STI Learning Guide Flashcards
What is the causative organism of gonorrhoea?
Neisseria gonorrhoeae
What are the symptoms of gonorrhoea?
In men: 10% asymptomatic Thick, profuse, yellow discharge Dysuria Rectal or pharyngeal infection often asymptomatic In women: >50% asymptomatic Vaginal discharge Dysuria Intermenstrual or post-coital bleeding
What are the possible complications of gonorrhoea?
In men: Epididymitis In women: Pelvic inflammatory disease Bartholin's abscess In both sexes: Acute monoarthritis (usually elbow or shoulder) Disseminated gonococcal infection (skin lesions- pustular with halo)
What is the incubation period of gonorrhoea?
Range 2 days to 2 weeks
Average 5-6 days
In what populations is gonorrhoea most common?
M>F
Most common in men who have sex with men
How is gonorrhoea investigated?
Nucleic acid amplification test (NAAT) on urine or swab from exposed site
Gram stained smear from urethra/cervix/rectum in symptomatic people
Culture of swab obtained from expose site (should be done in all cases to assess antibiotic sensitivity)
What is the treatment of gonorrhoea?
Blind treatment with ceftriaxone 1g IM
Can also treat based on antibiotic sensitivities
What is the follow-up for gonorrhoea?
Test of cure at two weeks
Test of reinfection at three months
What are the causative organisms of chlamydia?
Chlamydia trachomatis senovars D to K
What are the symptoms of chlamydia?
In men: >70% asymptomatic Slight watery discharge Dysuria In women: >80% asymptomatic Vaginal discharge Dysuria Intermenstrual or post-coital bleeding In both sexes: Conjunctivitis
What are the potential complications of chlamydia?
In men:
Epididymitis
In women:
Pelvic inflammatory disease (and thus increased risk of ectopic pregnancy)
Pelvic pain
Infertility (~1% of infected women affected)
In both sexes:
Reactive arthritis
Reiter’s syndrome (urethritis/cervicitis + conjunctivitis + arthritis)
In what populations is chlamydia most common?
<25
Most common in sexually active teenage women
How is chlamydia investigated?
First void urine in men
Swab from cervix, rectum, urethra as appropriate
All specimens tested with nucleic acid amplification test
How is chlamydia treated?
Doxycycline 100mg twice daily for one week
Azithromycin 1g single dose orally if pregnant
What is the follow-up for chlamydia?
Test for reinfection at 3-12 months
Earlier test for cure not indicated unless symptoms persist
What are the causative organisms of herpes?
Herpes simplex viruses types 1 and 2
What are the symptoms of herpes?
80% asymptomatic
If symptomatic, symptoms will be recurring (monthly, annually)
Burning/itching followed by blistering followed by tender ulceration
Tender inguinal lymphadenopathy
Flu-like symptoms
Dysuria
Neuralgic pain in back, legs and pelvis
What are the potential complications of herpes?
Autonomic neuropathy (urinary retention)
Neonatal infection
Secondary infection
What is the incubation period of herpes?
5 days up to months. Many never get symptoms
How is herpes distributed between populations?
Both strains equally common
Equal incidence in both sexes
HSV2 co-factor in HIV transmission
How is herpes investigated?
Clinical suspicion
Swab from lesion tested using PCR
How is herpes treated?
Primary outbreak: -Aciclovir -Lidocaine ointment Infrequent recurrences: -Lidocaine ointment -Aciclovir 1.2g once daily until symptoms gone (usually 1-3 days) Frequent recurrences: -Aciclovir 400mg bd long-term as suppression
What is the causative organism of trichomoniasis?
Trichomonas vaginalis
What are the symptoms of trichomoniasis?
Men are usually asymptomatic In women: -10-30% asymptomatic -Profuse, thin vaginal discharge (green, frothy and foul smelling) -Vulvitis
