Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 4C - GP > STI & Eye > Flashcards

STI & Eye Flashcards

1
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

which STI is usually asymptomatic?

A

chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

If a male has uretheral disachrge, what should you test for?

A

Gohonorrhea

Chlamydia (even though usually symptomatic, is more common than gonorrhea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how often should one be screened for chlamydia?

A

yearly from aged 15-30 if they are sexually active

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how does chlamydia normally present?

A

normally asymptomatic

discharge from penis / vagina

pain during urination

pain during sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the complications of chlamydia in men and women?

A

Men

  • Epididymitis & Epidydimo-Orchitis; which can lead to
    • Infertility
  • Reactive Arthritis (more common in men)

Women

  • Pelvic inflammatory disease; which can lead to
    • Infertility
    • Ectopic pregnancy
    • Persistent pelvic pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which STI can cause a reactive arthritis and in which sex?

A

chlamydia

reactive arthritis caused by chlamydia is more common in men than in women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the management of chlamydia?

A

Basics

Place & Person

Investigate & Confirm Diagnosis

  • NAAT: specimen collected by -
    • first pass urine
    • endocervical swab
    • cultured urethral discharge (if present)

Definitive Management

  • 1g azithromycin po as a single dose
  • Abstain from unprotected sexual intercourse for at least 7 days during and after treatment
  • A notifiable disease - must notify DHS within 5 days of diagnosis

Follow-Up

  • Contact tracing - advise to dicuss with sexual partners so they can be screened
  • Re-test for chlamydia 3-4 months post treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how do you investigate for chlamydia?

A

NAAT

Method of collection:

  • first pass urine
  • endocervical swab
  • urethral discharge (if present)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the typical presentation of gohnorrhea in men?

and in women?

A

Man with copious urethral discharge 2-10 days after unprotected sex (although chlamydia is still more common than gonorrhea, so still more likely to be chlamydia).

Women are usually asymptomatic or present with vague symptoms mimicking a UTI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is required to investigate for gonorrhea?

A

NAAT. Specimen collected by

  • Urine (mid stream)
  • Endocervical swab
  • Rectal swab
  • Throat swab
  • Culture of discharge

Also investigate for chlamydia if you suspect gonorrhea!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the definitive management of chlamydia?

what is the definitive management of gonorrhea?

how are these managements potentially related?

A

Chlamydia = 1g azithromycin po, single dose

Gonorrhea = Ceftriaxone 250mg IM, single dose

If you are treating for gonorrhea, but you haven’t ruled out chlamydia - treat for chlamydia as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the management of gonorrhea?

A

Investigate and Confirm Diagnosis

  • NAAT, collected by:
    • MSU
    • Rectal swab
    • Pharyngeal swab
    • Endocervical swab
    • Cultured discharge (if present)

Definitive Management

  • IM 250mg ceftriaxone
  • Advise to abstain for sex for 7 days?

Follow Up

  • Notifiable disease - notify DHS within 5 days
  • Contact tracing - treat sexual partners empirically
  • Offer eductaion RE safe sexual practises
  • Re-investiage 3-4 months after treatment, to ensure complete treatment
  • ALSO TEST / TREAT CHLAMYDIA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which STI is described as “the great imitator”?

A

Syphillus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the name of the microorganism which causes syphillus?

A

Treponema pallidum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does primary syphillus present?

A

A single painless ulcer in the genital area (chancre)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the pathophysiological progression of syphillus?

A

Remember Syphillus happens in Stages

  • Primary = Chancre
  • Secondary = Secondary erruption on skin and mucous membranes (rash) +/- systemic symptoms
  • Then long periods of latency
  • Teritiary (10-30 years after infection) = late lesions of skin, bone, viscera, cardiovascular and central nervous systems (this is why it’s called the great mimcker)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you investigate for syphillus?

A

Syphillis EIA (blood test)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the definitife management of syphilllis?

A

early (

late (>2 years or unknown) = IM benzthine penicillin, weekly for 3 weeks

tertiatry syphillis (>2 years and with skin, bone, CVS or neurological involement) = IV benzylpenicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the overall management of syphillis?

A

Investigate and Confirm Diagnosis

  • Seroloigcal test - Syphillis EIA

Definitive Management

  • Early - IM benzathine penicillin, once off
  • Late or unknown - IM benzathine penicillin, once per week for 3 weeks
  • Tertiary - IV benzylpenicillin for 15 days
  • Abstain from sex until completion of treatment

Follow-Up / Other

  • Test for other STIs
  • Notifiable disease - contact DHS
  • Contact tracing
  • Retest 3-4 months after completion of treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is a common presentation of bacteral vaginosis?

A

asymptomatic

fishy-smelling vaginal discharge

dysuria

vaginal pruritis

pyspareunia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how do you diagnose bacterial vaginosis?

