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STI Flashcards

1
Q

Describe how the rate of people acquiring new partners has increased.

A

increased numbers of partners/person • increased concurrent partners • more people having anal sex • more men reporting sex with men

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2
Q

Suggest why there may be in an increasing number of STIs presenting.

A

More people asking for tests
More clinicians considering STIs and testing for them
Higher rate of acquiring new partners

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3
Q

Describe the principles of a good consultation with someone with a possible STI.

A

Good history
HIV testing
Partner notification
Health promotion

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4
Q

Why is a sexual history necessary?

A

Determining possible casue of symptoms
Detecting high risk behaviour and advising on risk reduction
Tracing contacts

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5
Q

What are the two ways of partner notification?

A

Patient tells contacts

NHS tells contact

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6
Q

What area of health are promoted in the sexual history consultation?

A 
Condoms prevent transmission of some STIs: HIV, chlamydia, gonorrhoea
Oral sex carries risks too
Address hazardous drug use
Vaccination 
HIVpre-exposure prophylaxis
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7
Q

What is pharyngeal gonorrhoea the result of?

A

receptive oro-genital sex

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8
Q

How does pharyngeal gonorrhoea present?

A

Presents with discharge from the eyes, severe inflammation of the conjunctivitis and oedema of the eyelids, pain and photophobia.

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9
Q

What organism is the cause of gonorrhoea?

A

Neisseria Gonorrhoeae

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10
Q

How long is the incubation period of gonorrhoea?

A

2-10 days

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11
Q

What is the first line treatment of gonorrhoea?

A

Cefixime 400mg

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12
Q

What percentage of women with gonorrhoea are asymptomatic?

A

80%

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13
Q

What symptoms may men experience in gonorrhoea?

A

urethral discharge and dysuria

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14
Q

How does Molluscum Contagiosum present?

A

Flesh coloured umbilicated hemispherical papules usually 5mm in diameter after an incubation period of 3-12 weeks.

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15
Q

Where are Molluscum Contagiosum lesions found in a sexually transmitted infection?

A

genitals, lower abdomen and upper thighs

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16
Q

Which genotypes of the HPV virus are benign and cause genital warts?

A

HPV 6

HPV 11

17
Q

What HPV genotypes are associated with dysplastic conditions and cancers of the genital tract?

A

HPV 16

HPV 18

18
Q

How is chlamydia tested for?

A

Enzyme immunoassays

19
Q

How can chlamydia present?

A

Can be asymptomatic in 80%. Urethral symptoms. Conjunctivitis. Vaginal discharge, dysuria, inter menstral and post-coital bleeding. Lower abdominal pain, dyspareunia,

20
Q

What are the possible complications of chlamydia?

A

Infertility. Epididymio-orchitis, Reiter’s syndrome. Sexually acquired reactive arthropathy. Chronic pelvic pain

21
Q

What is the treatment of chlamydia?

A

Azithromycin 1g orally as a single dose

22
Q

What is pharyngeal gonorrhoea the result of?

A

receptive oro-genital sex

23
Q

How does pharyngeal gonorrhoea present with?

A

Presents with discharge from the eyes, severe inflammation of the conjunctivitis and oedema of the eyelids, pain and photophobia.

24
Q

What is a sexually transmissible organism?

A

A virus, bacteria, protozoan, insect or arthropod which can be spread by sexual contact

25
Q

What is a sexually transmitted infection (STI)?

A

An infection by a pathogen which is sexually transmissible and which is unlikely to be transmitted by non-sexual means

26
Q

What is a sexually transmitted disease (STD)?

A

A disorder of structure or function caused by a sexually transmitted pathogen
• Pelvic inflammatory disease • Genital warts

27
Q

How can HIV be prevented?

A
  • Correct and correct use of condoms- decrease transmission by 90%.
  • The short term use of antiretroviral therapy after potential HIV exposure should be considered an emergency method of HIV prevention.
  • The use of ART is also appropriate in those at high risk of acquiring HIV
28
Q

Describe the HIV virus>

A

A retrovirus which infects and replicates in human lymphocytes (CD4+ T cells) and macrophages

29
Q

What are the symptoms of the primary infection of HIV?

A

Fever, rash, myalgia, pharyngitis, mucosal ulceration, lymphadenopathy and headache/ aseptic meningitis

30
Q

What is an AIDS illness?

A
  • Certain tumours and infections that develop due to a weakness in the immune system are classified as AIDS illnesses.
  • CD4 cell count of <200
31
Q

What is the commonest late stage AIDS infection?

A

Pneumocystis Jiroveci Pneumonia - opportunistic infection. CD4 cells count usually <200. History of dry cough and increasing breathlessness over several weeks.

32
Q

Why is HIV resistant to treatment?

A

It is a retrovirus and therefore it encodes reverse transcriptase, allowing DNA copies to be produced from viral RNA. This is error prone, meaning a significant mutation rate, which contributes to treatment resistance.

33
Q

What are the routes through which HIV can be spread?

A
  • Sexual transmission
  • Injection drug misuse
  • Blood products
  • Vertical transmission
  • Organ transplant
34
Q

Who should be offered a HIV test?

A

Offer HIV test to anyone presenting with flu-like symptoms and a maculopapular rash.

35
Q

What type of virus is HIV?

A

Retrovirus

36
Q

What are the aims of antiretroviral therapy?

A

To reduce the HIV load to a level undetectable by standard laboratory techniques leading to immunological recovery, reduced clinical progression and reduced mortality. These aims should be met with the least possible side effects.

37
Q

What is antiretroviral therapy?

A

Different classes of drugs acting on different stages in HIV lifecycle. Adherence needs to be over 90%.

38
Q

What is combination antiretroviral therapy?

A

At least three drugs from at least two groups.

39
Q

What symptoms are included as genital symptoms?

A

• Discharge from an orifice • Pain from somewhere • Rashes •Lumps and swellings • Cuts, sores, ulcers • Itching • Change in appearance

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