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STI Flashcards

1
Q

What STIs present as discharge

A 
Gonorrhoea 
Chlamydia 
Trichomonas 
Candida 
BV
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2
Q

What STIs present as ulcer

A 
Syphilis 
HSV
LGV 
Chancroid 
Donovanosis
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3
Q

What STIs present as growths/lumps

A

Genital warts, HPV
Molluscum

Scabies
Pubic lice

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4
Q

What causes PAINFUL genital ulcers

A

HSV

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5
Q

What causes PAINLESS genital ulcers

A

syphilis

lymphogranuloma venereum

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6
Q

What can gonorrhoea cause in the neoonate if maternal gonorrhoea is untreated

A

Opthalmia neonatorum (neonatal conjunctivitis)

via transfer in birth canal

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7
Q

What can gonorrhoea cause in complement deficient patient

A

DIsseminated gonococcal infection > septicaemia, rash, arthritis

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8
Q

how does gonorrhoea present

A

urethritis
cervicitis
proctitis

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9
Q

What can you do for diagnosis of gonorrhoea

A

vaginal/urethral/rectal smear

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10
Q

How do you manage gonorrhoea

A

Ceftriaxone IM 250mg

OR

Cefixime PO 400mg

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11
Q

What do Chlamydia serovars A,B,C cause

A

TRACHOMA (infection of the eye > blindness9

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12
Q

What do chlamydia serovars D-K cause

A

genital chlamydia infection OR opthalmia neonatorum

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13
Q

What do chlamydia serovars L1,L2,L3 cause

A

lympho-granuloma venereum

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14
Q

How do you diagnose chlamydia

A

NAAT (Nucleic Acid Amplification Test)

from genital swab (F) or urine (M)

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15
Q

How do you treat uncomplicated chlamydia

A

Doxycycline 100mg BD 7/7

OR

azithromycin 1g STAT

OR

Erythromycin

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16
Q

What is LGN

A

Lympho Granuloma Venereum

Lymphatic infection with Chlamydia Trachomatis, from serovars L1,L2,L3

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17
Q

Explain early LGV (1st stage)

A

Lasts 3-12 days
Genital ulcer - painless, non-indurated
Balanitis, proctitis, cervicitis

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18
Q

Explain the second stage of early LGV

A

inguinal buboes: painful, 2/3 unilateral, may rupture, fever, malaise

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19
Q

Explain late LGV

A 
Ingunial lymphadenooathy 
abscess formation 
genital elephantitis  
genital ulcers
frozen pelvis 
rectal strictures
perirectal abscesses
lymphorroids
20
Q

Explain current LGV outbreak

A

rectal symptoms: tenesmus, pain, bleeding, mucous discharge

21
Q

How do you diagnose LGV

A

NAAT
Chlamydia confirmed on PCR (2 platforms)
Genotypic identification of L1,L2,L3

22
Q

How do you manage LGV

A

Doxycyline 100mg BD for 21/7

23
Q

What microscopy can you do for syphilis

A

Swab ulcer >

Dark ground microscopy

24
Q

What investigation do you do for syphilis PRIMARY

A

swab ulcer, then microscopy (dark ground)

25
what investigation do you do for syphilis SECONDARY
Antibody detection
26
what does VDLR slide test detect
Lipoidal antibody on both host and treponemal cells Risk of false positives, as reagemnts contain cardiolipin, lethicin, cholesterol
27
What is the problem with antibody detection in syphilis
remains positive for many years | so it is not good at confirming if treatment has worked
28
How does primary syphilis present
CHANCRE - Macule > papule > indurated painless genital ulcer 1-12 weeks after tranmission - Clean base, solid exhudate + regional lymphadenopathy
29
How long after primary infection does primary syphilis last
4-6 weeks
30
Explain symptoms of secondary syphilis
systemic bacteraemia low grade fever, malaise Symmetrical, non-pruritis maculopapular rash on back, trunmk, arms, legs, palms, soles Mucosal lesions Uveitis, choroidoretinitis Alopecia Snail track oral ulcers Condyloma acuminate (genital warts)
31
What are sx of latent syphilis
NONE - asymptomatic
32
What are sx of tertiary syphilis
Gummaa (granuloma) CV (aortitis, ++ spirochaetes, ++ inflammation) Neurosyphilis Argyl RObertson pupul
33
What is Argyl RObertson pupil
aka prostitute pupil | accomodates but does not react
34
How do you manage syphilis
single dose IM Benzathine Penicillin
35
What is a risk after treating syphilis, and how do you manage it
Jarish Heimer Reaction - fever - headache - myalgia - exacerbation of syphilitis symptoms Self resolves within 24h, so no need to treat
36
What investigation do you do for chancroid (haemophilius ducreyi)
Culture on chocolate agar
37
What does donovanosis cause
Granuloma inguinale
38
Where does donovanosis occur geographically
Africa, India, PNG, australia
39
explain donovanosis symptoms
large expanding ulcer starting as papule / nodule > breaks down > beefy red appearance
40
How do you investigate trichomoniasis
wet prep microscop, PCR
41
What is the cause of BV
abnoirmal vaginal flora, polymicrobial, low lactobacilli | Sexually associated, not transmitted
42
How do you manage candidiasis
Clotrimazole (topical) | Fluconazole (oral)
43
What presentation of molluscum indicates HIV
FACIAL molluscum
44
What is clinical tx for genital warts
cryotherapy | 2nd line: imiquimod
45
what is home tx for genital warts
podophyllotoxin solution/cream

Path - Micro (20 decks)

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