A
  • Clincially
    • presence of mucous dishachrge
    • fishy smell
  • clue cells on micrscopy (culture not required)
  • Vaginal pH >4.5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the defitive management of bacterial vaginosis?

A

metronidazole (orally or vaginal gel)

OR clindamycin (orally or vaginal gel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the pathophysiology of bacterial vaginosis?

A
  • Reduction in the acid-producing normal flora of the vagina [Lactobacillus]
  • Leads to growth of anaerobes and other fastidious microorganisms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is glaucoma and what are it’s types?

A

High intraoccular pressure causing death of optic nerve cells.

Open angle glaucoma = poor drainage of aqueous pressure due to dysfunctional drainge by the canal of schlemm

Closed angle glaucoma = poor drainage due to closure of the angle between the cornea and the iris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the typical presentation of open angle glaucoma?

A

It is asymptomatic!

Patient’s may have loss of peripheral vision, but usually won’t notice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What examination findings are typical of glaucoma?

A
  1. raised pressure
  2. cupping on ophthalmoscopy
  3. loss of peripheral vision (might have to be measured by a special machine called an automated perimetry)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the typical presentation of acute glaucoma?

A

An extremely red and painful eye

+/- N&V

Patients may reoprt seeing halos around lights

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are the examination findings of acute angle glaucoma?

A

Pupil is sluggish and mid-dilated

Slightly cloudy cornea

High pressures

Rock hard eye on palpation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the treatment of chronic glaucoma?

A
  1. Topical beta-blockers
  2. Also topical alpha-agonists, carbonic anhydrase inhibitor (Diamox), and prostaglandin analogues
  3. Trabeculectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is a cataract?

A

Any opacity of the lens, regardless of aetiology

(they can occur in different parts of the lens)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the causes of visual loss?

A

Gradual Visual Loss [COAD]

  • Cataracts
  • Open angle glaucoma
  • Age-related macular degeneration
  • Diabetic retinopathy

Suddent Visual Loss [BRCO]

  • Branch retinal vein occlusion
  • Retinal detachment
  • Central tretinal artery occlusion
  • Optic neuritis

Non-eye related causes [TMG]

  • TIA
  • Migraine
  • Giant cell arteritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the typical presentation of cataracts?

A

Gradual loss of vision

Reduced night vision

Glare from oncoming traffic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is a cotton wool spot and when do you see it?

A

ischaemic retina

diabetic retinopathy

35
Q

What is seen on ophthalmoscopy in diabetic retinoathy?

A

dot and blot haemorrhaes

cotton wool spots (ischaemic retina)

neovascularisation (which occurs in large areas of ischaemia)

hard exudates (lipid accumulation from swelling)

36
Q

What are the three types of retinal detachment?

A

Rhegmatogenous (the usual type)

Tractional (can happen in diabetics)

Exudative (tumor or something pushing from below)

37
Q

What are the symptoms of retinal detachment? (And the DDx for each)

A
  • Flashing lights
    • DDx = migraine and posterior vistreous detachment
  • Floaters (look like dark specks that obscure vision - like a swarm of flies)
    • DDx = posterior vitreous detachment
  • Curtain of darkness coming down
    • DDX = TIA
38
Q

what is the typical presentation of age-related macular degeneration?

A

Older patient

Progressive steady decline in central vision

Difficulty in reading (new glasses don’t help)

39
Q

Elderly pt, sudden unilateral vision loss.

What are the DDx?

And what are the prognoses of each?

A

Branch retinal vein occlusion (will resolve spontaneously in 2 months)

Central retinal artery occlusion (requires urgent surgical referral)

40
Q

What is the clinical presentation of optic neuritis?

A

Sudden vision loss (central scotoma is classic)
Decreased contrast and color sensitivity

Pain with eye movement

41
Q

What is optic neuritis associated with?

A

MS

42
Q

What is the management of optic neuritis

A

Specialist referral

IV steroids

43
Q

What are the examination findings of optic neuritis?

A

Optic nerve head edema
Relative afferent pupillary defect

44
Q

painful eye in the context of a foreign body?

A

corneal abrasion

which if infected may lead to corneal ulcer

45
Q

What is the management of a dendritic ulcer on the cornea due to HSV?

A

antivirals prescribed by opthalmologist

DON’T prescribe steroids

46
Q

What is another name for anterior uveitis?

A

iritis

47
Q

What is another name for iritis?

A

anterior uveitis

48
Q

What is the uvea?

A

iris, ciliary body, and the choroid

all
connected to each other and are histologically similar

49
Q

What is the aetiology of anterior uveitis?

A

idiopathy

or associated with rheumatological conditions (HLA-B27)

50
Q

What is a synechia?

A

A synechia is an eye condition where the iris adheres to either the cornea (i.e. anterior synechia) or lens (i.e. posterior synechia).

51
Q

what is the aetiology of synechia?

