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STI's Flashcards

1
Q

What organism causes Gonorrhoeae?

A

Neisseria Gonorrhoeae

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2
Q

Wat type of organism is Neisseria Gonorrhoeae?

A

Gram negative diplococcus

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3
Q

What is the intubation period of gonorrhoeae?

A

2-5 days

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4
Q

Who does gonorrhoeae normally affect?

A

Men who have sex with men?

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5
Q

What 3 ways does gonorrhoeae present in males?

A

Urethral discharge
Dysuria
Tender inguinal nodes

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6
Q

What 3 ways does gonorrhoeae present in females?

A

Cervicitis
Dysuria
Abnormal bleeding

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7
Q

What complication can occur in men if gonorrhoeae is left untreated?

A

Epididymis

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8
Q

What complication can occur in women if gonorrhoeae is left untreated?

A

Pelvic inflammatory disease

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9
Q

What can pelvic inflammatory disease lead to?

A

Infertility

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10
Q

what complications can occur in men and women if gonorrhoeae is left untreated?

A

Monoarthritis in elbow or shoulder

Disseminated gonococcal infection

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11
Q

How does a disseminated gonococcal skin infection present?

A

Skin lesion that is pustular with a halo

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12
Q

How do you diagnose gonorrhoea?

A

Microscopy and culture- NAAT on urine or exposed site

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13
Q

What is the management for gonorrhoea?

A

IM 1g ceftriaxone

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14
Q

What is an alternative treatment for gonorrhoea?

A

Oral cefixime 400mg (single dose) + oral azithromycin 2g (single dose)

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15
Q

What is another name for vaginal candidiasis?

A

Thrush

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16
Q

What is the fungal cause of vaginal candidiasis?

A

Candida albicans

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17
Q

What is an alternative fungal cause of vaginal candidiasis?

A

Candida glabrata

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18
Q

What are the main risk factors of vaginal candidiasis?

A

Diabetes
Immunosuppression
Pregnancy
Drugs: Antibiotics, Steroids

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19
Q

What is vaginal candidiasis if its symptomatic?

A

Thrush

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20
Q

What are the 4 main symptoms of thrush?

A

Discharge
Vulvitis
Itch
Vulval erythema

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21
Q

How is the thrush discharge described?

A

non-offensive cottage cheese

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22
Q

What is seen on examination of thrush?

A

Vulval erythema
Fissuring
Satellite lesions

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23
Q

How is thrush diagnosed?

A

Characteristic history of itching and discharge

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24
Q

What should be done if you aren’t sure about thrush?

A

Vaginal swab

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25
Q

What is the management of thrush if it is mild?

A

It may self-correct

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26
Q

What is the local treatment for thrush?

A

Clotrimazole pessary (500mg PV stat)

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27
Q

What is the oral treatment for thrush?

A

Itraconazole 200mg PO bd for 1 day or Fluconazole 150mg PO stat

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28
Q

What is the contraindication in pregnancy?

A

Oral treatment

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29
Q

What is the commonest cause of vaginal discharge?

A

Bacterial vaginosis

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30
Q

What is the main anaerobic organism?

A

Gardnerella vaginalis

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31
Q

What is the triad of bacterial vaginosis?

A

Overgrowth of BV associated bacteria
Reduction in lactic acid producing aerobic lactobacilli
Leads to raised vaginal pH.

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32
Q

Is bacterial vaginosis sexually transmitted?

A

No

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33
Q

Who is bacteria vaginosis exclusively seen in?

A

Sexually active women

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34
Q

How does bacterial vaginosis normally present in 50% of cases?

A

Asymptomatically

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35
Q

What is the main feature of bacterial vaginosis?

A

Fishy, offensive vaginal discharge

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36
Q

What is the criteria for diagnosis of bacterial vaginosis?

A

Amsel’s criteria

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37
Q

What is the requirement for the diagnosis of bacterial vaginosis?

A

3 of the 4 points of Amsel’s criteria

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38
Q

What are the 4 points of the Amsel’s criteria?

A

Thin, white homogenous discharge
Clue cells on microscopy: stippled vaginal epithelial cells
Vaginal pH > 4.5
Positive whiff test (addition of potassium hydroxide results in fishy odour)

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39
Q

What is the management of bacterial vaginosis?

A

Oral metronidazole for 5-7 days

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40
Q

What are the alternative managements for bacterial vaginosis?

A

Topical metronidazole Topical clindamycin

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41
Q

What are the complications of bacterial vaginosis?

A

Endometritis if uterine instrumentation/delivery
Premature labour
HIV acquisition

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42
Q

What are the alternative managements for bacterial vaginosis?

A

Topical metronidazole

Topical clindamycin

43
Q

What is the most prevalent sexually transmitted infection in the UK?

A

Chlamydia

44
Q

How long is the intubation period for chlamydia?

A

7-21 days

45
Q

What is the bacterial cause of chlamydia?

A

Chlamydia trachomatis

46
Q

How does chlamydia mainly present?

A

Asymptomatically

47
Q

What way can chlamydia present in women?

A

Cervicitis-discharge and bleeding

Dysuria

48
Q

What way an chlamydia present in men?

