Sexually Transmitted Infections Flashcards
Which organism causes Gonorrhoea?
Neisseira gonorrhoae
What are the symptoms of Gonorrhoea?
- Men: 10% asymptomatic, thick profuse yellow discharge and dysuria. (rectal and pharyngeal infection often asymptomatic)
- Women: >50% asymptomatic, vaginal discharge, dysuria or itermenstrual/post coital bleeding
What are the potential complications of Gonorrhoea?
- Acute monoarthritis in elbow or shoulder and skin lesions (dessimated infection)
- Males: epididymitis
- Females: pelvic inflamm. disease and Bartholin’s abscess
Which population group are most likely to get Gonorrhoea?
Men - particularly MSM
How can Gonorrhoea be diagnosed?
- Nucleic acid amplification test on urine or swab
- Gram stained smear in symptomatic people
- Culture of swab obtained specimen
How can Gonorrhoea be managed?
- Blind treatment with ceftriaxone (can also treat according to antibiotic sensitivities)
- Test of cure at 2 weeks and of reinfection at 3 months
Which organism causes chlamydia?
Chlamydia trachomatis
What are the symptoms of chlamydia?
- 70% of men and 80% of women are asymptomatic
- Men: watery discharge and dysuria
- Women: vaginal discharge, dysuria, intermenstrual/ post-coital bleeding
- Both: conjunctivitis
What are the complications of chlamydia?
- Men: epidydymitis
- Women: PID
- Both: reactive arthritis/Reiter’s syndrome
How is chlamydia diagnosed?
- First void urine in men
- Swab taken from cervix, urethra, rectum etc.
- All tested using NAAT
How is a chlamydia infection managed?
- Doxycycline
- Azithromycin if pregnant
- Test for reinfection at 3-12 months
What are the symptoms of herpes infection?
- 80% have no symptoms
- Burning/itching then blistering then tender ulceration
- Tender inguinal lymphadenopathy and flu-like symptoms
- Dysuria
- Neuralgic pain back, pelvis and legs
What are the complications of herpes infection?
- Autonomic neuropathy (urinary retention)
- Neonatal infection
- Secondary infection
How can herpes infection be diagnosed?
- Clinical impression
- Swab from lesion tested using PCR
How can herpes infection be treated?
- Primary outbreak: aciclovir and lidocaine ointment
- Infrequent recurrences: lidocaine ointment and aciclovir (until symptoms are gone)
- Frequent recurrences: long term aciclovir
Which organism causes trichomoniasis?
Trichomonas vaginalis
What are the symptoms of trichomoniasis?
- Men are usually asymptomatic and 10-30% of women are also asymptomatic
- Women: profuse thin vaginal discharge (greenish, frothy and foul smelling) and vulvitis
What are the potential complications of trichomoniasis?
-Miscarriage and preterm labour
How can trichomoniasis be diagnosed?
- PCR on a vaginal swab
- Microscopy of wet preparation of vaginal discharge
- No test for men
How is trichomoniasis treated?
Metronidazole
Which organism causes anogenital warts?
HPV types 6 and 11
What is a potential complication of anogenital warts?
Neonatal laryngeal papillomatosis (rare)
How can anogenital warts be diagnosed?
- Appearance
- Biopsy if unusual to exclude intraepithelial neoplasia
How can anogenital warts be treated?
- Podophyllotoxin or imiquimod
- Cryotherapy
- Diathermy or scissor removal for bulky warts
Which organism causes syphilis?
Treponema pallidum
What are the stages of syphilis?
- Primary: local ulcer
- Secondary: rash, mucosal ulceration, neuro symptoms, patchy alopecia etc.
- Early latent: no symptoms <2yrs since caught
- Late latent: no symptoms but >2yrs
- Tertiary: neurological, cardiovascular or gummatous - skin lesions
What are the potential complications of syphilis?
Neurosyphilis: cranial nerve palsies, cardiac or aortal involvement
How can syphilis be diagnosed?
- Clinical signs
- Serology foor TP IgG enzyme immunoassays, TPPA and RPR
- PCR on sample
How can syphilis be treated?
Benzathine penicillin or doxycycline
Give four examples of infections which only need genital contact to transmit
- Pubic lice
- Scabies
- Warts
- Herpes
