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gp conditions year 4 > STI > Flashcards

STI Flashcards

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1
Q

What bacteria causes chlamydia and is it gram positive or negative?

A

chlamydia trachomatis

gram negative

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2
Q

what is the most common STI in the UK and what is it a common cause of?

A

chlamydia

infertility

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3
Q

Risk factors for chlamydia

A

young
sexually active
multiple partners

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4
Q

What % of people with chlamydia are asymptomatic?

A

50% men

75% females

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5
Q

What does the National Chlamydia Screening programme entail?

A

everyone under 25 and sexually active to be screened annually for chalmydia or if partner changes
positive re-test 3 months

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6
Q

GUM clinic STI screening list

A

chalmydia
gonorrhoea
syphilis - blood
HIV - blood

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7
Q

2 types of swabs used

A

charcoal swabs

NAAT swabs

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8
Q

What do charcoal swabs allow for?

A

microscopy
culture
sensitivities

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9
Q

transport medium - charcoal swab

A

amies transport medium

keep microorganisms alive

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10
Q

What does microscopy entail?

A

gram staining

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11
Q

What can charcoal swabs be used for?

A

endocervical swabs

high vaginal swabs

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12
Q

What can charcoal swabs confirm?

A 
bacterial vaginosis 
candidiasis
gonorrhoea 
trichomonas vaginalis 
group B strep
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13
Q

What do NAAT detect?

A

DNA or RNA

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14
Q

What STIs use NAAT?

A

chlamydia

gonorrhoea

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15
Q

What can NAAT be performed on?

A

vulvovaginal swab
endocervical swab
first catch urine sample

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16
Q

What can NAAt be performed on - men

A

first catch urine

urethral swab

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17
Q

Rectal and pharyngeal NAAT swabs

A

chlamydia in rectum or throat

anal or oral sex

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18
Q

After gonorrhoea is demonstrated on NAAT what is done next?

A

endocervical charcoal swab

microscopy, culture, sensitivities

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19
Q

Who to consider chlamydia in - women

A 
sexually active 
abnormal discharge 
pelvic pain 
abnormal vaginal bleeding
painful sex
painful urination
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20
Q

Who to consider chalmydia in - men

A

urethral discharge or discomfort
painful urination
epididymo-orchitis
reactive arthritis

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21
Q

Examination findings

A

Pelvic or abdominal tenderness
cervical motion tenderness
inflamed cervix
purulent discharge

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22
Q

First line treatment - uncomplicated chlamydia

A

doxycycline 100mg 2 daily for 7 days

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23
Q

When is doxycycline CI?

A

breastfeeding and pregnancy

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24
Q

treating chlamydia in pregnancy/breastfeeding

A

azithromycin 1g then 500mg for 2 days
erythromycin 500mg 4xdaily for 7 days
amoxicillin 500mg 3xdaily 7 days

25
Q

When could a test of cure be done?

A

rectal chlamydia
pregnancy
symptoms persist

26
Q

Factors to consider going forward

A

GUM - contact trace
look for other STIs
prevention
safeguarding - young people

27
Q

Complications - chlamydia

A 
PID
chronic pelvic pain 
infertility 
ectopic pregnancy 
reactive arthritis 
epididymo-orchitis
28
Q

Pregnancy related complications - chlamydia

A

preterm delivery
low birth weight
postpartum endometriosis
neonatal infection - conjunctivitis

29
Q

What is lymphogranuloma venereum?

A

condition affecting lymphoid tissue around site of infection with chlamydia
MSM

30
Q

3 stages of LGV

A

primary stage - painless ulcer
lymphadenitis
proctitis (tenesmus)

31
Q

treating LGV

A

doxycycline 100mg 2xdaily for 21 days

32
Q

Chlamydia conjunctivitis

A

chronic erythema, irritation and discharge more 2 weeks
unilateral
young adults and neonates with affected mothers

33
Q

What bacteria causes syphilis?

A

treponema pallidum

34
Q

What type of bacteria is treponema pallidum?

A

spirochete

spiral shaped bacteria

35
Q

incubation period syphilis

A

21 days

36
Q

How can syphilis be contracted?

A 
oral, vaginal or anal sex
vertical transmission 
IVDU
blood transfusions 
transplants
37
Q

Name different phases of syphilis

A 
primary 
secondary 
latent 
tertiary 
neurosyphilis
38
Q

primary syphilis

A

painless ulcer - chancre

local LN

39
Q

secondary syphilis

A

systemic sx - skin and mucous membranes
maculopapular rash
condylomata lata
LN, fever, alopecia, oral lesions

40
Q

latent syphilis

A

asymptomatic

within 2years of infection (early latent) and after 2 years is late latent

41
Q

tertiary syphilis

A

many years after
development of gummas
aortic aneurysms
neurosyphilis

42
Q

When can neurosyphilis occur?

A

any stage

43
Q

What are gummas?

A

granulomatous lesions that affect skin, organs and bones

44
Q

neurosyphilis symptoms

A 
headache 
altered behaviour 
dementia 
tabes dorsalis 
ocular syphilis 
paralysis 
sensory impairment
45
Q

tabes dorsalis

A

demylination of spinal cord posterior columns

46
Q

specific pupil finding in neurosyphilis

A

Argyll-Robertson pupil

47
Q

Argyll-Robertson pupil

A

constricted pupil that accommodates when focusing on near object but does not respond to light

48
Q

diagnosing syphilis

A

antibody test - screening
rapid plasma regain and VDRL
dark field microscopy and PCR

49
Q

Managing syphilis

A

screening other STIs
sexual activity advice until treated
contact tracing

50
Q

treating syphilis

A

deep im dose of penicillin

51
Q

Treating HPV

A

local cytotoxic therapy - 5FU
cryotherapy
surgical - laser, curettage

52
Q

Treating HSv2/genital herpes

A

acyclovir

53
Q

Treating HIV

A

Systemic ART
nucleoside reverse transcriptase inhibtor
integrase inhibitor, reverse transcriptase inhibitor, protease inhibitor

54
Q

Treating hep B

A

ART - entecavir

interferon sc or im

55
Q

Treating gonorrhoea

A

ceftriaxone im

azithromycin

56
Q

symptoms gonorrhoea

A

urethritis, Bartholin gland cyst, salpingitis, PID

epididymitis

57
Q

Treating candida albicans

A

local antimycotic agent - clotrimazole

fluconazole PO

58
Q

Treating pubuc lice

A

permethrin 1% - insecticide

gp conditions year 4 (72 decks)

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