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Infection > STI > Flashcards

STI Flashcards

1
Q

how to diagnose gonorrhoea
when to do
specimen in men and women
sending culture

A

no earlier than 3 days after sexual contact
swab in women
urine first pass in men
both send for NAAT
if positive send culture to identify resistant strains

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2
Q

NGU organisms-5

A 
chlamydia 11-50%
mycoplasma genitalium 6-50%
ureaplasma 5-26%
trachomatis vaginalis 1-20%
adenoviruses
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3
Q

what is chlamydia

A

gram negative coccoid obligate intracellular parasite

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4
Q

asymptomatic chlamydia in men and women

A

70% of women and 50% of men

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5
Q

incubation period chlamydia

how to contact trace

A

3-14 days

6 months

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6
Q

microscopy diagnosis criteria for NGU

A

more than 5 polymorphnuclear leucocytes per high powered field

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7
Q

gonorrhoea contact tracing

A

symptomatic last 2 weeks of last partner if longer than 2 weeks
asymptoamtic
abstain sexual intercourse until 7 days after treatment finishes

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8
Q

mycoplasma
how to diagnose
treatment

A 
difficult to diagnose
no diagnostic test
no cell wall
treat if recurrent urethritis
azithromycin 1g single dose
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9
Q

trichomonas vaginalis type bacteria

treatment

A

Trichomonas vaginalis is an anaerobic, flagellated protozoan parasite and the causative agent of trichomoniasis.
7 days metronidazole or tindazole 2g single dose

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10
Q

HSV
which type in genitalia
how causes latent infection
how diagnose

A

HSV 2 more recurrent and more common in genitalia
infects epithelial cells then nerve endings, move along axon to establish persistant infection in sacral ganglia
in reactivation virus travels down nerve axon to skin and mucosal surfaces

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11
Q

reactivation triggers for HSV

A 
local trauma
surgery
UV light
immunosuppresion 
fever
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12
Q

complications of HSV

A

aspetic meningitis
autonomic dysfunction
urinary retention

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13
Q

treatment HSV

A

all patients with first symptomatic episode should receive anti viral therapy
oral aciclovir or valacyclovir or famciclovir

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14
Q

syphilis organism name type

A

trponema pallidum

coiled spirochete bacterium

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15
Q

higher rate of HIV infection compared to general population in syphylis

A

77 times higher

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16
Q

incubation period primary syphilis

A

contact to development of chancre is 10-90 days

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17
Q

characteristics chancre syphylis

A 
painless
single
indurated 
clean base
discharging clear serum
usual inguinal LN
may look similar herpes
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18
Q

how long chancre takes to heal

A

3-8 weeks

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19
Q

secondary syphylis symptoms

A

macupapular non itchy rash on palms and soles and vagina mucosal lesions
fever
LN
bacteraemia lasts 3-5 months after initial infections
vasculitis, hepatitis, iritis, nephritis, neurological problems

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20
Q

how many develop tertiary syphilis from secondary

A

15-40%

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21
Q

how many develop tertiary syphilis from secondary

A

15-40%

22
Q

tertiary syphilis time after initial infection

types 3

A

3-15 years
gummatous syphilis chornic soft tumours gummas can occur anywhere
cardiovascular syphilis aortitis and aortic aneurysm
neurosyphilis

23
Q

tests for syphilis
antibody test
when positive

A

treponemal and non treponemal test
serology detection anti treponemal antibodies using VDRL test of non specific antigen
or specific treponemal antigens
antibody tests usually positive 2-5 weeks after infection

24
Q

syphilis test using microscopy

A

dark field microscopy
seroud fluid from chancre
has to be done within 10 mins of getting sample

25
Q

syphilis test using microscopy

A

dark field microscopy
seroud fluid from chancre
has to be done within 10 mins of getting sample

26
Q

other tests syphilis

A

direct fluorescent antibody

PCR

27
Q

treatment syphilis

A

penillin, long acting procaine penicillin 600mg IM daily for 10 -12 days
or infection bezathine penicillin 2.4g per week for two weeks

28
Q

what reaction can occur in primary syphilis

A

Jarisch Herxheimer reaction in 50% of primary adn 90% of secondary being treated
endotoxin release when large numbers organisms killed abx, mild fever, malaise, headache few hours, can be severe reaction in tertiary syphilis

29
Q

other infections causing ulcer 4

A

chancroid
granuloma inguinalae (donovanosis)
Lymphogranuloma venereum
molluscum contagiosum

30
Q

organism of chancroid

A

haemophilus ducreyi gram negative
north india and malawi
tender papules developing into pustules then ulcers, regional LN

31
Q 
granumloma inguinale
organism
symptoms
may mimic
risk group person
A 
klebsiella granulomatis
rare ulcerative STI
anal sex
progressive painless uclers no LN
SCC may mimic this so biopsy if fail resolve
32
Q 
lymphogranuloma  venereum
organism
symptoms
laterality
increasing incidence
A 
chlamydia 
also known durand nicolas favre diease
painful femoral or inguinal LN known as buboes
typically unilateral
no visible genital lesions
increasing incidence MSM
33
Q 
molluscum contagiosum
type of virus
area of genitals
how manage
which groups get infected
when resolve
appearance of lesion
A

double stranded DNA virua
can be genitals, buttocks, upper thighs, pubic region
high prevalance HIV
children often infected
smooth dome shaped papules central umbilication
manage conservatively if no IC resolve in 6-12 months

