STDs Flashcards
what are the most common STIs
HPV chlamydia (candida) trichomonas vaginalis herpes gonorrhoea syphylis hep b chancroid (haemophilus) lymphogranuloma venereum
describe the epidemiology
young people
have many more partners
what are the risk factors for STIs
young failure to use a barrier sex with people of the same sex IV drug use african origin social deprivation prostitution and paying for sex poor access to advice and treatment non regular relationships
what are the determinants of risky sexual behaviours
individual factors
external influences- peer pressure, attitudes and prejudices and stigma
service provision
what are the causes of genital discharge disease
chlamydia trachomatis
gonorrhoea
what are the features of chlamydia
obligate intracellular gram negative
can cause trachoma( eye disease)
or causes genital infection
or causes lymphogranuloma venereum
may cause eye infections in neonates
what are the symptoms of chlamydia
vaginal/ anal/ urethral discharge post coital bleeding epididymal tenderness abdo tenderness pelvic tenderness reiter's syndrome (arthritis, urethritis and conjunctivitis) proctitis pharyngitis perihepatitis skin lesions watery discharge
what chlamydia investigations are there
urine (nucleic acid amplification test)
endocervical swab
antigen detection
cell culture
what is chlamydia treated with
azithromycin and tetracycline
what are the features of gonorrhoea
gram negative
intracellular diplococcus
humans only
infects epithelial cells of mucous membrane
localised infection and production of pus
can be assymptomatic
what are the symptoms of gonorrhoea
inflammation and discharge cervical discharge rectal infection oral pharyngitis disseminated infection septic infection dysuria salpingitis (PID) post coital bleeding epididymal tenderness can be transmitted orogenitally PAIN AND PUSS - men
what is opthalmia neonatorum
conjunctivitis contracted by new borns during delivery
mother infected wiht N gonorrhoea or C trachomatis
can cause blindness
how is gonorrhoea diagnoses
microscopy
NAAT
culture
how is gonorrhoea treated
cetriaxone
cefixime
ciprofloxacin
increasing resistance
may have a concommitant chlamydia infection - doxycycline
what are the features of thrush
itchy vaginitis
may present as a UTI
microscopy/ culture used to diagnose
how is thrush treated
oral fluconozole
or topical/ pessary triazole
what are the features of trichomonas vaginalis
anaerobic, flagellated protozoa infects vagina/ urethra causes trichomoniasis common in men, uncommen in woman yellowish vaginal discharge
what is trichomonas vaginalis treated with
metronidazole
where are genital warts found
shaft of penis
vagina, vulva and cervix
what are the features of HPV
hyperplastic epithelial lesions
incubation for 1- 6 months
what symptoms can HPV cause
cervical carcinoma anal carcinoma urogenital warts laryngeal papillomas common, flat and plantar warts
what are the treatments of HPV
podophyllum
cryo
laser
surgery
what does gardasil protect against
most types of cervical cancer
what are the features of hepes
both types can infect the mouth and genitals
what are the features of neonatal herpes
spread during birth
may result in a disseminated infection
what are the features of herpes
febrile flu like prodrome neuropathic pain bilateral crops of painful blisters tender lymph nodes local oedema dysuria vaginal or urethral discharge
what is genital herpes treated with
aciclovir
what are the features of a reccurent herpes infection
virus becomes latent in sensory ganglia
periodic reactivation
with lesions or viral shedding
episodes are usually shorter
HSV2 will have 4 attacks in first year
hsv1 wil have 1 attach in the first twelve months
attacks become less frequent over time
what are the features of HSV diagnosis
appearance
swab from ulcer
viral culture
serology
what organism causes syphylis
treponema pallidum
gram negative spirochete
what are the stages of syphylis
primary - genital or oral ulcer at site of infection
secondary- red maculopapular rash plus pale moist papules in urogenital region and mouth (condylomas)
tertiary- degeneration of NS, aneurysms, granulomas in liver, skin and bones
what is congenital syphylis
placental transfer
can cause spontaneous abortion
babies develop secondary syphylis
how is syphylis diagnosed
from lesions or infected lymph nodes
dark field microscopy
naat
immunoglobulin
what is chancroid
caused by gram negs painful genital ulcers microscopy treated with a macrolide eg erythromycin
how can HIV be transmitted
blood
sex
perinatally
what are the two types of HIV
HIV 1 most common
HIV2 less virulent
retroviridae lentivirus
what does retrovirus mean
uses reverse transcriptase to make dna copy from viral rna
describe progression from HIV to AIDS
seroconversion asymptomatic persistant generalised lymphadenopathy AIDS related clinical features AIDS
greater viral load means quicker progression
how is HIV treated
nucleoside reverse transcriptase inhibitors
non nucleoside reverse transcriptase
protease inhibitors
what is highly anti retroviral therapy
combinations of drugs
e.g. 1 NRTI + 1 PI
or 2 NRTIs and 1 NNRTIs
how is HIV diagnosed
diagnosis of HIV antibodies NAAT viral RNA detected viral load measured follow up a negative result
what virus is hep B
hepadnivirus
double stranded DNA
how is Hep B transmitted
blood needles sex birth haemodialysis
what are the stages of infection of HBV
long incubation period
acute hepatitis
fulminant disease 1% mortality
50% of patients develop chronic active hepatitis leading to cirrhosis and hepatocellular carcinoma
pre icteric stage and icteric stage
what are the features of the pre icteric stage in hep b
malaise
anorexia
nausea
pain in RuQ
how is HBV treated
pegylated interferon
nucleoside analogues
how is HBV prevented
vaccine
immunoglobulin
blood screening
needle exchange
can HCV be sexually transmitted
rarely
where does HCV replicate
liver cells
rarely progresses to cirrhosis
how is HCV treated
interferon
ribavirin
what is seroconversion
the point at which hiv antibodies become detectable
usually accompanied by flu like symptoms
reiter’s
chlamydia
macrolide
chancroid
aciclivor
herpes
azithromycine and tetracycline
chlamydia
ceftriaxone cefixime ciproflaxin
gonorrhoea
doxycycline
gonorrhoea and chlamydia
fluconazole and triazole
thrush
benzyl penicillin
syphylis
