Sexually Transmitted Infections Flashcards
What are the most common STIs in the UK?
- Chlamydia
- Human papilloma virus
- Neisseria gonorrhoeae
- HErpes simplex virus
- Treponema pallidum (syphilis)
What is the average number of new sexual partners over a 5 year period for men and women?
- Men: 3.8
- Women 2.4
What are the risk factors for STIs?
- Young age
- FAilure to use barrier contraceptives
- Non-regular sexual relationships
- Men who have sex with men
- IV drug use
- African origin
- Social deprivation
- Sex workers
- Poor access to advice and treatment of STIs
What are the determinants of risky sexy behaviour?
- Individual factors: low self-esteem, lack of skills, lack of knowledge of the risks of unsafe sex
- External influences: peer pressure, attitudes and predjudices of society
- Service provision: accessibility of sexual health services and/or lack or resources such as condoms
What are the 3 basic ways we can test for STIs?
- NAATs (chlamydia, gonnorhoea, herpes)
- Microscopy, culture and sensitivity (gonnorhoea, candida, Bacterial vaginosis, trichomonas vaginalis)
- Blood tests (syphilis, HIV, Hepatitis)
What are the features of chlamydia trachomatis?
- Obligate
- Intracelluar
- Gram -ve
What are the different chlamydia serotypes?
- A, B, C - trachoma
- D-K - genital infection
L1, L2, L3 - lymphogranuloma venereum cancer
What are the chlamydia symptoms in men?
- Urethral/anal discharge
- Epididymal tenderness
- Prostatitis
- Reiter’s syndrome
- Procitis
- Pharyngitis
- Perihepatitis - upper abdominal pain
What are the chlamydia symptoms in women?
- Vaginal/anal discharge
- Post-coital bleeding
- Abdominal tenderness
- Pelvic tenderness
- Infertility
- Reiter’s syndrome
- Procitis
- Pharyngitis
- Perihepatits - upper abdo pain
What are some complications with chlamydia?
Pelvic inflammatory disease (1-30%) - Tubal infertility (1-20%) Sexually acquired reactive arthritis (+ Reiter's) Epididymo-orchitis Peri-hepatitis
What is associated with Reiter’s?
- Urethritis
- Conjunctivitis
- Arthritis
Where can chlamydia and gonorrhoea investigations be taken from?
Women - Vulvo-vaginal swab (VVS) self taken Men - First catch urine (FCU) Extra genital sites: - Rectal/pharyngeal
What is the treatment of chlamydia?
- Doxycycline 100mg twice daily 7 days
- Avoid sexual contact
- Partner notification
What is Lymphogranuloma venerum (LGV)?
- Caused by one of 3 invasive serovars (L1-3) of chylamydia trachomatis
- Presents with solitary genital lesion, proctitis, lympadanpothay
- Treated with doxycycline
What are the main feaatures of neisseria gonorrhoeae?
- Gram negative
- Intracellular diplococcus
What do the neisseria gonorrhoeae cells infect?
- Epithelial cells of mucous membrane of GU tract or rectum
- Development of localised infection with production of pus
What percentage of men have symptoms of gonorrhoea compared with chlamydia?
- Gonorrhoea - 90%
- Chlamydia - 10%
What percentage of women will be asymptomatic with gonorrhoea?
50%
What does female urethral infection involve?
Dysuria +/- frequency
What does endocervical gonorrhoea infection involve?
- 50% increased/altered vaginal discharge
- 25% lower abdo pain
- Occasionally inter-menstraul bleeding (IMB)