Sexually Transmitted Infections of the Genital Tract Flashcards
What is a commensal micro-organism?
A micro-organism that derives food or other benefits from another organism without hurting or helping it
What is a pathogen?
A micro-organism that can cause disease
What is an infection?
The invasion and multiplication of an organism that’s not usually found in the body; if no symptoms - subclinical, if symptoms - clinical
What is a sexually transmissible micro-organism?
A virus, bacteria or parasite which can be spread by sexual contact
What is a sexually transmitted infection?
An infection by an organism which is sexually transmissible and which is less likely to be transmitted by other means e.g. Neisseria gonorrhoeae, HPV type 6
What is a sexually transmitted disease?
A disease caused by an STI e.g. pelvic inflammatory disease, genital warts
What are venereal diseases?
Syphilis
Gonorrhoea
Chancroid
What are the common sexually transmitted bacteria in the UK?
Chlamydia trachomatis
Klebsiella granulomatis
Mycoplasma genitalium
What are the common sexually transmitted viruses in the UK?
HSV
HIV
HPV
Molluscum contagiosum virus
What are the common sexually transmitted parasites in the UK?
Pthirus pubis
Sarcoptes scabei
Trichomonas vaginalis
What are the organisms/conditions which are controversial in terms of whether they are infection or colonisation?
Mycoplasma hominis
Ureaplasma urealyticum
Bacterial vaginosis
Genital candidosis
What infections can be transmitted by genital contact only?
Pubic lice (pthirus pubis) Scabies (sarcoptes scabeii) Warts (HPV types 6 and 11) Herpes (HSV types 1 and 2)
What sexually transmissible infection is transmitted by blood transmission or group sex?
Hepatitis C
What are the effects of STIs on morbidity?
Cause unpleasant symptoms and psychological distress
In what ways are STIs a drain on resources?
Managing infertility due to chlamydia
Cost of IVF
Cost of HIV medication and management of HIV-related conditions
Why might the number of diagnoses of STIs have changed over time?
May be due to a true change in number of cases, or due to a change in diagnoses but no actual change in number of cases
Greater awareness of STIs so more people asking for tests and more doctors considering diagnosis of STI and testing for them
Better tests available e.g. nucleic amplification tests vs enzyme immunoassays for chlamydia
According to the NATSAL study, what has causes the increase in diagnosis of STIs?
Increased numbers of partners/people
Increased concurrent partners
More people having anal sex
More men reporting sex with men
What are the implications of transmissible STIs?
Partner notification
What are the implications of STIs which are asymptomatic most of the time?
Symptom awareness and screening
What should you do for STIs which are manageable but not curable?
Treatment and prevention of complications
How can STIs be avoidable?
Primary prevention - education
What are the common symptoms of STIs?
Ulceration Lumps Urethritis Discharge Rashes
Systemic
- Fever
- Rash
- Lymphadenopathy
- Malaise
- Infertility
What is involved in the management of someone with symptoms suggesting an STI?
Good history
Partner notification
HIV testing
Health promotion
What are the standard history components of someone with symptoms suggesting an STI?
Presenting complaint HPC PMH/SH DH Gynae history Direct questions about symptoms e.g. discharge and pain Sexual history
What are the components of the sexual history?
When did you last have sexual contact?
Casual contact vs regular partner, how long you were with them for if regular partner
Contact male or female?
Asking about nature of sex is sometimes useful e.g. anxiety about a specific incident, if it is going to alter where you swab from
Did you use condoms?
Other contraception used
Nationality of contact
What are the components of male risk assessment?
Have you ever had sexual contact with a man?
Have you ever injected drugs?
Sexual contact with anyone who has injected drugs or someone from outside the UK
Medical treatment outside the UK
Involvement with sex industry
What are the possible modes of partner notification?
Patient tells contact - client referral
NHS tells contact - provider referral
Why might an HIV test be offered/recommended?
Most STIs are risk factors for HIV acquisition and transmission
If someone has had one STI they could have another
What should you cover in health promotion?
Condoms prevent transmission of some STIs e.g. HIV, chlamydia, gonorrhoea, but they aren’t very good at preventing transmission of other STIs e.g. herpes and warts
Oral sex also carries risks
Alcohol and other drugs