A

Urethral discharge

Dysuria

49
Q

What is the first line investigation for chlamydia in women?

A

Vulvovaginal swab

50
Q

What is the first line investigation for chlamydia in men?

A

Urine test

51
Q

What do you use to test the specimens in chlamydia?

A

NAAT

52
Q

What is the first line management of chlamydia?

A

Doxycycline 100mg

53
Q

What is the management of chlamydia when pregnant?

A

Azithromycin 1g

54
Q

What is the main complication of chlamydia in men?

A

Epididymitis

55
Q

What are the main complications of chlamydia in women?

A

Pelvic inflammatory disease
Endometritis
Infertility

56
Q

What are the complications of chlamydia in males and females?

A

Reactive arthritis
Reiter’s syndrome
Perihepatitis

57
Q

What are the 2 strains of herpes?

A

HSV-1

HSV-2

58
Q

Which strain are genital herpes more commonly caused by?

A

HSV-2

59
Q

What is the intubation period of herpes?

A

5 days

60
Q

What might a primary infection of herpes present with?

A

Severe gingivostomatitis

61
Q

What is gingivostomatitis?

A

Raw gums
Ulcers around mouth
Fever

62
Q

What can herpes also present with?

A

Cold sores
Painful genital ulcers
Tender inguinal lymphnodes
Dysuria

63
Q

What can recurrent episodes of herpes present with?

A

Neuralgic pain in the back, pelvis and legs

64
Q

What in the main diagnosis of herpes?

A

Clinical diagnosis

65
Q

What can you use to confirm herpes?

A

Swab of the ulcer

66
Q

What is the management of the gingivostomatitis?

A

Oral aciclovir

Chlorhexidine mouthwash

67
Q

What is the management of genital herpes?

A

Oral acicilovir

68
Q

What is the management of herpes cold sores?

A

Topical aciclovir

69
Q

What is the management if primary attack of herpes occurs at greater than 28 weeks gestation

A

Caesarean section

70
Q

What should pregnant women with recurrent herpes be treated with?

A

Suppressive therapy

71
Q

What are the main complications of herpes?

A

Autonomic neuropathy (urinary retention)
Neonatal infection
Secondary infection

72
Q

What is trichomoniasis caused by?

A

Trichomonas vaginalis

73
Q

What type of organism is trichomonas vaginalis?

A

Parasite

74
Q

What are the main presentations of trichomonas in women?

A

Vaginal discharge
vulvovaginitis
strawberry cervix
pH>4.5

75
Q

How is the vaginal discharge in trichomonas described?

A

Offensive
Yellow/green
Frothy

76
Q

What are the main presentations of trichomonas in men?

A

Asymptomatic

Urethritis

77
Q

What is the main investigation of trichomoniasis?

A

Microscopy of a wet mount shows motile trophozoites

78
Q

What is the management of trichomoniasis?

A

Oral metronidazole for 5-7 days

79
Q

What are the main complications of trichomoniasis?

A

Miscarriage

Premature birth

80
Q

What are the main causes of anogenital warts?

A

HPV types 6 and 11

81
Q

How do anogenital warts present?

A

Small ) fleshy protuberances which are slightly pigmented

May bleed or itch

82
Q

How are anogenital arts diagnosed?

A

Visual inspection

83
Q

What is the first line management of anogenital warts?

A

Topical podophyllum

Cryotherapy

84
Q

What is second line management of anogenital warts?

A

Imiquimod (topical cream)

85
Q

What is syphilis caused by?

A

Treponema pallidum

86
Q

What type of bacteria is treponema pallidum?

A

A spirochaete

87
Q

What is the primary feature of syphilis?

A

Chancre (a painless ulcer at the site of sexual contact)

88
Q

What are the secondary features of syphilis?

A

Rash on trunk, palms and soles

Buccal ‘snail track’ ulcers (30%)

89
Q

What does early latent mean? (syphilis)

A

No symptoms but less than 2 years since caught

90
Q

What does late latent mean? (syphilis)

A

No symptoms but more than 2 years since caught

91
Q

How is syphilis diagnosed?

A

Clinical signs

Serology

92
Q

What is looked for in syphilis serology?

A

TP
IgGEIA
TPPA
RPR

93
Q

What is the first line management of syphilis?

A

Intramuscular benzathine penicillin

94
Q

What is the alternative management of syphilis?

A

Doxycycline

95
Q

What are the main complications of syphilis?

A

Neurosyphilis – cranial nerve palsies are commonest
Cardiac or aortal involvement
Congenital syphilis

96
Q

What is balanitis?

A

Inflammation of the glans penis

97
Q

What is prosthitis?

A

Inflammation of the foreskin

98
Q

What is inflammation of of both the glans penis and the foreskin?

A

Balanoposthitis

99
Q

What is the bacterial cause of balanitis?

A

Candida balanitis

100
Q

How does balanitis present?

A

Rash at the end of the penis

101
Q

How is balanitis diagnosed?

A

Clinical history ad examination

102
Q

What is the general management of balanitis?

A

Gentle saline washes

Wash properly under the foreskin

103
Q

What is the management of balanitis with severe irritation and discomfort?

A

1% hydrocortisone

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