A

Synechiae can be caused by ocular trauma, iritis or iridocyclitis and may lead to certain types of glaucoma.

52
Q

what is the management of anterior uveitis?

A

requires urgent referral!

Topical steroid drops reduce the inflammation

Topical cyclopentolate (dilate the pupil and break down synechiae)

53
Q

What is the episclera?

A

The episclera is a thin layer of tissue that lies between the conjunctiva and the connective tissue layer that forms the white of the eye (sclera)

54
Q

what is episcleritis?

What is it’s prognosis?

A

Benign self-limiting condition

Resolves in two weeks without treatment

55
Q
A
56
Q

What is another name for pre-septal / post-septal cellulitis?

A

pre-septal = peri-orbital cellulitis

post-septal = orbital cellulitis

57
Q

What is the management of periorbital / orbital cellultis?

A

periorbital cellulitis

often managed with oral antibiotics

orbital cellulitis

​more serious condition requiring hospitalisation and parental antibiotics

complications such as intraorbital abscess formation may require surgical intervention

58
Q

How do you DDx between episcleritis and scleritis?

A

instillation of phenylephrine 2.5%

the phenylephrine blanches the conjunctival and episcleral vessels but leaves the scleral vessels undisturbed. If a patient’s eye redness improves phenylephrine instillation, the diagnosis of episcleritis can be made.

59
Q

What is the difference between a stye (external hordeolum) and a Chalazion (meibomian cyst)

A

Stye is an infection, red and tender

Chalazion is not tender, and is hard (due to sterile inflammation)

60
Q

What is another name for stye?

A

external hordeolum

61
Q

What is another name for a chalazion?

A

mebomiam cyst

62
Q

What is blepharitis

A

Blepharitis is a chronic eye condition characterised by inflammation of the eyelids.

63
Q

What is the name for inflammation of the eyelids?

A

Blepharitis is a chronic eye condition characterised by inflammation of the eyelids.

64
Q

What is Trichiasis?

A

Abnormally positioned eyelashes that grow back toward the eye, touching the cornea or conjunctiva

65
Q

what is photokeratitis?

A

photokeratitis is akin to a sunburn of the cornea and conjunctiva

66
Q

How do you differentiate between viral and bacterial conjunctivities?

A

There are no specific clinical signs to differentiate bacterial and viral conjunctivitis.

67
Q

What is the clinical picture fo conjunctivitis?>

A

Key features

  • Gritty red eye
  • Purulent discharge
  • Clear cornea

History

  • Purulent discharge which causes the eyelashes to stick together in the morning
  • Starts on one eye and spreads to the other (usually)
  • Hx of contact with a person that has similar symptoms
68
Q
A
69
Q

What is a risk factor for retinal detachment?

A

myopia

70
Q

what is seen on opthalmoscopy in gluucoma?

A

Cupping

Measure the cup:disc ratio

71
Q

Which are arteries and which are veins?

A

Arteries - plaer, thinner

Veins - thicker, darker

72
Q

What type of haemorrhages are seen in diabetic retinopathy?

A

dot and blot haemorrhages

73
Q

what type of haemorrahes are seen on hypertensive retinopathy?

A

flame haemorrhages

74
Q

What’s this?

A

Red cherry spot

Central retinal artery occlusion

75
Q

What is conjunctival injection?

A
76
Q

What is this and how is it treated?

A

Dendritic ulcer of HSV

Treated with antivirals

77
Q

What is this?

A

Anterior synechia

78
Q

What’s this?

What is the epidemiology and typical clinical picture?

A

episcleritis

Affects young adults

Moderate ache

Milder symptoms than those experienced by patients with iritis

The conjunctival inflammation is usually localised to one sector

79
Q

What is erysipelas?

A

Caused by group A strep

involving the upper dermis that characteristically extends into the superficial cutaneous lymphatics.

Tender, intensely erythematous, indurated plaque with a sharply demarcated border. Its well-defined margin can help differentiate it from other skin infections (eg, cellulitis)

80
Q

What is the orbital septum?

describe the two types of cellulitis

A

pre-septal / peri-orbital cellulitis is anterior to the orbital septum

post-septal / orbital cellulits extends behind the septum

81
Q

What is this?

A

stye

external hordeolum

82
Q

What’s this?

A

Entropion

83
Q

What’s this?

What is it’s clinical presentation?

What is it’s aetiology?

What is it’s prognosis?

A

Large bleed + Painless + Normal vision

May be associated with hypertension or heavy bouts of coughing or straining

Resolves spontaneously within 2-3 weeks

84
Q

What’s this slight redness in the corner of my eye?

What treatment is required?

A

Pterygium

Common in hot climates

Benign fibrovascular growth from the conjunctiva

No treatment required unless growth reaches cornea à refer to ophthalmologist to be peeled back

Year 4C - GP (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions