STI Flashcards
which STIs are curable
syphilis
gonorrhoea
chlamydia
trichomoniasis
what STIs are uncurable
Hep B
Herpes simplex
HIV
HPV
have there been any cases of drug resistant STIs
yes 2017 3 cases of N gonorrhoea which is resistant
why was there a steep decline in genital warts since 2014
due to girls/boys also getting the HPV vaccine
give examples of bacterial STIs
chlamydia
gonorrhoea
syphilis
give examples of parasitic STIs
trichomoniasis
how can trichomoniasis be treated
single dose antibiotics
how can Herpes/HIV be cured
can be modulated but not cured
how can hep B be cured
it cannot be cured but antivirals can slow liver damage down
how do we separate diseases
non viral
viral
examples of viral STIs
HPV
herpes simplex virus 1& 2
hep B
HIV
what are the risk factors of STIS
Unprotected sex Oral sex Multiple partners- risk is proportional to numbers Previous STIs Alcohol/rec drug misuse Injecting drugs Young( 50% cases is in 15-24 age groups) Erectile dysfunction medications Holiday sex
describe syphilis
chronic STI
has this outer sheath which impairs the immune system
sexually transmitted
can be vertical syphilis- from mother to baby- congenital syphilis
what is congenital syphilis
syphilis from birth from mother to baby via vertical transmission
what bacteria is syphilis from
gram -ve bacteria called treponema pallidum
what are the four stages of
primary
secondary
latent
tertiary
describe primary syphilis
symptoms occur 10-90 days after exposure
lesion( chancre ) at the site of infection
progression to ulcer after 7 days
when do symptoms of primary syphilis start showing
10-90 days
what are the symptoms of primary syphilis
chancre at the site of infection
painless solitary
can be found on genital/oral area
lymphadenopathy
how does primary syphilis spread
via haemtologic and lymphatic dissemination
how does the chancre heal
with or without therapy
what histological cells can be seen in the primary syphilis infiltrate
plasma cells
macrophages
lymphocytes
what is the treatment for primary syphilis
benzathine penicillin
doxycycline
how is primary syphilis diagnosed
serology
PCR
darkfield microscopy
when does secondary syphilis occur
2 weeks to 6 mnths post exposure
clinical symptoms of secondary syphilis
painless superficial lesions of the skin on the palms and soles of feet symmetric rash - on moist areas such as inner thighs, anogenital condylomata lata lymphadenopathy mild fever malaise
what is condylomata lata
broad based elevated plaques
what are the symptoms of secondary syphilis
visual changes- uveitis retinal necrosis
CN nerve palsies
aseptic meningitis syndrome
describe latent syphilis
asymptomatic
1 year post infection
symptom relapse due to bacterial replication
what are the three components of tertiary syphilis
neurosyphilis
cardiovascular syphilis
benign tertiary syphilis
what are the components of neurosyphilis
· Meningovascular syphilis
· General paresis
Tapes dorsalis
describe meningovascular syphilis
when the syphilis affects the meninges around the brain but also the base
what else can we have in meningovascular syphilis
obliterative vascular inflammation heubner arteritis
cerebral gummas what extend into the parenchyma
what are cerebral gummas
plasma cell rich lesions
what else can syphilis lead to
psychiatric admissions
symptoms of tertiary syphilis
memory loss personality change depression argyll robertson pupils severe dementia
what is argyll robertson pupil
when pupils do not constrict to bright lights
bilateral small pupils
describe tabes dorsalis
involves the peripheral nerves
what are the symptoms of tabes dorsalis
lighting pains
ataxia
argyll robertson pupil
what is ataxia
loss of proprioception
describe cardiovascular tertiary syphilis
Inflammation of the proximal aorta
Also can involve occlusion of the vasa vasorum which is scarring of the proximal aortic wall causing loss of elasticity
describe gummatous syphilis
formation of gummas in the bone skin and mucous membranes of the upper resp airway
what serology can we carry out for syphilis
VDRL- venereal disease research lab
TPPA- treponema pallidum particle agglutination assay
what does VDRL show
non specific IgG/IgM
quantitative testing
how do we test for neurosyphilis
CSF testing- +ve VDRL and raised WCC
which bacteria causes chlamydia
bacteria chlamydia trachomatis
describe chlamydia
most common STI in UK
more than 50% cases asymptomatic
how does chlamydia affect women
the cervix and or urethra which leads to PV discharge
how does chlamydia affect men
urethra leading to dysuria
what does chlamydia put you at risk of
Pelvic inflammatory disease
Endometriosis
Premature births/infertility
Reactive arthritis( Reiter syndrome)
symptoms of chlamydia
no oral manifestations
sore throat, pharyngitis
treatment of chlamydia
antibiotic therapy
azithromycin or doxycycline
what bacteria causes gonorrhoea
NEISseria gonorrhoea -ve aerobic
describe what happens to women when they have gonorrhoea
urethral/ vaginal discharge and dysuria which can lead to pelvic inflammatory disease
describe what happens to men with gonorrhoea
dysuria
urethral discharge
epididymis
treatment of gonorrhoea
IM ceftriaxone
oral cefixime
oral azithromycin
what are the symptoms of gonorrhoea
sore throat with redness exudates
describe Pelvic inflammatory disease
ascending infection of the vulva vagina which spreads to other areas of female genital systems
what are the main causes of pelvic inflammatory disease
gonorrhoea and chlamydia
what are the symptoms of pelvic inflammatory disease
pelvic pain adnexal tenderness fever discharge puerperal infections post spontaneous abortions
what are the acute complications of PID
peritonitis and bacteraemia which can cause endocarditis, meningitis
what are the chronic complications of PID
infertility and tubal obstruction
pelvic pain
intestinal obstruction due to adhesions forming
what is the treatment of PID
antibiotics
describe HPV
causes cervical cancer
which strains of HPV are transmitted via oral genital contact
6 and 11
how does HPV enter
is the basal epithelial layer through microabrasions in genital skin during sexual contact
what is the treatment of HPV
cryotherapy
immune modulation
surgical
which strains of HPV are likely to cause visible warts
16
18
what are the two types of Herpes simplex virus
HSV-1
HSV-2
how does HSV-1 transmit
transmission oral to oral contact
how is HSV-2 transmitted
STI that causes genital herpes
what are the symptoms of herpes
painful blisters or ulcers at the site of infection
describe HSV-1
Cold sores
They are vesicles which form larger vesicles
Usually found at the mucocutaneus junction of the skin/lips
They can rupture/ulcerate to live viral particles and transfer
genital infection is due to oral-genital contact
what are the symptoms of herpes simplex
Cervical lymphadenopathy
Malaise
Fever
Irritability
can we eliminate Herpes simplex
latent in the trigeminal ganglion and reactivate
There is no clue but we can help alleviate symptoms
what do antivirals control
the duration
frequency
severity
