Sexually Transmitted infections and HIV Flashcards
What are issues in STIs
Always more than one patient- always have to talk to the person in front of you about someone else such as the sexual partners and their children
Vertical transmission
Partner notification
Confidentiality
High rates of re-infection - every time you get infected with chylamdia and every time you get infected you have an enhanced inflammatory reaction therefore this can effect fertility
May be life-long infection
Stigma and psychological morbidity
what are the risks of STIs
Age - depends on age, anyone can get one but shift towards younger ages
Sexual partner - male will depend on whether they have exclusively male or female parterres, sex between men has a higher risk of STIs
Sexual practice - type of sex that you have, certain sort of sex have a higher risk - anal and vaginal sex has a higher transmission than oral sex
Condom usage - present STIs
Ethnicity
Area of residence
what is the impact of STI the highest in
Heterosexuals under age 25
MSM
Black ethnic minorities
what is the most common STI
Chlamydia
what has a large increase in STI diagnosis in male and male sex
Syphilis 20% increase
Gonorrhoea 22% increase with increasing drug resistance
what is the full name for chylamydia
Chlamydia trachomatis
what has caused the reduction in chlamydia
- chlamydia screening has decreases the diagnosis rate
What STIs are common in women
- warts heights
- herpes
- gonorrhoea
- syphilis
what are the common STIs in mean
- Warts
- Gonorrhoea - increasing rate
- herpes
- syphilis
What type of pathogen in chylamydia trachoma’s
Obligate intracellular pathogen
what symptoms cause show in chlamydia trachomatis
- asymptomatic infection common
What is a serorvars
distinct variation within a species of bacteria/ virus or in immune cells of different individuals
what symptoms can serovars D-K
Males - Urethritis - clear watery discharge, epipdidymitis, prostatitis
Females - Cervicitis(increase in vaginal discharge, spotting after sexual intercourse), Pelvic Inflammatory Disease, Fitz-Hugh Curtis - intra-abdominal syndrome
Neonate - conjunctivitis and pneumonia
what symptoms can serovars L1-3 cause
Lymphogranuloma venereum (lymphatic issues) - Buboes, proctitis
- usually rectally acquired, can cause abdominal pain and change in bowel habits
what are the complications of chlamydia trachomatis
- reactive arthritis - due to reaction inflammatory processes that has been triggered by the presence of chlamydia in the genital tract
- infertility - more often you have chlamydia the more your infertility can go up - can cause tubule damage and lead to ectopic pregnancy
what are the types chlamydia trachomatis
serovars D-K
serovars L1-3 cause
What is the treatment of chlamydia trachomatis
Azithromycin, Doxycycline
what are the features of chlamydia in the neonate
Neonate - conjunctivitis and pneumonia
What are the symptoms of Neisseria gonorrhoea
- males
- females
- neonates
Males – Urethritis, proctitis (rectally acquired), sore throat, epididymitis, prostatitis
Females – Cervicitis, PID, Peri-hepatitis, septic abortion
Neonates – Conjunctivitis
what are the complications of neisseria gonorrhoea
Septic arthritis,
blindness,
infertility
septicaemia
How do you treat neisseria gonorrhoea
– Ceftriaxone
Drug resistance increasing
what causes genital warts
Human Papilloma Virus (DNA)
6 and 11
what HPV is associated with carcinoma
Some associated with carcinoma (16, 18, 31,33)
what are the symptoms of HPV
90% asymptomatic
How do you manage genital warts
Vaccination
Management
- Topical podophyllotoxon, imiquimod
- Cryotherapy - freeze them of
what HSV is oral and what HSV is genital
HSV-1 oral
HSV-2 genital
- can have both - can have either infection or both in either site
How does HSV behave
Primary infection - can be severe and people can get sick or it can be asymptomatic, can go on for a long period of time
Latency - once you are infection they stay there forever, integrate into the host DNA and viruses
Reactivation -
What is the treatment of HSV
Aciclovir
Famciclovir - prodrugs
Valaciclovir - prodrugs
what is another word for syphilis
Treponema pallidum
what are the types of syphilis
Primary - genital ulcer at site of infection - painless so not noticed by the individual
Secondary - rash, lymphadenopathy
Latent - may not know that you have it but it stays present in the body for a long period of time and causes damage
Tertiary - effect the cardiovascular symptom, music-skeletal system and brain as it is a cause of dementia,
Congenital
what are the symptoms of symphilis
Often asymptomatic in early stages
What is the treatment of syphlis
Penicillin - injections
Doxycycline - for allergic to penicillin, slightly less efficous
Describe primary syphilis
Chancre usually single, painless
Dark ground positive - see organisms under the microscope
Lymphadenopathy
Serology may be negative
Infectious++
How do you diagnose syphilis
- serology
- in the early stages of syphilis may be negative therefore need to repeat the blood tests
Describe secondary syphilis
Rash, fever, lymphadenopathy
Condyloma lata
Serology positive
Infectious++
- effects soles of hand and feet can cause redness
what does untreated HIV cause
AIDS
what is untreated HIV associated with
- decreased CD4 lymphocytes associated in the blood
how is HIV treated
- Use of retrovirus
- viral suppression
- allows immune recovery/preservation
- normal life expectancy
- other morbidities is related to inflammation
- U=U - undetectable means untransmissable
when can you not pass on HIV
- when they have undetectable viral load they are untransmissable
what are complications related to HIV related to
- chronic inflammation high rates that are driven by HIV
late diagnosis of HIV has a
high mortality rate
Who gets HIV
- heterosexual
- men who have sex with men
HIV treatment as prevention
- Vertical transmission Partner studies U=U - individual couples - population effect - test and treat
- post exposure prophylaxis
- pre-exposure prophylaxis is used - PREP
what makes up HAART treatment
- protease inhibitors
- integrase inhibitors
- nucleoside reverse transcriptase inhibiters
- fusion inhibitors
- Non-Nucleoside RT inhibitor
what are the short term and long term side effects of HAART
Short-term
Nausea / vomiting / headache
Sleep disturbance (efavirenz)
Long-term Lipodystrophy (NRTIs and PIs) Renal dysfunction (tenofovir) Peripheral neuropathy (d4T, AZT, DDI) Lactic acidosis – may be fatal (d4T, DDI)
