STI's Flashcards by caitlinmcgrane01@gmail.com McGrane

What organism causes Gonorrhoeae?

Neisseria Gonorrhoeae

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Wat type of organism is Neisseria Gonorrhoeae?

Gram negative diplococcus

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What is the intubation period of gonorrhoeae?

2-5 days

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Who does gonorrhoeae normally affect?

Men who have sex with men?

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What 3 ways does gonorrhoeae present in males?

Urethral discharge
Dysuria
Tender inguinal nodes

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What 3 ways does gonorrhoeae present in females?

Cervicitis
Dysuria
Abnormal bleeding

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

Epididymis

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

Pelvic inflammatory disease

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What can pelvic inflammatory disease lead to?

Infertility

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

Monoarthritis in elbow or shoulder

Disseminated gonococcal infection

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How does a disseminated gonococcal skin infection present?

Skin lesion that is pustular with a halo

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How do you diagnose gonorrhoea?

Microscopy and culture- NAAT on urine or exposed site

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What is the management for gonorrhoea?

IM 1g ceftriaxone

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What is an alternative treatment for gonorrhoea?

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

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What is another name for vaginal candidiasis?

Thrush

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What is the fungal cause of vaginal candidiasis?

Candida albicans

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What is an alternative fungal cause of vaginal candidiasis?

Candida glabrata

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What are the main risk factors of vaginal candidiasis?

Diabetes
Immunosuppression
Pregnancy
Drugs: Antibiotics, Steroids

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What is vaginal candidiasis if its symptomatic?

Thrush

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What are the 4 main symptoms of thrush?

Discharge
Vulvitis
Itch
Vulval erythema

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How is the thrush discharge described?

non-offensive cottage cheese

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What is seen on examination of thrush?

Vulval erythema
Fissuring
Satellite lesions

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How is thrush diagnosed?

Characteristic history of itching and discharge

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

Vaginal swab

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What is the management of thrush if it is mild?

It may self-correct

What is the local treatment for thrush?

Clotrimazole pessary (500mg PV stat)

What is the oral treatment for thrush?

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

What is the contraindication in pregnancy?

Oral treatment

What is the commonest cause of vaginal discharge?

Bacterial vaginosis

What is the main anaerobic organism?

Gardnerella vaginalis

What is the triad of bacterial vaginosis?

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

Is bacterial vaginosis sexually transmitted?

Who is bacteria vaginosis exclusively seen in?

Sexually active women

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

Asymptomatically

What is the main feature of bacterial vaginosis?

Fishy, offensive vaginal discharge

What is the criteria for diagnosis of bacterial vaginosis?

Amsel's criteria

What is the requirement for the diagnosis of bacterial vaginosis?

3 of the 4 points of Amsel's criteria

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

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)

What is the management of bacterial vaginosis?

Oral metronidazole for 5-7 days

What are the alternative managements for bacterial vaginosis?

Topical metronidazole Topical clindamycin

What are the complications of bacterial vaginosis?

Endometritis if uterine instrumentation/delivery Premature labour HIV acquisition

What are the alternative managements for bacterial vaginosis?

Topical metronidazole | Topical clindamycin

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

Chlamydia

How long is the intubation period for chlamydia?

7-21 days

What is the bacterial cause of chlamydia?

Chlamydia trachomatis

How does chlamydia mainly present?

Asymptomatically

What way can chlamydia present in women?

Cervicitis-discharge and bleeding | Dysuria

What way an chlamydia present in men?

Urethral discharge | Dysuria

What is the first line investigation for chlamydia in women?

Vulvovaginal swab

What is the first line investigation for chlamydia in men?

Urine test

What do you use to test the specimens in chlamydia?

NAAT

What is the first line management of chlamydia?

Doxycycline 100mg

What is the management of chlamydia when pregnant?

Azithromycin 1g

What is the main complication of chlamydia in men?

Epididymitis

What are the main complications of chlamydia in women?

Pelvic inflammatory disease Endometritis Infertility

What are the complications of chlamydia in males and females?

Reactive arthritis Reiter’s syndrome Perihepatitis

What are the 2 strains of herpes?

HSV-1 | HSV-2

Which strain are genital herpes more commonly caused by?

HSV-2

What is the intubation period of herpes?

5 days

What might a primary infection of herpes present with?

Severe gingivostomatitis

What is gingivostomatitis?

Raw gums Ulcers around mouth Fever

What can herpes also present with?

Cold sores Painful genital ulcers Tender inguinal lymphnodes Dysuria

What can recurrent episodes of herpes present with?

Neuralgic pain in the back, pelvis and legs

What in the main diagnosis of herpes?

Clinical diagnosis

What can you use to confirm herpes?

Swab of the ulcer

What is the management of the gingivostomatitis?

Oral aciclovir | Chlorhexidine mouthwash

What is the management of genital herpes?

Oral acicilovir

What is the management of herpes cold sores?

Topical aciclovir

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

Caesarean section

What should pregnant women with recurrent herpes be treated with?

Suppressive therapy

What are the main complications of herpes?

Autonomic neuropathy (urinary retention) Neonatal infection Secondary infection

What is trichomoniasis caused by?

Trichomonas vaginalis

What type of organism is trichomonas vaginalis?

Parasite

What are the main presentations of trichomonas in women?

Vaginal discharge vulvovaginitis strawberry cervix pH>4.5

How is the vaginal discharge in trichomonas described?

Offensive Yellow/green Frothy

What are the main presentations of trichomonas in men?

Asymptomatic | Urethritis

What is the main investigation of trichomoniasis?

Microscopy of a wet mount shows motile trophozoites

What is the management of trichomoniasis?

Oral metronidazole for 5-7 days

What are the main complications of trichomoniasis?

Miscarriage | Premature birth

What are the main causes of anogenital warts?

HPV types 6 and 11

How do anogenital warts present?

Small ) fleshy protuberances which are slightly pigmented | May bleed or itch

How are anogenital arts diagnosed?

Visual inspection

What is the first line management of anogenital warts?

Topical podophyllum | Cryotherapy

What is second line management of anogenital warts?

Imiquimod (topical cream)

What is syphilis caused by?

Treponema pallidum

What type of bacteria is treponema pallidum?

A spirochaete

What is the primary feature of syphilis?

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

What are the secondary features of syphilis?

Rash on trunk, palms and soles | Buccal 'snail track' ulcers (30%)

What does early latent mean? (syphilis)

No symptoms but less than 2 years since caught

What does late latent mean? (syphilis)

No symptoms but more than 2 years since caught

How is syphilis diagnosed?

Clinical signs | Serology

What is looked for in syphilis serology?

TP IgGEIA TPPA RPR

What is the first line management of syphilis?

Intramuscular benzathine penicillin

What is the alternative management of syphilis?

Doxycycline

What are the main complications of syphilis?

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

What is balanitis?

Inflammation of the glans penis

What is prosthitis?

Inflammation of the foreskin

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

Balanoposthitis

What is the bacterial cause of balanitis?

Candida balanitis

How does balanitis present?

Rash at the end of the penis

How is balanitis diagnosed?

Clinical history ad examination

What is the general management of balanitis?

Gentle saline washes | Wash properly under the foreskin

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

1% hydrocortisone