Sexually Transmitted Infections Flashcards
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 sexual behaviour?
- individual factors: low self-esteem, lack of skills, lack of knowledge of the risks of unsafe sex
- external influences: peer pressure, attitudes and prejudices of society
- service provision: accessibility of sexual health services and/or lack of resources like condoms
Describe NAATs
- nucleic acid and amplification testing (swab in vagina and rotated for 30s) - detects DNA - for chlamydia and n.gonnorhoea - PCR for herpes - 2 week window
Describe microscopy, culture and sensitivity testing
- for n. gonorrhoea, candida, BV and trichomonas vaginalis
- charcoal swab
Describe blood testing
- for syphilis, HIV and hepatitis
Describe the features of chlamydia
- has different serotypes for different types of infection
- D-K = genital infection
- symptoms include vaginal/urethral/anal discharge, post-coital bleeding, epididymal tenderness etc
- can be asymptomatic
What are the complications of chlamydia?
- pelvic inflammatory disease (associated with infertility, ectopic and pain)
- sexually acquired reactive arthritis
- epididymo-orchitis
- peri-hepatitis
What is the management for chlamydia?`
- doxycycline 100mg twice a day for a week
- avoid sexual contact for duration of treatment
- partner notification
What is LGV?
- lymphogranuloma venerum
- caused by one of the 3 invasive serovars of chlamydia (L1/2/3)
- presents as solitary genital lesion, proctitis, lymphadenopathy
- treated with doxycycline
Describe the different manifestations of gonorrhoea and the symptoms
- penile urethral infection (muculopurulent discharge)
- female urethral infection (increased/decreased frequency or urinartion or dysuria)
- endocervical infection (increased/altered vaginal discharge, maybe lower abdo pain)
- rectal (mostly asymptomatic but can cause anal discharge/discomfort/pain)
- pharyngeal (mostly asymptomatic but can cause sore throat)
What is the management for gonorrhoea?
- ceftriaxone
- ciprofloxacin
- partner notification and treatment
Describe thrush
- acute dermatitis of vulva/vagina caused by yeast invasian (candida albicans)
- causes itch, vulval pain, superficial dyspareunia
- curd like white vaginal discharge
What is the treatment for thrush?
- topical clotrimazole
Describe the stages of syphilis
- primary: hard genital or oral ulcer at site of infection
- secondary: red maculopapular rash everywhere and moist papules in UG region and mouth
- tertiary: degeneration of NS, aneurysms and granulomatous lesions (gummas) in liver, skin and bones
What is the treatment of symphilis?
- early (primary, secondary or early latent): benzathine pencilin (single dose)
- late latent, CV and gummatous syphilis: benzathine penicilin ( weekly for 3 weeks)
- neurosyphilis: procaine penicillin once a day for 2 weeks and benzylpenicillin daily every 4hrs for 2 weeks
What can HPV cause and its treatment?
Can cause:
- cervical carcinoma
- UG warts
- laryngeal papillomas
- common, flat and plantar warts
Treatment:
- podophyllum
- cryo
- laser
- surgery
Describe the types of herpes simplex virus
- HSV-1: affects oral region and causes cold sores
- HSV-2: associated with genital infection
Describe primary genital herpes and treatment
- tingling neuropathic pain in genital area
- extensive bilateral crops of painful blisters in genital area including vagina and cervix in women
- tender inguinal lymph nodes and local oedema
- dysuria
- discharge
- can reoccur
Treatment:
- saline bathing
- LA
- aciclovir