Sexually Transmitted Infections Flashcards
Which type of genital herpes simplex has higher viral shedding?
type 2
What STI is known as the great imitator?
syphilis
What % of patients with chlamydia are asymptomatic?
70 women and 50% men
What is the gram stain appearance of chlamydia?
gram negative
What is the risk of PID with chlamydia?
9%
What are the risks associated with an episode of PID?
ectopic pregnanyc and tubal factor infertility
What are the common female presentations for chlamydia?
post-coital or intermenstrual bleeding; lower abdo pain; dyspareunia and mucopurulent cervicitis
What ar ethe common male presentations for chlamydia?
urethral discharge; dysuria; urethritis; epididymo-orchitis; proctitis
What are the symptoms with lymphogranuloma venereum?
rectal pain; discharge and bleeding
What is the risk of other STIs associated with lymphgranuloma venerum?
high risk- 67% HIV
When can chlamydia be tested for after exposure?
14 days
What is the test for females for chlamydia?
vulvovaginal swab NAAT
what is the test for males for chlamydia?
first void urine NAAT
When should a rectal swab for chlamydia be added with MSM?
if has receptive anal intercourse
What is the incubation period of urethral infection in men for gonorrhoea?
2-5 days
What is the risk of transmission of gonorrhoea from an infected woman to male?
20%
Waht is the risk of transmission of gonorrhoea from infected man to female?
50-90%
What is the presentation of gonorrhoea in males?
urethral discharge; dysuria; asymptomatic (<10%)- pharyngeal/rectal
What is the presentation of gonorrhoea in females?
asymptomatic (upto 50%); altered/increased vaginal discharge; dysuria; pelvic pain
What is the first line treatment for gonorrhoea?
ceftriaxone 500mg IM and azithromycin 1G
What is the second line treatment for gonorrhoea?
cefixim 400mg oral
What should be done in all patients after treatment of gonorrhoea?
test of cure
What is the incubation time for genital herpes?
3-6 days
How long does the primary infection of genital herpes last?
14-21 days
What are the symtpoms of a primary genital herpes infection?
blistering and ulceration of the external genitalia; pain; external dysuria; vaginal or urethral discharge; local lymphdenopathy; fever and myalgia
What type of HSV is recurrent episodes more common with?
HSV-2
What are the symptoms in recurrent episodes?
localised anogenital tinglin, burning or soreness, unilateral, small blisters and ulcers
How long does it take a recurrent episode of genital herpes to resolve?
5-7 days
What is the treatment for genital herpes?
oral aciclovir; topical lidocaine if very painful
What is the investigation fro genital herpes?
swab base of ulcer for HSV PCR
When is viral shedding higher?
more frequent in first year of infection; more in individuals with frequent recurrences; reduced by suppressive therapy
What is the lifetime risk of acquiring HPV infection?
80%
What types of HPV cause anogenital warts?
6 and 11
What are the treatment option for HPV?
podophyllotoxin; imiquimod; cryotherapy; electrocautery
What is the MOA of podophyllotoxin (Warticon)?
cytotoxic
What is the MOA of imiquimod?
immune modifier
What bacterium causes syphilis?
treponema pallidum
How can syphilis be transmitted?
sexual contact; trans-placental/during birth; blood transfusions; non-sexual contact-healthcare workers
What stages of syphilis are infective?
primary; secondary and early latent
What is the mean incubation period for syphilis?
21 days
Aside from a chancre what other signs are seen with priamry syphilis?
non-tender local lymphadenopathy
What are the symptosm of secondary syphilis?
skin- macular; follicular or pustular rash on palms and soles; lesions of mucous membranes; generalised lymphadenopathy; patchy alopecia; condylomata lata
What is condylomata lata?
highly infectious lesion which exudes a serum teeming with treponemes
What is the screening serological test for syphilis?
ELISA/EIA (enzyme immunoassay)
What is the treatment for early syphilis?
benzathine penicillin x1
What is the treatment for late syphilis?
benzathine penicillin x3
How much should titres decrease by 3-6 months in early syphilis?
four-fold
