STI clinical care Flashcards
broadly what are the two types of urethral discharge in males ?
physiological
pathological
what are the physiological secretions in males ?
pro-semen
prostatorrhea
what are the types of pathological urethral secretions ?
gonococcal
non gonococcal
what is the clinical picture of gonococcal urethral secretions ?
profuse, purulent, painful along with dysuria
what is the clinical presentation of non-gonoccoal urethral secretions ?
scanty discharge, mild, itching
given that you have an asymptomatic patient coming into the STI clinic what is the best first thing to do ?
after history and examination
perform a urine test to check for chlamydia and gonorrhea
given that a symptomatic patient came into the STI clinic with symptoms ehat is the investigation that you should ask for ?
- ask for a urethral swab to check for gonorrhea and chlamydia
- ask for a blood test to test for syphilis and HIV
what is the treatment for gonococcal urethritis ?
either :
cefixime 400 mg single dose
or
azithromycin 1g single dose
which of the proposed gonococcal treatments are better ?
the azithromycin as it targets both gonococcal infections along with chlamydia co-infection
single dose therapy should always be chosen whenever possible
what is the cure for chlamydia ?
azithromycin
what is the cure for gonorrhea ?
cefixime
what is the cure for trochomonas ?
metronidazole
what is the cure for syphilis ?
benzathine penicillin
what is the next best step in management after administration of treatment ?
educate patient about safe sex and the use of condoms
patient must inform partner
test for other STIs
Advice on vaccination regarding Hep A and Hep B
If a homosexual man was to present with a single shallow painless ulcer what is the most likely diagnosis ?
syphilis
if a male was to present with multiple, grouped painful ulcers what is the most likely diagnosis ?
herpes simplex
what is the causative organism in syphilis ?
treponema pallidum
what is the causative organism in chlamydia ?
chlamydia trochmatis
what is the causative organism of trichomonas ?
trichomonas vaginalis ( mostly happens in women)
what is bacterial vaginosis ?
overgrowth of natural vaginal bacteria , not really an STI
if a female were to come complaining of white itchy vaginal discharge and only has one sexual partner , what is the most likely diagnosis ?
candida infection ( thrush)
if on microscopy we find clue cells, what is the most likley diagnosis ?
bacterial vaginosis
what is the treatment for bacterial vaginosis ?
metronidazole
what is important to consider when treating chlamydia ?
azithromycin single dose should be given to both the patient and their partner
what is the relation between HIV and STIs ?
STIs facilitate HIV transmission
