STI and GI Tract Flashcards
how are infections transmitted during sex
trauma IV drug user fomties ingestion sexual/genital secretions direct inoculation
risk factors for STIs
<25 years old change in sexual partner non condom use men who have sex with men (MSM) Hx of STI large urban areas social deprivation black ethnicity
where do STIs affect in the GI tract
can effect everywhere
where does hepatitis A/B/C effect in GI tract
liver biliary tract
where does shigella affect the GI tract
small and large bowel
where does amoebiasis affect the GI tract
large bowel
where does giardia affect the GI tract
small bowel
transmission of gonorrhoea
direct contact mucosal surfaces with infected secretions;
anal sex
trans mucosal spread
fomite
symptoms of rectal gonorrhoea
short incubation period lower abdominal pain diarrhoea rectal bleeding anal discharge (mucus) tenesmus change in bowel habit may be asymptomatic
associated symptoms of rectal gonorrhoea
urethral/vaginal discharge
dysuria
tests for gonorrhoea
proctoscopy
PCR
gram stain rectal swab
pathology of gonorrhoea
inflamed mucosae
purulent exudate
complications of gonorrhoea
abscess formation
increased susceptibility/transmissibility of HIV
management of gonorrhoea
ceftriaxone
test of cure
public health interventions
how is chlamydia transmitted
direct contact mucosal surfaces with infected secretions;
anal sex
trans mucosal spread
fomite
symptoms of rectal chlamydia
mostly asymptomatic milder than gonorrhoea anal discomfort/itch anal discharge (mucus/blood) low abdominal pain altered bowel habit associated symptoms
tests for chlamydia
proctoscopy
gram stain rectal swab
CT
PCR
management for chlamydia
doxycycline
test of cure
public health interventions
epidemiology of lymphogranuloma venereum
MSM (+HIV) associated with; group sex drug use syphilis hepatitis C
primary clinical features of lymphogranuloma venereum
ulcer
secondary clinical features of lymphogranuloma venereum
inguinal syndrome
ano-rectal syndorme
tertiary clinical features of lymphogranuloma venereum
strictures
fistulae
geneital elephantiasis
tests for lymphogranuloma venereum
full STI screen
fexi-sigmoidoscopy
management for lymphogranuloma venereum
doxycycline
public health interventions
pathology of Lymphogranuloma venereum
friable rectal mucosa
large ulcers
contact bleeding
why is test of cure important
if treatment does not cure diagnosis e.g. piles
may be differential diagnosis e.g. Lymphogranuloma venereum
primary clinical features of syphilis
solitary painless ulcer
secondary clinical features of syphilis
mucosal patches and ulcers mouth, anogenital, rectal condylomata lata systemic inflammation (eye) hepatitis proctoscopy-colitis
symptoms of syphilis
multi-systemic disease; pain defaecation blood mixed in stools crampy abdominal pains rash lymphadenopathy
tests for syphilis
colonoscopy
rectal biopsy
management for syphilis
benzathene penicillin
public health interventions
follow-up serology
how is herpes transmitted
ano-genital
oro-anal
symptoms of herpes
pain ulcers painful defaecation bleeding peri-anal mucosa (may extend into rectum) viraemic symptoms (primary infection)
how is human papilloma virus transmitted
ano-genital
oro-anal
signs of HPV
anal warts - can extend to rectum
complications of HPV
increasing prevalence of AIN and anal cancers in MSM and HIV+ people
HIV and the GI tract
gut associated lymphoid tissue is the largest immune compartment - GI in constant state of physiological inflammation
depletion of intestinal GALT
clinical presentation of GALT loss
unknown HIV enteropathies opportunistic infeciton persistent immune activation - microbial translocation accelerated immunosenescence
