Sexually Transmitted Infections Flashcards
List 6 risk factors for STIs.
Non-modifiable:
- Young age
- Female (except gonorrhoea)
- Living in big cities
Personal factors:
- Partner choice (e.g. MSM)
- Condom use
Network-based factors:
-Large sexual networks
List 6 principles of STI management.
- Definitive diagnosis before treatment
- Screen for accompanying STIs (esp. HIV)
- Simple treatment regimens
- Follow up after treatment
- Partner notification
- Non-judgemental patient support
What do you need to find out in a sexual history?
5Ps: Partners Practices Pregnancy Past history Protection
Last time they had sex
Location of sex
Which 2 tests would you do for gonorrhoea?
Urethral gram film
NAAT (nucleic acid amplification test)
- Males: urine
- Females: vulvovaginal swab
What is the main clinical feature of gonorrhoea?
Urethral discharge
What are the 2 complications of gonorrhoea?
Disseminated gonorrhoea
Drug resistant gonorrhoea
List 3 features of disseminated gonorrhoea.
Painful joints
Small skin lesions
Joint swelling
List the 3 components of gonorrhoea treatment.
State dose, administration and duration of any drugs.
Ceftriaxone, 500mg IM
Azithromycin, 1g oral
Partner notification
Which bacteria causes chlamydia?
Chlamydia trachomatis
List 3 clinical features of chlamydia.
Asymptomatic
Pelvic pain
Pain during sex
Describe 1 subtype of chlamydia.
List 8 features of this condition.
Lymphogranuloma venereum (LGV)
Severe proctitis, e.g. -Constipation -Rectal bleeding -Pain -Discharge -Rectal fullness Ulceration Inguinal bubos
List 3 consequences of long term chlamydia infection.
Tubal damage
Pelvic inflammatory disease
Infertility
List 2 aspects of chlamydia treatment.
State dose, administration and duration for any drugs.
Azithromycin, 1g (oral)
Doxycycline, 100mg (oral) - twice daily for 1 week
Which bacteria causes syphilis?
Treponema pallidum
Outline the natural history of syphilis, including time scales and symptoms.
Primary syphilis (3 weeks) -Chancre
Secondary syphilis (8-16 weeks)
- Rash
- Alopecia
Tertiary syphilis (10-40 years)
- Gumma
- Cardiovascular complications
- Neurological complications
What is a “gumma”?
A form of granuloma, presenting as a soft, non-cancerous growth in syphilis
Give 2 examples of CVD complications in advanced syphilis.
Stroke
Aortic dilatation
Give 4 examples of neurological problems in advanced syphilis.
Headache
Altered behaviour
Movement problems
Eye problems (ocular syphilis)
List 2 consequences of long term syphilis infection.
Miscarriage
Stillbirth
How is syphilis treated?
Penicillin (injection)
List 4 other bacterial STIs.
Trichomonas vaginalis
Mycoplasma genitalium
Donovanosis (granuloma inguinale)
Chancroid
List 5 examples of viral STIs.
Human papilloma virus HSV HIV Molluscum contagiosum Hepatitis B/C
How are genital warts treated? (3)
Condyline
Aldara
Liquid nitrogen treatment
How is HSV treated?
List dose, administration and duration of drug treatment.
Aciclovir, 200mg (oral)
5x per day, for 5 days
How would you diagnose chlamydia?
Proctoscopy
What tests would you do to diagnose syphilis? (1)
What types of tests would you do in patients you KNOW have syphilis? (3)
DIAGNOSIS: Syphilis antibodies (blood test)
IN SYPHILIS PATIENTS:
Vision screening
Hearing screening
Neuropathy screening
What are the clinical features of trichomoniasis?
Which antibiotic would you use to treat it?
Vaginal discharge
Metronidazole
What are the clinical features of mycoplasma genitalium?
Urethritis
Cervical inflammation
Pelvic inflammation
