discharge (can block the urethra and cause pain)
May be asymptomatic (10%)

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8
Q

What are the symptoms of gonorrhoea in females?

A 
Mostly asymptomatic (80%)
Causes cervicitis
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9
Q

What are the symptoms of gonorrhoea transmitted via the oral-genital route?

A

May have pharyngitis and lymphadenopathy

May be asymptomatic

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10
Q

What is the hypothesised reason for increasing rates of antibiotic resistance in N. gonorrhoeae?

A

Many other members of Neisseria colonise mucous membranes of the body (including the throat) as normal flora; these organisms can all exchange genes, including those encoding for antibiotic resistance

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11
Q

In what % of untreated cases does disseminated gonorrhoea occur?

A

0.5-3%

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12
Q

What are the symptoms of disseminated gonorrhoea?

A 
Arthritis
Maculopapular rash
Meningitis
Endocarditis
Epididymitis
Peri-hepatitis (Fitz-Hugh-Curtis syndrome)
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13
Q

What is Fitz-Hugh-Curtis syndrome?

A

A peri-hepatitis caused by the ascension of N. gonorrhoeae up the female genital tract, into the abdominal cavity via the ovaries, where it causes infection of the liver capsule and produces “violin-string adhesions”

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14
Q

What increases the risk of gonorrhoea dissemination?

A

Risk increases post menses

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15
Q

What are the 2 possible complications of gonorrhoea?

A

Dissemination

PID

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16
Q

What are the possible consequences of untreated PID?

A

Tubal scarring

Infertility (10-20%)

17
Q

What are some possible abnormal findings in PID?

A

Pain on bimanual palpation of the cervix

Fluid, abscesses on imaging

18
Q

What is the characteristic presentation of neonatal gonococcal opthalmia?

A

Gross purulent conjunctivitis in first week of life

Mild disease indistinguishable from other causes

19
Q

What are the possible consequences of untreated neonatal gonococcal opthalmia?

A

Perforation and blindness in days 2-5

20
Q

What is the treatment for neonatal gonococcal opthalmia?

A

Cefotaxime 50mg/kg IV, 8-hourly for 7 days
Regular irrigation of eyes
Treatment of mother and sexual contacts

21
Q

What diagnostic specimens may be required for gonorrhoea screening?

A

Cervical swab into charcoal transport
Male urethral swabs
Urine (first void, ~10mL)
Other specimens: conjunctiva, pharynx, skin lesions, anal, CSF, blood, synovial fluid

22
Q

What kind of media are used for laboratory investigations into gonorrhoea?

A

Non-selective (chocolate blood agar in CO2) used for CSF, joint fluid aspirate
Selective (Thayer-Martin agar) used for swabs taken from an area with normal flora
Culture for antibiotic sensitivities

23
Q

What makes up Thayer-Martin agar? What does each agent do?

A

Colistin: inhibits growth of Gram negatives
Vancomycin: inhibits growth of Gram positives
Nystatin: anti-fungal

24
Q

What samples are required for nucleic acid amplification tests (NAAT) for gonorrhoea?

A

Genital (cervical or vaginal) swabs

First void urine

25
Q

In what % of cases of gonorrhoea is there co-infection with chlamydia?

A

50%

26
Q

What is the advantage with using NAAT to diagnose gonorrhoea?

A

Less invasive samples (patient can self-collect)

Combined chlamydia and neisseria detection

27
Q

Approximately what % of N. gonorrhoeae display antibiotic resistance to ceftriaxone? How is this overcome?

A

~30%

Higher doses of ceftriaxone (previously 125mg, now 500mg)

28
Q

How is gonorrhoea treated?

A

Ceftriaxone 500mg IM/IV and azithromycin 1g oral
OR ciprofloxacin 500mg oral (if sensitive)
OR amoxicillin 3g + probenecid 1g oral in endemic areas (sensitivity has been retained)

Hannah's Reproductive (5 decks)

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