St A - Sexually Transmitted Infections Flashcards

1
Q

What are the top 3 most common STIs?

A

1) Chlamydia Trachomatis,
2) Human Papilloma Virus,
3) Neisseria Gonnorhoeae

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2
Q

What are the risk factors for getting an STI?

A
  • 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
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3
Q

What are some determinants of risky sexual behaviour?

A

Individual factors - low self-esteem, lack of skills, lack of knowledge of unsafe sex.

  • External influences - peer pressure, attitudes and prejudices of society.
  • Service provision - accessibility of sexual health services and/or lack of resources such as condoms
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4
Q

What are three basic microbial testing for STIs?

A

1) NAAT - used for chlamydia and n.gonnorhoea and herpes.
2) Microscopy, culture and sensitivity -used for N.gonorrhoeae, candidam bacterial vaginosis and trichomonas,
3) Blood tests - syphilis, HIV and hepatitis

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5
Q

What are the female and male symptoms of chlamydia trachomatis

A

female - Vaginal or anal discharfe, post-coital bleeding, abdo tenderness, pelvic tenderness, infertility, reactive arthritis, proctitis, pharyngitis and perihepatitis.
Male - Urethral/anal discharge, epididymal tenderness, prostatitis, reactive arthritis, proctitis, pharyngitis and perihepatitis.

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6
Q

What are some of the complications of a chlamydia infection?

A
  • Pelvic inflammatory disease (associated with infertility, ectopic pregnancies and chronic pelvic pain)
  • Sexually acquired reactive arthritis (SARA) (urethritis, arthritis and conjunctivitis)
  • Epididymo-orchitis,
  • Peri-hepatitis
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7
Q

What are some of the chlamydia investigations?

A

Women - Vulvo-vaginal swab (self taken)
Men - First catch urine
Extra genital sites - rectal and pharyngeal.

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8
Q

How is chlamydia treated?

A

Doxycycline 100mg twice daily for 7 days whilst avoiding sexual contact and notify partner

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9
Q

What is lymphogranuloma venerum?

A

It is caused by one of the three invasive serovars of chlamydia trachomatis. It presents with a solitary genital lesion, proctitis and lymphadenopathy. Treatment if doxycycline

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10
Q

Describe features of the neisseria gonorrhoea infection

A

Gram negative bacteria that infections the epithelial cells of the mucous membrane of GU tract or rectum. Resulting in the development of localised infection with production of pus

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11
Q

What are the symptoms of gonorrhoea in men and women?

A

Females - Dysuria, rectal infection, salpingitis, PID, pharyngeal infection, post-coital bleeding and septic arthritis.
Males - Urethral discharge, anal discharge (with/without pain and bleeding)
- Epididymal tenderness, pharyngeal infection and septic arthritis

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12
Q

What are some of the investigations for Gonorrhoea?

A
  • Light microscopy,
  • NAAT,
  • For men its First catch urine,
  • For women its a vulvo-vaginal swab,
  • For men who have sex with men take a rectal and pharyngeal sample
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13
Q

What is the treatment for gonorrhoea?

A

Ceftriaxone 1g IM or ciprofloxacin 500mg orally however there is increasing resistance to antibiotics but most respond to ceftriaxone. Parner needs notified and tested

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14
Q

How does a candida albicans (thrush) infection present?

A

Itch, vulval pain, superficial dyspareunia and curd like vaginal discharge.

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15
Q

How is thrush diagnosed and treated?

A

Diagnosis - clinical and microscopy.

Treatment - Topical clotrimazole

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16
Q

What are the stages of a treponema pallidum infection (syphilis)

A

Primary - Hard genital or oral ulcer at site of infection.
Secondary - Red maculopapular rash anywhere plus pale moist papules in urogenital region and mouth.
Tertiary - Degeneration of NS, aneurysms and granulomatous lesions in liver, skin and bones.

17
Q

How is syphilis diagnosed?

A
  • From lesions or infected lymph nodes early on.
  • Dark field microscopy,
  • Direct fluorescent antibody (DFE) test,
  • EIA for immunoglobin
18
Q

What is the treatment for syphilis?

A

Early syphilis - Benzathine penicillin (single dose).

- Late latent, cardiovascular and gummatous syphilis -Benzathine penicillin for 3 weeks

19
Q

What does the human papilloma virus cause?

A
  • Urogenital warts,
  • Cervical cancer,
  • Laryngeal papillomas,
  • Common, flat and plantar warts
20
Q

How can the HPV be diagnosed and treated?

A

Virus can be seen on colposcopy.

Treatment - Podophyllum, cryo, laser and surgery

21
Q

What are some prevention mechanisms for HPV?

A

Killed HPV vaccines which are given to girls aged 12-13, and MSM under age 45

22
Q

Describe the two types of herpes simplex virus?

A

HSV-1 which usually affects the oral region and causes cold sores.
HVS-2 which is associated with genital infection

23
Q

How does the primary genital herpes infectoin present?

A

Flu-like symptoms, tingling neuropathic pain in genital area, extensive bilateral crops of painful blisters in genital area, tender lymph nodes, local oedema, vaginal/urethral discharge

24
Q

What is the treatment of primary infection genital herpes

A
  • Saline bathing,
  • Local anasthetics,
  • Aciclovir
25
Q

What is recurrant genital herpes

A

Occurs following primary infection as the virus can become latent in local sensory ganglia. Therefore there is periodic reactivation.

26
Q

How can you diagnose HSV?

A
  • Clinical appearance,
  • Viral culture,
  • NAAT of a swab from base of ulcer,
  • Serology