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Reproductive > STI infections & common genital symptoms > Flashcards

STI infections & common genital symptoms Flashcards

1
Q

What is a commensal micro-organism?

A

A micro-organism that derives food or other benefits from another organism without hurting or helping it

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2
Q

What is a pathogen?

A

A micro-organism that can cause disease

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3
Q

What is a sexually transmissible microbe?

A

A virus, bacteria or protozoan which can be spread by sexual contact

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4
Q

What is an STI?

A

An infection by a pathogen which is sexually transmissible and which is unlikely to be transmitted by non-sexual means

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5
Q

What is an STD?

A

A disorder of structure or function caused by a sexually transmitted pathogen

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6
Q

What are examples of bacterial STI’s?

A

Chlamydia trachomatis
Klebsiella granulomatis
Mycoplasma genitalium

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7
Q

What are examples of viruses which are STI’s?

A

HSV
HIV
HPV
Molluscum contagiosum virus

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8
Q

What are examples of parasites which cause STI’s?

A

Pthirus pubis
Sarcoptes scabei
Trichomonas vaginalis

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9
Q

What are the characteristics on an STI?

A

Transmissible
Asymptomatic most of time
All manageable, but not always curable
Avoidable

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10
Q

What are implications of STI’s?

A

Partner notification
Hard to eradicate, prevention
Treatment & prevention of complications
Primary prevention - education

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11
Q

What can be spread via genital contact only?

A

Pubic lice
Scabies
Warts (HPV 6 &11)
Herpes (HSV 1 & 2)

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12
Q

What can be spread via group sex?

A

Hepatitis C

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13
Q

Why are STIs important?

A 
Morbidity
Unpleasant symptoms
Psychological distress
Cost of resources
Common
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14
Q

What are common STI presentations?

A

Ulceration
Lumps
Discharge
Rashes

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15
Q

What are systemic symptoms of STIs and adverse outcomes?

A 
Fever
Rash
Lymphadenopathy
Malaise
Infertility
Cancer
Adverse pregnancy outcomes
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16
Q

Why do diagnoses of STIs change over time?

A

True change in number of cases

Change in diagnoses but no actual change in number of cases

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17
Q

What does the equation R0=βcD mean?

A 
R0 = reproductive number (average no of infections produced)
β = likelihood of transmission
c = rate of acquiring new partners
D = duration of infectivity
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18
Q

With the equation R0=βcD, what does R0>1 mean for no of STI cases?

A

Epidemic is sustained

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19
Q

With the equation R0=βcD, what does R0<1 mean for no of STI cases?

A

Epidemic reduces

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20
Q

What is the NATSAL study?

A

National survey of sexual attitudes and lifestyle every 10yrs

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21
Q

What is the sexual network analysis?

A

Modelling and mapping spread of STIs

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22
Q

What are ‘cores’ and assortative mixing?

A

High prevalence within subpopulation but limited spread through wider community e.g. IVDU

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23
Q

What does random mixing mean for STI spread?

A

Lower prevalence but wider dissemination along ‘chains’

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24
Q

What are the principles of management in someone presenting with STI?

A

History
HIV testing
Partner notification
Health promotion

25
Q

What is necessary in sexual history?

A 
Presenting complaint - direct q's about symptoms
HxPC
PM/SHx
DHx
Gynae Hx
26
Q

What are questions to ask in sexual history?

A 
When did you last have sexual contact?
Casual contact vs regular partner?
How long with partner?
Male or female partners?
Nature of sex act sometimes
Did you use condoms?
Other contraception used?
Nationality of contact?
27
Q

What are risk assessment questions for a man?

A

Have you ever had sexual contact with a man?
Have you ever injected drugs?
Sexual contact with someone who has injected drugs/outside the UK?
Medical treatment outside UK?
Involvement with sex industry/prostitute?

28
Q

What are the two ways of partner notification ‘contact tracing’?

A

Patient tell contacts - ‘client referral’

NHS tells contacts - ‘provider referral’

29
Q

If someone has an STI what should you offer?

A

HIV testing

30
Q

What are health promotion options for STIs?

