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Med Spec (Infectious Diseases) > Sexually Transmitted Infections > Flashcards

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
Q

In women, and asymptomatic men, with chlamydia, which contacts should be traced?

A

All partners from the last 6 months, or the most recent sexual partner

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26
Q

What complication of chlamydia infection is more likely to be seen in men?

A

Reactive arthritis

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27
Q

What are some risks associated with chlamydia infection in women?

A

PID, tubal infertility, ectopic pregnancy

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28
Q

Lymphogranuloma venereum is a subtype of chlamydia which is seen in who?

A

Those from tropical countries and MSM

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29
Q

How long is treatment for lymphogranuloma venereum given for?

A

3 weeks

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30
Q

What organism is responsible for causing gonorrhoea?

A

Neisseria gonorrhoeae

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31
Q

Which organism is the following statement referring to: a gram negative intracellular diplococcus?

A

Neisseria gonorrhoeae

32
Q

What is the incubation period of neisseria gonorrhoeae?

A

2-5 days

33
Q

Gonorrhoea infections where are most likely to be clinically silent?

A

The rectum and pharynx

34
Q

Is gonorrhoea infection more common in males or females?

A

Males

35
Q

What is the screening test for gonorrhoea?

A

NAATs

36
Q

If a NAATs has come back positive, or a patient is symptomatic, for gonorrhoea, what investigation is best?

A

Microscopy and culture

37
Q

Where are samples best to be taken from in males and females with suspected gonorrhoea?

A

Endocervical swabs in females, urethral swabs in males

38
Q

What is the first line treatment for gonorrhoea?

A

1g IM ceftriaxone

39
Q

When is a test of cure indicated for those treated for gonorrhoea?

A

2 weeks after treatment

40
Q

What are some features of disseminated gonococcal infection?

A

Tenosynovitis, migratory polyarthritis and dermatitis

41
Q

What is the most common cause of septic arthritis in young adults?

A

Gonorrhoea

42
Q

Which organism is the following statement referring to: a spirochaete which does not stain with gram stain?

A

Treponema pallidum

43
Q

What is the organism responsible for causing syphilis?

A

Treponema pallidum

44
Q

What is the incubation period of syphilis?

A

9-90 days

45
Q

What are the two main features of primary syphilis?

A

Chancre and local non-tender lymphadenopathy

46
Q

What is a chancre?

A

A painless ulcer at the site of sexual contact

47
Q

Other than fevers and lymphadenopathy, what are some more specific features of secondary syphilis?

A

Rash (on trunk, palms and soles), buccal ‘snail track’ ulcers and condylomata lata

48
Q

What ophthalmological feature is associated with tertiary syphilis?

A

Argyll-Robertson pupil

49
Q

How long does it take to develop syphilis serology?

A

Up to 6 weeks

50
Q

What microscopic examination can be used to identify syphilis?

A

Dark field microscopy

51
Q

What are two examples of non-specific syphilis antibodies? What happens to these after treatment?

A

VDRL and RPR - these become negative after treatment

52
Q

What are some examples of specific syphilis antibodies? What happens to these after treatment?

A

ELISA and TPPA - these remain raised after treatment

53
Q

What is the screening test used for syphilis?

A

ELISA

54
Q

If ELISA testing is positive for syphilis, what are used as confirmatory tests?

A

TPPA and RPR

55
Q

What is the first line management for syphilis?

A

IM benzyl-penicillin

56
Q

Patients with syphilis should be followed up until when?

A

The RPR is negative

57
Q

What is an emerging sexually transmitted pathogen which is associated with non-gonococcal urethritis and PID?

A

Mycoplasma genitalium

58
Q

What organisms are responsible for genital herpes?

A

Predominantly HSV-2 but also HSV-1

59
Q

With which type of HSV is viral shedding more likely to occur?

A

HSV-2

60
Q

How long does the primary infection of genital herpes last for?

A

14-21 days

61
Q

How does the primary infection of genital herpes present?

A

Severe genital ulceration and pain

62
Q

How is genital herpes tested for?

A

Swab of a deroofed blister for HSV-PCR

63
Q

How is genital herpes managed?

A

PO aciclovir for 5 days

64
Q

If a primary attack of genital herpes occurs during pregnancy, what management is required?

A

Elective C-section at 28 weeks

65
Q

What organism is responsible for causing genital warts?

A

HPV types 6 and 11

66
Q

What is the best treatment for multiple, non-keratinised genital warts?

A

Topical podophyllum (Warticon)

67
Q

What is the best treatment for a solitary, keratinised genital wart?

A

Cryotherapy

68
Q

What is the second line treatment for genital warts?

A

Imiquimod cream

69
Q

The majority of anogenital HPV infections clear without intervention within how long?

A

1-2 years

70
Q

Is trichomonas vaginalis sexually transmitted?

A

Yes

71
Q

Which organism is the following statement referring to: a highly motile, flagellated, protozoan parasite?

A

Trichomonas vaginalis

72
Q

Describe the vaginal discharge associated with trichomonas vaginalis?

A

Offensive, yellow/green, frothy

73
Q

Strawberry cervix is associated with which infection?

A

Trichomonas vaginalis

74
Q

What is the investigation of choice for trichomonas vaginalis?

A

High vaginal swab for microscopy

75
Q

How is trichomonas vaginalis managed?

A

PO metronidazole for 7 days

76
Q

How are pubic lice treated?

A

Malathion lotion

77
Q

How soon after the development of a chancre does secondary syphilis develop?

A

2-8 weeks

Med Spec (Infectious Diseases) (4 decks)

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