STI Flashcards
Describe how the rate of people acquiring new partners has increased.
increased numbers of partners/person • increased concurrent partners • more people having anal sex • more men reporting sex with men
Suggest why there may be in an increasing number of STIs presenting.
More people asking for tests
More clinicians considering STIs and testing for them
Higher rate of acquiring new partners
Describe the principles of a good consultation with someone with a possible STI.
Good history
HIV testing
Partner notification
Health promotion
Why is a sexual history necessary?
Determining possible casue of symptoms
Detecting high risk behaviour and advising on risk reduction
Tracing contacts
What are the two ways of partner notification?
Patient tells contacts
NHS tells contact
What area of health are promoted in the sexual history consultation?
Condoms prevent transmission of some STIs: HIV, chlamydia, gonorrhoea Oral sex carries risks too Address hazardous drug use Vaccination HIVpre-exposure prophylaxis
What is pharyngeal gonorrhoea the result of?
receptive oro-genital sex
How does pharyngeal gonorrhoea present?
Presents with discharge from the eyes, severe inflammation of the conjunctivitis and oedema of the eyelids, pain and photophobia.
What organism is the cause of gonorrhoea?
Neisseria Gonorrhoeae
How long is the incubation period of gonorrhoea?
2-10 days
What is the first line treatment of gonorrhoea?
Cefixime 400mg
What percentage of women with gonorrhoea are asymptomatic?
80%
What symptoms may men experience in gonorrhoea?
urethral discharge and dysuria
How does Molluscum Contagiosum present?
Flesh coloured umbilicated hemispherical papules usually 5mm in diameter after an incubation period of 3-12 weeks.
Where are Molluscum Contagiosum lesions found in a sexually transmitted infection?
genitals, lower abdomen and upper thighs
Which genotypes of the HPV virus are benign and cause genital warts?
HPV 6
HPV 11
What HPV genotypes are associated with dysplastic conditions and cancers of the genital tract?
HPV 16
HPV 18
How is chlamydia tested for?
Enzyme immunoassays
How can chlamydia present?
Can be asymptomatic in 80%. Urethral symptoms. Conjunctivitis. Vaginal discharge, dysuria, inter menstral and post-coital bleeding. Lower abdominal pain, dyspareunia,
What are the possible complications of chlamydia?
Infertility. Epididymio-orchitis, Reiter’s syndrome. Sexually acquired reactive arthropathy. Chronic pelvic pain
What is the treatment of chlamydia?
Azithromycin 1g orally as a single dose
What is pharyngeal gonorrhoea the result of?
receptive oro-genital sex
How does pharyngeal gonorrhoea present with?
Presents with discharge from the eyes, severe inflammation of the conjunctivitis and oedema of the eyelids, pain and photophobia.
What is a sexually transmissible organism?
A virus, bacteria, protozoan, insect or arthropod which can be spread by sexual contact
What is a sexually transmitted infection (STI)?
An infection by a pathogen which is sexually transmissible and which is unlikely to be transmitted by non-sexual means
What is a sexually transmitted disease (STD)?
A disorder of structure or function caused by a sexually transmitted pathogen
• Pelvic inflammatory disease • Genital warts
How can HIV be prevented?
- 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
Describe the HIV virus>
A retrovirus which infects and replicates in human lymphocytes (CD4+ T cells) and macrophages
What are the symptoms of the primary infection of HIV?
Fever, rash, myalgia, pharyngitis, mucosal ulceration, lymphadenopathy and headache/ aseptic meningitis
What is an AIDS illness?
- Certain tumours and infections that develop due to a weakness in the immune system are classified as AIDS illnesses.
- CD4 cell count of <200
What is the commonest late stage AIDS infection?
Pneumocystis Jiroveci Pneumonia - opportunistic infection. CD4 cells count usually <200. History of dry cough and increasing breathlessness over several weeks.
Why is HIV resistant to treatment?
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.
What are the routes through which HIV can be spread?
- Sexual transmission
- Injection drug misuse
- Blood products
- Vertical transmission
- Organ transplant
Who should be offered a HIV test?
Offer HIV test to anyone presenting with flu-like symptoms and a maculopapular rash.
What type of virus is HIV?
Retrovirus
What are the aims of antiretroviral therapy?
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.
What is antiretroviral therapy?
Different classes of drugs acting on different stages in HIV lifecycle. Adherence needs to be over 90%.
What is combination antiretroviral therapy?
At least three drugs from at least two groups.
What symptoms are included as genital symptoms?
• Discharge from an orifice • Pain from somewhere • Rashes •Lumps and swellings • Cuts, sores, ulcers • Itching • Change in appearance
