STDs

Question 1

what are the most common STIs

Answer 1

HPV
chlamydia
(candida)
trichomonas vaginalis 
herpes
gonorrhoea 
syphylis 
hep b
chancroid (haemophilus)
lymphogranuloma venereum

Question 2

describe the epidemiology

Answer 2

young people

have many more partners

Question 3

what are the risk factors for STIs

Answer 3

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

Question 4

what are the determinants of risky sexual behaviours

Answer 4

individual factors
external influences- peer pressure, attitudes and prejudices and stigma
service provision

Question 5

what are the causes of genital discharge disease

Answer 5

chlamydia trachomatis

gonorrhoea

Question 6

what are the features of chlamydia

Answer 6

obligate intracellular gram negative

can cause trachoma( eye disease)
or causes genital infection
or causes lymphogranuloma venereum
may cause eye infections in neonates

Question 7

what are the symptoms of chlamydia

Answer 7

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

Question 8

what chlamydia investigations are there

Answer 8

urine (nucleic acid amplification test)
endocervical swab
antigen detection
cell culture

Question 9

what is chlamydia treated with

Answer 9

azithromycin and tetracycline

Question 10

what are the features of gonorrhoea

Answer 10

gram negative
intracellular diplococcus
humans only
infects epithelial cells of mucous membrane
localised infection and production of pus
can be assymptomatic

Question 11

what are the symptoms of gonorrhoea

Answer 11

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

Question 12

what is opthalmia neonatorum

Answer 12

conjunctivitis contracted by new borns during delivery
mother infected wiht N gonorrhoea or C trachomatis
can cause blindness

Question 13

how is gonorrhoea diagnoses

Answer 13

microscopy
NAAT
culture

Question 14

how is gonorrhoea treated

Answer 14

cetriaxone
cefixime
ciprofloxacin

increasing resistance

may have a concommitant chlamydia infection - doxycycline

Question 15

what are the features of thrush

Answer 15

itchy vaginitis
may present as a UTI
microscopy/ culture used to diagnose

Question 16

how is thrush treated

Answer 16

oral fluconozole

or topical/ pessary triazole

Question 17

what are the features of trichomonas vaginalis

Answer 17

anaerobic, flagellated protozoa 
infects vagina/ urethra
causes trichomoniasis 
common in men, uncommen in woman 
yellowish vaginal discharge

Question 18

what is trichomonas vaginalis treated with

Answer 18

metronidazole

Question 19

where are genital warts found

Answer 19

shaft of penis

vagina, vulva and cervix

Question 20

what are the features of HPV

Answer 20

hyperplastic epithelial lesions

incubation for 1- 6 months

Question 21

what symptoms can HPV cause

Answer 21

cervical carcinoma
anal carcinoma 
urogenital warts 
laryngeal papillomas
common, flat and plantar warts

Question 22

what are the treatments of HPV

Answer 22

podophyllum
cryo
laser
surgery

Question 23

what does gardasil protect against

Answer 23

most types of cervical cancer

Question 24

what are the features of hepes

Answer 24

both types can infect the mouth and genitals

Question 25

what are the features of neonatal herpes

Answer 25

spread during birth | may result in a disseminated infection

Question 26

what are the features of herpes

Answer 26

``` febrile flu like prodrome neuropathic pain bilateral crops of painful blisters tender lymph nodes local oedema dysuria vaginal or urethral discharge ```

Question 27

what is genital herpes treated with

Answer 27

aciclovir

Question 28

what are the features of a reccurent herpes infection

Answer 28

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

Question 29

what are the features of HSV diagnosis

Answer 29

appearance swab from ulcer viral culture serology

Question 30

what organism causes syphylis

Answer 30

treponema pallidum gram negative spirochete

Question 31

what are the stages of syphylis

Answer 31

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

Question 32

what is congenital syphylis

Answer 32

placental transfer can cause spontaneous abortion babies develop secondary syphylis

Question 33

how is syphylis diagnosed

Answer 33

from lesions or infected lymph nodes dark field microscopy naat immunoglobulin

Question 34

what is chancroid

Answer 34

``` caused by gram negs painful genital ulcers microscopy treated with a macrolide eg erythromycin ```

Question 35

how can HIV be transmitted

Answer 35

blood sex perinatally

Question 36

what are the two types of HIV

Answer 36

HIV 1 most common HIV2 less virulent retroviridae lentivirus

Question 37

what does retrovirus mean

Answer 37

uses reverse transcriptase to make dna copy from viral rna

Question 38

describe progression from HIV to AIDS

Answer 38

``` seroconversion asymptomatic persistant generalised lymphadenopathy AIDS related clinical features AIDS ``` greater viral load means quicker progression

Question 39

how is HIV treated

Answer 39

nucleoside reverse transcriptase inhibitors non nucleoside reverse transcriptase protease inhibitors

Question 40

what is highly anti retroviral therapy

Answer 40

combinations of drugs e.g. 1 NRTI + 1 PI or 2 NRTIs and 1 NNRTIs

Question 41

how is HIV diagnosed

Answer 41

``` diagnosis of HIV antibodies NAAT viral RNA detected viral load measured follow up a negative result ```

Question 42

what virus is hep B

Answer 42

hepadnivirus | double stranded DNA

Question 43

how is Hep B transmitted

Answer 43

``` blood needles sex birth haemodialysis ```

Question 44

what are the stages of infection of HBV

Answer 44

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

Question 45

what are the features of the pre icteric stage in hep b

Answer 45

malaise anorexia nausea pain in RuQ

Question 46

how is HBV treated

Answer 46

pegylated interferon nucleoside analogues

Question 47

how is HBV prevented

Answer 47

vaccine immunoglobulin blood screening needle exchange

Question 48

can HCV be sexually transmitted

Answer 48

rarely

Question 49

where does HCV replicate

Answer 49

liver cells rarely progresses to cirrhosis

Question 50

how is HCV treated

Answer 50

interferon | ribavirin

Question 51

what is seroconversion

Answer 51

the point at which hiv antibodies become detectable | usually accompanied by flu like symptoms

Question 52

reiter's

Answer 52

chlamydia

Question 53

macrolide

Answer 53

chancroid

Question 54

aciclivor

Answer 54

herpes

Question 55

azithromycine and tetracycline

Answer 55

chlamydia

Question 56

ceftriaxone cefixime ciproflaxin

Answer 56

gonorrhoea

Question 57

doxycycline

Answer 57

gonorrhoea and chlamydia

Question 58

fluconazole and triazole

Answer 58

thrush

Question 59

benzyl penicillin

Answer 59

syphylis