A

Condoms - HIV, chlamydia, gonorrhoea NOT herpes, warts

Alcohol and drug advice

31
Q

What are common genital symptoms/presenting complaints?

A 
Discharge
Pain
Rashes
Lumps and swellings
Cuts, sores, ulcers
Itching
Change in appearance
Vague sense something not right
32
Q

What could be causing STI-like symptoms?

A

STI
Other microbial problem
Non-microbial

33
Q

What are microbial conditions not regarded at STDs?

A 
Vulvovaginal candidosis
Bacterial vaginosis
Balanoposthitis
Tinea cruris
Erythrasma
Infected sebaceous glands
Impetigo
Cellultitis
34
Q

What organism usually causes vulvovaginal candidosis?

A

Candida albicans

35
Q

Where is candida albicans in vulvovaginal candidosis usually acquired from?

A

Bowel

36
Q

What are the signs/symptoms of vulvovaginal candidosis?

A

Asymptomatic

Symptomatic ‘thrush’: itch, discharge ‘cottage cheese’ or just increased amount

37
Q

What are the risk factors for vulvovaginal candidosis?

A 
Diabetes
Oral steroids
Immune suppression
Pregnancy
Reproductive age group
38
Q

How is vulvovaginal candidosis diagnosed?

A

History

Exam findings: fissuring, erythema with satellite lesions, discharge

39
Q

What are the investigations for vulvovaginal candidosis?

A

Gram stained preparation

Culture

40
Q

What is the treatment for vulvovaginal candidosis?

A

Azole antifungals: clotrimazole PV once + clotrimazole HC if vulvitis
or
fluconazole PO once
Maintain skin - avoid irritants, treat dermatitis

41
Q

What is the commonest cause of abnormal vaginal discharge?

A

Bacterial vaginosis

42
Q

What are the signs/symptoms of bacterial vaginosis?

A

Asymptomatic 50%
Watery grey/yellow ‘fishy’ discharge
Worse after period/sex
Sore/itch from dampness

43
Q

What is bacterial vaginosis caused by?

A

Imbalance of bacteria rather than infection

Biofilm problem

44
Q

What are the bacteria changes in bacterial vaginosis?

A

Increased anaerobes

Reduced lactobacilli

45
Q

What are complications associated with bacterial vaginosis?

A

Endometriosis
Premature labour
Risk of HIV acquisition

46
Q

What is the investigation for bacterial vaginosis?

A

Gram stained smear of vaginal discharge

47
Q

What is the treatment for bacterial vaginosis?

A

Metronidazole: oral or vaginal gel
Clindamycin: vaginal

48
Q

What is Zoon’s balanitis?

A

Chronic inflammation secondary to overgrowth of commensal organism plus foreskin malfunction

49
Q

What is candidal balanitis?

A

Inflammation to the glans of the penis due to candida albicans

50
Q

What usually causes impetigo on the penis?

A

Staph aureus

Strep pyogenes

51
Q

What is a genital dermatophyte infection usually caused by?

A

Trichophyton rubrum

52
Q

What is tine cruris?

A

Fungal infection that affects the skin of your genitals, inner thighs and buttocks

53
Q

What is erythrasma?

A

A superficial skin infection that causes brown, scaly skin patches

54
Q

What are Fox-Fordyce spots?

A

Visible sebaceous glands that are present in most individuals. They appear on the genitals as small, painless, raised, pale, red or white spots or bumps 1 to 3 mm in diameter that may appear on the scrotum, shaft of the penis or on the labia, as well as the inner surface (retromolar mucosa) and vermilion border of the lips of the face

55
Q

What are vulval papillomatosis?

A

Pink, asymptomatic fine projections of the vestibular epithelium or labia minora

56
Q

What are penile pearly papules?

A

Small protuberances that may form on the ridge of the glands of the penis, normal anatomical variation

57
Q

What are Tyson’s glands?

A

Modified sebaceous glands located around the corona and inner surface of the prepuce of the human penis

58
Q

What are other causes of genital symptoms?

A 
Pain syndromes
Dermatoses
Congenital
Trauma
Neoplasm
Manifestations of systemic disease

Reproductive (20 decks)

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