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Y3 OBS AND GYNAE > Sexually-transmitted Infections > Flashcards

Sexually-transmitted Infections Flashcards

1
Q

What is the most common bacterial STI? What kind of organism is it?

A

Chlamydia

Gram negative bacterium

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2
Q

How is chlamydia transmitted?

A

Vaginal
Anal
Oral

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3
Q

In what age group is the highest incidence of chlamydia?

A

20-24 year olds

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4
Q

How does chlamydia typically present in a female?

A 
Asymptomatic (70-80%)
Post-coital or intermenstrual bleeding
Lower abdo pain
Dyspareunia
Mucopurulent cervicitis
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5
Q

How does chlamydia typically present in a male?

A 
Asymptomatic (50%)
Urethral discharge
Dysuria
Urethritis
Epididymo-orchitis
Proctitis (LGV)
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6
Q

What is the treatment for chlamydia?

A

Doxycycline 100mg BD x 1 week

Azithromycin 1g stat followed by 500mg daily for 2 days

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7
Q

What kind of organism is N. gonnorrhoea? How does it appear on gram stain?

A

Gram negative intracellular diplococcus

Polymorphs, kidney bean shaped diplococci

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8
Q

How does gonnorrhoea typically present in males?

A

Urethral discharge >80%
Dysuria
Asymptomatic <10%
Pharyngeal/rectal infections mostly asymptomatic

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9
Q

How does gonorrhoea typically present in a female?

A 
Dysuria
Pelvic pain (<5%)
Increased/ altered vaginal discharge
Asymptomatic in up to 50%
Pharyngeal/rectal infections mostly asymptomatic
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10
Q

List diagnostic tests for gonorrhoea

A

NAATs (screening test)
Microscopy if symptomatic
Culture if microscopy positive

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11
Q

What is the treatment for gonorrhoea?

A

Ceftriaxone 500mg IM

Test of cure in all patients (2 weeks)

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12
Q

If ceftriaxone is contraindicated, what is the 2nd line treatment for gonorrhoea?

A

Cefixime 400mg oral

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13
Q

How long does genital herpes usually last?

A

14-21 days following incubation of 3-6 days

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14
Q

How does a primary infection of genital herpes typically present?

A 
Blistering/ulceration
Pain
Extreme dysuria
Discharge
Lymphadenopathy
Fever and myalgia (prodrome)
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15
Q

Is it more common to get recurrent genital herpes via HSV1 or HSV2?

A

HSV2

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16
Q

How is genital herpes treated?

A

Oral aciclovir 400mg TDS
Topical lidocaine 5% if painful
Saline bathing
Analgesia

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17
Q

Viral shedding for HSV1 is higher than HSV2. True/False?

A

False

HSV2 viral shedding higher than HSV1

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18
Q

What is the most common viral STI in the UK?

A

HPV (causing genital warts)

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19
Q

What is the incubation period of HPV?

A

3 weeks to 9 months

20
Q

Which strain of HPV is the most common cause of anogenital warts? How do they appear?

A

Low risk - 6 and 11

Cauliflower appearance

21
Q

How are genital warts caused by HPV treated?

A 
Podophyllotoxin (Warticon) - 1st line
Imiquimod (Aldara) - 2nd line (1st if perianal warts or immunocompromised) 
Cryotherapy - 1st line in pregnancy
Electrocautery
HPV vaccination
22
Q

Which organism causes syphillis?

A

Treponema pallidum (spirochaete)

23
Q

What are the main modes of transmission of syphilis?

A

Sexual contact
Trans-placental
Blood transfusion
Non-sexual contact - healthcare workers

24
Q

What are the 5 stages of syphilis?

A 
EARLY INFECTIOUS
Primary
Secondary
Early latent
LATE NON-INFECTIOUS
Late latent
Tertiary
25
Q

What are the features of primary syphilis?

A

Chancre (painless lesions)
Lesions at site of innocculation (genital or extragenital)
Non-tender lymphadenopathy

26
Q

What are the features of secondary syphilis?

A 
Maculopapular rash
Palms and soles affected
Lesions of mucous membranes
Generalised lymphadenopathy
Alopecia
Condylomata lata
27
Q

What are the 2 groups of tests that are down to diagnose syphilis?

A

Microscopy + PCR to detect organism

Serological testing to detect antibody

28
Q

What are the non-specific serological tests for syphilis?

A

VDRL

RPR

29
Q

What are the specific serological tests for syphilis? Which is used for screening?

A

TPPA
ELISA (used for screening)
FT antibody absorption
INNO-LIA

30
Q

How is early and late syphilis treated respectively?

A

LONG ACTING PENICILLIN

2.4MU benzathine penicillin once or three times a day

31
Q

What is partner notification? List the main methods

A

VOLUNTARY process of informing people who have been in contact with an STI
Patient referral
Provider referral
Provisional referral

32
Q

Partner notification is not needed for…

A

Warts, herpes (no benefit in asymptomatic finding)

Vaginal thrush, bacterial vaginosis (not STIs)

33
Q

List vaccinations that can be given to prevent STIs

A

Hepatitis B
Hepatitis A
HPV

34
Q

What is PreP therapy?

A

Medicine taken before exposure to reduce risk of infection, particularly HIV

35
Q

What is PEPSE?

A

Medicine taken after exposure to reduce risk of infection, particularly HIV and Hepatitis B

36
Q

List complications of chlamydia

A

PID
Tubal damage (infertility, ectopic pregnancy)
Chronic pelvic pain
Transmission to neonate
Adult conjunctivitis
Reiter’s syndrome
Fitz-Hugh-Curtis syndrome (perihepatitis)

37
Q

What is the triad of symptoms present in Reiter’s syndrome?

A

Conjunctivitis
Urethritis
Arthritis

38
Q

What is LGV? What are the clinical signs?

A

Serovars of chlamydia trachomatis (L1-3), common in MSM

Rectal pain, discharge, bleeding, concurrent STIs

39
Q

What is the diagnostic tests for chlamydia?

A

Test 14 days following exposure
NAAT - females (vulvovaginal swab), males (first void urine)
Rectal swab in MSM who have had receptive UPAI

40
Q

List lower genital tract complications of gonorrhoea

A 
Bartholinitis (inflam of Barth glands next to vagina)
Tysonitis (inflam of Tyson glands)
Periurethral abscess
Rectal abscess
Epididymitis
Urethral stricture
41
Q

List upper genital tract complications of gonorrhoea

A 
Endometritis
PID
Hydrosalpinx
Infertility
Ectopic pregnancy
Prostatitis
42
Q

How is genital herpes diagnosed?

A

Swab base of ulcer for HSV PCR

43
Q

Which group of people are there special circumstances for the management of genital herpes?

A

Pregnant women

44
Q

What are the two main classifications of syphillus?

A

Congenital

Acquired

45
Q

What is the most highly infectious lesion in syphillus, and it exudes serum?

A

Condylomata lata

46
Q

Syphillus is followed up until…

A

RPR is negative or serofast

47
Q

What is the interval period for testing for chlamydia or gonorrhoea?

A

14 days

Y3 OBS AND GYNAE (44 decks)

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