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Sexually Transmitted Infections Flashcards

1
Q

What are some factors predisposing to candida infection?

A

Recent antibiotic use, poorly controlled diabetes, immunocompromise

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2
Q

What are the two main symptoms of candida infection, in both males and females?

A

Itch and a white coloured discharge

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3
Q

Vaginal discharge which is described as being like ‘cottage cheese’ is most suggestive of what infection?

A

Candida

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4
Q

In females, candida infection is usually a clinical diagnosis. If necessary, what type of swabs can be used for cultures?

A

High vaginal swabs

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5
Q

What are the three main treatment options for candida infection in women?

A

Topical clotrimazole 1% cream, clotrimazole pessary, oral fluconazole

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6
Q

What treatment option for candida infection is contraindicated in pregnant women?

A

Oral fluconazole

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7
Q

Recurrent vaginal candidiasis is defined as how many episodes in a year?

A

Four or more

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8
Q

Is bacterial vaginosis a sexually transmitted disease?

A

No (but it is much more common in sexually active individuals)

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9
Q

Which bacteria is responsible for causing bacterial vaginosis?

A

Gardnerella vaginalis

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10
Q

In bacterial vaginosis, the vaginal flora is taken over by which type of organism?

A

Anaerobic bacteria

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11
Q

Describe the vaginal discharge that occurs in bacterial vaginosis?

A

Thin, white, homogenous

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12
Q

Clue cells on microscopy is most suggestive of what diagnosis?

A

Bacterial vaginosis

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13
Q

What happens to the vaginal pH in bacterial vaginosis?

A

It is raised (> 4.5)

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14
Q

Explain what is meant by a positive ‘whiff test’ in patients with bacterial vaginosis?

A

Adding 10% potassium hydroxide to the discharge produces a fishy odour

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15
Q

How is bacterial vaginosis treated?

A

Oral metronidazole for 7 days

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16
Q

What is the commonest STI in the UK?

A

Chlamydia

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17
Q

What is the incubation period of chlamydia trachomatis?

A

7-21 days

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18
Q

Which organism is the following statement referring to: an obligate intracellular pathogen which does not stain with gram stain?

A

Chlamydia trachomatis

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19
Q

What is the investigation of choice for diagnosing chlamydia? Where are samples taken from in both males and females?

A

NAATs- vulvovaginal swabs are used in females, first pass urine samples are used in males

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20
Q

How soon after possible chlamydia exposure can testing be carried out?

A

Two weeks after

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21
Q

What is the first line treatment for chlamydia?

A

100mg PO doxycycline bd for 7 days

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22
Q

What antibiotic is used second line for chlamydia treatment?

A

Azithromycin

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23
Q

Should contacts of confirmed chlamydia cases be offered treatment prior to the results of their investigations being known?

A

Yes

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24
Q

In men with urethral symptoms of chlamydia, which contacts should be traced?

A

All contacts in the four weeks prior to symptoms

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25
In women, and asymptomatic men, with chlamydia, which contacts should be traced?
All partners from the last 6 months, or the most recent sexual partner
26
What complication of chlamydia infection is more likely to be seen in men?
Reactive arthritis
27
What are some risks associated with chlamydia infection in women?
PID, tubal infertility, ectopic pregnancy
28
Lymphogranuloma venereum is a subtype of chlamydia which is seen in who?
Those from tropical countries and MSM
29
How long is treatment for lymphogranuloma venereum given for?
3 weeks
30
What organism is responsible for causing gonorrhoea?
Neisseria gonorrhoeae
31
Which organism is the following statement referring to: a gram negative intracellular diplococcus?
Neisseria gonorrhoeae
32
What is the incubation period of neisseria gonorrhoeae?
2-5 days
33
Gonorrhoea infections where are most likely to be clinically silent?
The rectum and pharynx
34
Is gonorrhoea infection more common in males or females?
Males
35
What is the screening test for gonorrhoea?
NAATs
36
If a NAATs has come back positive, or a patient is symptomatic, for gonorrhoea, what investigation is best?
Microscopy and culture
37
Where are samples best to be taken from in males and females with suspected gonorrhoea?
Endocervical swabs in females, urethral swabs in males
38
What is the first line treatment for gonorrhoea?
1g IM ceftriaxone
39
When is a test of cure indicated for those treated for gonorrhoea?
2 weeks after treatment
40
What are some features of disseminated gonococcal infection?
Tenosynovitis, migratory polyarthritis and dermatitis
41
What is the most common cause of septic arthritis in young adults?
Gonorrhoea
42
Which organism is the following statement referring to: a spirochaete which does not stain with gram stain?
Treponema pallidum
43
What is the organism responsible for causing syphilis?
Treponema pallidum
44
What is the incubation period of syphilis?
9-90 days
45
What are the two main features of primary syphilis?
Chancre and local non-tender lymphadenopathy
46
What is a chancre?
A painless ulcer at the site of sexual contact
47
Other than fevers and lymphadenopathy, what are some more specific features of secondary syphilis?
Rash (on trunk, palms and soles), buccal 'snail track' ulcers and condylomata lata
48
What ophthalmological feature is associated with tertiary syphilis?
Argyll-Robertson pupil
49
How long does it take to develop syphilis serology?
Up to 6 weeks
50
What microscopic examination can be used to identify syphilis?
Dark field microscopy
51
What are two examples of non-specific syphilis antibodies? What happens to these after treatment?
VDRL and RPR - these become negative after treatment
52
What are some examples of specific syphilis antibodies? What happens to these after treatment?
ELISA and TPPA - these remain raised after treatment
53
What is the screening test used for syphilis?
ELISA
54
If ELISA testing is positive for syphilis, what are used as confirmatory tests?
TPPA and RPR
55
What is the first line management for syphilis?
IM benzyl-penicillin
56
Patients with syphilis should be followed up until when?
The RPR is negative
57
What is an emerging sexually transmitted pathogen which is associated with non-gonococcal urethritis and PID?
Mycoplasma genitalium
58
What organisms are responsible for genital herpes?
Predominantly HSV-2 but also HSV-1
59
With which type of HSV is viral shedding more likely to occur?
HSV-2
60
How long does the primary infection of genital herpes last for?
14-21 days
61
How does the primary infection of genital herpes present?
Severe genital ulceration and pain
62
How is genital herpes tested for?
Swab of a deroofed blister for HSV-PCR
63
How is genital herpes managed?
PO aciclovir for 5 days
64
If a primary attack of genital herpes occurs during pregnancy, what management is required?
Elective C-section at 28 weeks
65
What organism is responsible for causing genital warts?
HPV types 6 and 11
66
What is the best treatment for multiple, non-keratinised genital warts?
Topical podophyllum (Warticon)
67
What is the best treatment for a solitary, keratinised genital wart?
Cryotherapy
68
What is the second line treatment for genital warts?
Imiquimod cream
69
The majority of anogenital HPV infections clear without intervention within how long?
1-2 years
70
Is trichomonas vaginalis sexually transmitted?
Yes
71
Which organism is the following statement referring to: a highly motile, flagellated, protozoan parasite?
Trichomonas vaginalis
72
Describe the vaginal discharge associated with trichomonas vaginalis?
Offensive, yellow/green, frothy
73
Strawberry cervix is associated with which infection?
Trichomonas vaginalis
74
What is the investigation of choice for trichomonas vaginalis?
High vaginal swab for microscopy
75
How is trichomonas vaginalis managed?
PO metronidazole for 7 days
76
How are pubic lice treated?
Malathion lotion
77
How soon after the development of a chancre does secondary syphilis develop?
2-8 weeks

Med Spec (Infectious Diseases) (4 decks)

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