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Jonathan's Reproduction > STI > Flashcards

STI Flashcards

1
Q

What are some common presentations of STI

A

discharges from mouth or genital, genital lesions, warts

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2
Q

What is the typical presentation of Neisseria gonorrhoea in men?

A

urethral discharge, pain due to clogged up urethra

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3
Q

What are some presentation of Neisseria gonorrhoea with oral sex

A

pharyngitis, lymphadenopathy

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4
Q

T/F Neisseria gonorrhoea is a gram +ve rod

A

False, it is gram -ve cocci

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5
Q

What is the target adhesion site of Neisseria gonorrhoea

A

the columnar epithelial cells in urethra or cervix

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6
Q

Why is Neisseria gonorrhoea infection more common in younger women?

A

Older women have squamous lining on cervix, offering more protection

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7
Q

What does the histology of Neisseria gonorrhoea swab look like?

A

packed with neutrophils with phagocytosed diplococci

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8
Q

What is the typical presentation of Neisseria gonorrhoea in female?

A

asymptomatic

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9
Q

What is the reason for the increasing resistance of Neisseria gonorrhoea

A

exchange of genetic material with Neisseria in mouth during oral sex

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10
Q

What is Fitz-Hugh-Curtis Syndrome?

A

A disseminated symptom of gonorrhoea, which involves bacteria ascending up the fallopian tube to infect around the liver

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11
Q

T/F Gonorrhoea is the most common STI

A

False, it is second to Chlamydia

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12
Q

What is the presentation of pelvic inflammatory disease?

A

tubal scarring + increased risk of infertility, fever, pelvic tenderness, discharge

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13
Q

T/F Babies are subjected to gonorrhoea infection if the mum is infected

A

True, they are exposed during delivery, typically presents with purulent/scarring/perforation of cornea and blindness

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14
Q

Why must we diagnose babies with gonorrhoea before any treatment?

A

We treat gonorrhoea with IV Cefotaxime, but if it’s other bacterial infection, we can just use topical antibiotic

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15
Q

What is a better way to diagnose gonorrhoea (better than swab)

A

First void specimen

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16
Q

What must we do when we culture Neisseria gonorrhoea

A

Use selective agar to inhibit normal flora to avoid lost of pathogen in the background

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17
Q

T/F PCR of STI diagnosis routinely combines gonorrhoea and Chlamydia

A

True. It’s not as specific for gonorrhoea as there may be cross reaction with Neisseria spp.

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18
Q

What is the treatment of gonorrhoea

A

Ceftriaxone (cephelosporin), working on cell wall

Azithromycin, working on 50s ribosome

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19
Q

T/F vaccine is available for Neisseria gonorrhoea

A

False

20
Q

Which part of the Chlamydia cycle is infectious

A

Elementary bodies, which live outside the cells. Chlamydia is an obligate intracellular organism

21
Q

What is serovar (of Chlamydia)

A

they are serological variants, a way to characterise Chlamydia infections

22
Q

What does the elementary body turn into once it infects a cell?

A

reticulate body, which replicates and rupture into large numbers

23
Q

What is the presentation of Chlamydia in men

A

dysuria, meatal erythema (redness at tip of penis), clear urethral discharge, testicular pain, prostatitis

24
Q

What is the difference between discharge from Chlamydia and gonorrhoea?

A

Chlamydia - clear

Gonorrhoea - thick and obvious

25
Q

Chlamydia is usually asymptomatic in women, but what are the possible symptoms?

A

cervicitis
endometriosis
vaginal discharge, dysuria, pelvic pain if bacteria ascends

26
Q

Describe the process of Chlamydia Lymphogranuloma venereum (LGV)

A

Chlamydia can spread to local lymph nodes in a few weeks to cause a lot of suppuration. If not drained, they can cause fistula

27
Q

What are the possible symptoms of a baby infected with Chlamydia during delivery

A

conjunctivitis within 2 weeks

delayed pneumonia with staccato cough

28
Q

Why do we do follow up tests with patients treated for Chlamydia

A

there is a chance of reinfection or there may be a lack of response to initial treatment

29
Q

What are the options of treatment Chlamydia

A

Azithromycin or Doxycycline

Avoid doxycycline for pregnant women

30
Q

T/F Trochomonas vaginalis is a gram +ve bacteria

A

False, it’s a parasite with interesting mobility

31
Q

What is the quality of discharge from infection of Trochomonas vaginalis

A

frothy, green-yellow, more alkaline

32
Q

Aside from discharge, what are some other presentations of Trochomonas vaginalis

A

strawberry cervix due to erythema, friable mucus

33
Q

Is fixed gram stain a good technique for Trochomonas imaging?

A

No, wet-prep is better for observing its motility. Fix-stained Trochomonas just looks like neutrophil

34
Q

What are the options of treatment for Trochomonas vaginalis

A

Metronidazole or Tinidazole

35
Q

What is the presentation of primary syphilis

A

painless chancre

36
Q

What is the presentation of secondary syphilis?

A

systemic rash, lymphadenopathy, abdo pain from hepatitis

37
Q

T/F Early latent syphilis describes latency within 1 year

A

True, while late latent indicates 2 years after infection

38
Q

T/F You are much more infectious in early latent stage of syphilis

A

True, and it’s also more likely to be asymptomatic

39
Q

Why is late latent syphilis harder to treat?

A

the organism has lower metabolic demand at this stage

40
Q

What is the presentation of tertiary syphilis?

A

gumma in joints and root of aorta, neurosyphilis which can lead to mental illness

41
Q

T/F Microscopy is a good technique to diagnose syphilis

A

False, Treponema pallidum doesn’t gram stain well

42
Q

What is the treatment of syphilis?

A

Single dose of penicillin for primary and secondary infection. 3 weeks of weekly injection for late latent

43
Q

How does Mycoplasma genitalium present?

A

urethritis in men, cervicitis in women

acute endometriosis, PID

44
Q

How do we diagnose M. genitalium?

A

electron microscopy or NAAT (PCR, but not widely available)

45
Q

What is the treatment of M. genitalium

A

Azithromycin, but if fail, use Moxifloxacin

Jonathan's Reproduction (15 decks)

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