34
Q 
HPV type of virus
which subtypes cervical cancer
which serotype penile cancer
which are low risk oncogenic and what do they cause
which causes buscke lowenstein tumour
A

double stranded DNA virus
HPV 16 and 18 high risk mucosal types responsible cervical cancer
HPV 16 ascc most with SCC sertoype
6 and 11 non oncogenic, responsible anogenital warts

35
Q 
HPV vaccine
which serotypes
two types vaccines
which at risk group used for 
how to give vaccine dose
A

gardasil
6,11,16,18
bivalent prevent HPV causing 70% cervical cancers
quadrivalent also includes prevention 90% genital warts, can be used in males to prevent genital warts and anal cancer high risk MSM
dose three IM injections over 6 month period

35
Q 
HPV vaccine
which serotypes
two types vaccines
which at risk group used for 
how to give vaccine dose
A

gardasil
6,11,16,18
bivalent prevent HPV causing 70% cervical cancers
quadrivalent also includes prevention 90% genital warts, can be used in males to prevent genital warts and anal cancer high risk MSM
dose three IM injections over 6 month period

36
Q

HIV type of virus
what is HIV test initial screening test
supplemental test

A

single stranded RNA virus
initial test screen anti HIV antibodies EIA
confirmed by supplemental antibody tests, HIV-1 RNA assay

37
Q

urological manifestation HIV
renal
prostate
testicle

A 
clinical TB of GU tract
renal abscess, infection with aspergillus, toxoplasma
prostatitis usually ecoli can be fungi
epididymal testicular infections
renal failure
microscopic haematuria
38
Q

most common intrascrotal pathology with HIV

A

testicular atrophy

39
Q

risk of cancer with HIB

which type of testicular cancer

A

higher risk testicular tumours
renal cancer
penile cancer
seminoma 20-50 times, no increased risk non seminoma

40
Q

risk of cancer with HIB

which type of testicular cancer

A

higher risk testicular tumours
renal cancer
penile cancer
seminoma 20-50 times, no increased risk non seminoma

41
Q

stones and HIV

what is incidence of stones

A 
increased risk with protease inhibitors
indinavir can form cystals in urine
up to 22%
radiolucent on x ray and CT
but if mixed with ca can be radioopaque
42
Q

look back periods for chlamydia and gonorrhoea

A

Chlamydia 1 month, symptomatic males
6 months or last partner if longer, asymptomatic males and all females

Gonorrhoea 2 weeks symptomatic males
3 months or last partner if longer, asymptomatic males and all females

43
Q

treponemal syphilis test

A

Because of the possibility of false positives with nontreponemal tests, confirmation is required with a treponemal test, such as treponemal pallidum particle agglutination (TPHA) or fluorescent treponemal antibody absorption test (FTA-Abs).

43
Q

treponemal syphilis test

A

Because of the possibility of false positives with nontreponemal tests, confirmation is required with a treponemal test, such as treponemal pallidum particle agglutination (TPHA) or fluorescent treponemal antibody absorption test (FTA-Abs).

44
Q

NICE more likley man has STI 4 factors

A

Have had more than one partner in the last year
Have a recent new partner
Have had a previous STI
Are aged 25 or younger

45
Q

sexual history 12

A

When did you last have sexual intercourse?
With a man or woman?
Were they a casual or regular partner?
Where were they from?
In which country did you have sex?
What kind of sex did you engage in?
For each type, for example, oral/vaginal/anal did you use a condom? For heterosexual sex was any contraception used? Relate risk of pregnancy
Does your partner have any symptoms?
Have you had any other partners in the last six weeks? If so return to question 2.
Did you have pain during or after intercourse?
Have you had any previous STI?
Have you ever had a sexual health check up before?
Have you ever had an HIV/hepatitis/syphilis test before?
Have you ever been vaccinated against hep A/B or ever had hepatitis?

46
Q

type of urine sample first void

A

Samplealso referred to as afirstmorningspecimen. Thissampleis collected thefirsttime the patient urinates in the morning. Afirst voided specimenis the most concentrated and is the preferredspecimenfor pregnancy testing, bacterial cultures and microscopic examinations

47
Q

gonorrhoea other sides

A

rectum
eyes
throat
joints

48
Q

gonorrhoea other sides

A

rectum
eyes
throat
joints

49
Q

gram staining principles

A

gram positive has thick cell wall of peptidoglycan which retains colour of crystal violet
gram negative thinner cell wall retains red of safranin

50
Q

gram stain technique

A

cyrstal voilet all purple,
add iodine
add alcohol, gram positive purple from cystal violet, grame negative colourness
add safranin red, gram negative turns red

Infection (16 decks)

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