Sexually Transmitted Infections Flashcards
What is the name of the position in which females receive a vaginal exam?
Lithotomy position, to do a speculum exam
What are the common symptoms and signs of urethritis?
Urethral discharge and dysuria
Sometimes meatitis
What are the main causes of urethritis?
Neisseria gonorrhoea (Gonorrhea) Chlamydia trachomatis (Chlamydia)
What type of bacteria are N.gonorrhoea?
Gram negative diplococci
NB - this is the only causative organism of urethritis that shows up on a gram stain
How is gonorrhoea treated?
Ceftriazone 500mg IM with azithromycin 1g single dose
How is chlamydia treated?
Azithromycin 1g orally single dose
OR
Doxycycline 100mg twice daily for a week
What are some possible GONOCOCCAL complications of urethritis?
- Bartholinitis
- Epididymo-orchitis/prostatitis
- PID
- Disseminated gonococcal infection
- Sexually acquired reactive arthritis
- Transmission to neonate
What are some possible CHLAMYDIAL complications of urethritis?
- PID and tubal damage
- Fitz-Hugh Curtis Syndrome
- Transmission to neonate (conjuncitivits, pneumonitis)
What is lymphogranuloma venereum?
A more advanced form of chlamydia, affecting the lymphatics and lymph nodes
What is bacterial vaginosis? (nb. this is not an STI),
Treatment?
Overgrowth of anaerobic bacteria, especially GARDNERELLA VAGINALIS ,causing a decrease in LACTOBACILLI
Treat with Metronidazole
What are the symptoms of BV?
Hay/Ison criteria - 3/4 of:
- Bad smelling, thin, homogenous grey vaginal discharge
- pH > 4.5
- Positive amine test
- Clue cells
What is candidiasis?
AKA thrush - this is a fungal infection, characterised by vulvo-vaginitis with fissuring and thick white ‘cottage cheese’ non-smelly vaginal discharge
What are some precipitating factors for candidiasis?
Pregnancy, diabetes, antibiotic use, anaemia, immunosuppression, endocrine disorders, irritants, poor hygiene
How is candidiasis treated?
Clotrimazole pessary or single dose fluconazole
What is trichomoniasis?
Parasite-caused STI, involving vulvo-vaginitis with an offensive yellow vaginal discharge
NB - it is asymptomatic in men
How is trichomoniasis treated?
Metronidazole
Which STIs can cause ulcers?
Herpes simplex
Syphilis
Tropical STIs eg. chancroid
Scabies
What are the symptoms of HSV?
Multiple vesicles with clear fluid that burst to give superficial erosions, which are very painful
How is HSV treated?
5 day course of acyclovir and analgesia, however it is a virus so cannot be cured
What characteristic rash does syphilis cause?
Painless sores, particularly on the palms of hands and soles of feet
Which STIs can cause lumps?
Molloscum contagiosum
Genital warts
Secondary syphilis
Scabies
Which virus causes genital warts?
Human papilloma virus (6&11)
Which virus causes cervical cancer?
Human papilloma virus (16&18)
How are warts treated?
Cryotherapy Podophyllotoxin cream Surgical Removal Trichloroacetic acid Immune modulation - imiquimod
What causes syphilis?
Spirochete bacteria called TREPONEMA PALLIDUM
What are the stages of syphilis?
Early (infectious) < 2 years
- Primary
- Secondary
- Early latent
Late (non-infectious) < 2 years
- Late latent
- Cardiovascular
- Neurosyphilis
- Gummatous
How is syphilis treated?
1st line: Procaine or Benzathine Penicillin
2nd line: Doxycycline
What is PCR?
Polymerase chain reaction (PCR) is a technique used in molecular biology to amplify a single copy or a few copies of a piece of DNA across several orders of magnitude, generating thousands to millions of copies of a particular DNA sequence. It is used in diagnosis in many of these STIs
What is a motile organism on wet mount diagnostic of?
TV - trichomonas vaginalis
What are the symptoms of TV?
Green frothy discharge, strawberry cervix
