STI's Flashcards
What is the most commonly reported STI
Chlamydia
What percentage of people with chlamydia are asymptomatic
70 percent of women
50 percent of men
What organism causes chlamydia
gram negative chlamydia trachomatis bacteria
Which age group has the highest incidence of chlamydia infection
20-24 year olds
What percentage of women with chlamydia develop Pelvic inflammatory disease
9 percent
What other conditions does PID put a woman at risk of
10 times more likely to have a ectopic pregnancy
15-20 percent increased risk of tubal factor infertillity
How may a symptomatic woman present with chlamydia infection
post coital or intermenstrual bleeding
lower abdo pain
dyspareunia
mucopurulent cervicitis
How can a man present with chlamydia
urethral discharge
dysuria
urethritis
epididymo-orchitis
What are the main complications of chlamydia infection
PID
tubal damage
chronic pelvic pain
neonatal transmission
conjunctivitis
SARA/reiter’s syndrome - more common in men
Perihepatitis (Fitz-Hugh-CUrtis syndrome)
What is the diagnostic test of choice for chlamydia
NAAT - nucleic acid amplification test
How should chlamydia be tested for
two weeks after possible exposure
females- vulvovaginal swab
men- first void urine
MSM- rectal swab also if receptive anal intercourse
How is chlamydia treated?
Azithromycin 1g single dose
Or Doxycycline 100mg BD for one week
No need to retest to ensure infection has cleared
What causes gonorrhoea and what are the common infection sites
gram negative intracellular diplococcus
Mucous membranes- urethra, endocervix, rectum and pharynx
How long is the incubation period of gonorrhoea infection in a man in the urethra
2-5 days
What is the risk of transmission of gonorrhoea between an uninfected and infected individual
20 percent risk from infected woman to male partner
50-90 percent risk from infected man to female partner
How does gonorrhoea present in males
Asymptomatic in less than 10 percent of cases
Urethral discharge in 80 percent
Dysuria
pharyngeal/rectal infections usually asymptomatic
how can gonorrhoea present in females
asymptomatic in up to 50 percent
increase/altered vaginal discharge (40 percent)
dysuria
pervic pain
pharyngeal and rectal infection usually asymptomatic
how is gonorrhoea diagnosed
Microscopy - urethral and endocervical swab
Culture- male urethra, femal endocervic
NAATs
How is gonorrhoea treated
1st line - ceftriaxone 500mg IM
Second line- Cefixime 400mg oral
Co treat with azithromycin 1g
Test cured in all patients
What organism causes syphilis?
treponema pallidum
How is syphilis usually transmitted?
sexual contact trans placental/during birth blood transfusions non sexual contact- health care workers It may be congenital or acquired
what are the stages of acquired syphilis infection
Early infections - primary, secondary, early latent
Late non- infectious - late latent, tertiary
how long is the incubation period for primary syphillus
9-90 days (mean is 21)
what are the features of primary syphilis
Lesion is traditionally known as a primary chancre (painless)
Lesions appear at the site of inoculation
Sites are genital in 90 percent of cases
non tender local lymphadenopathy`
what are the features of secondary syphilis
skin rash lesions on mucous membranes generalized lymphadenopathy patchy alopecia condylomata lata
how is syphilis treated
early- 2.4 MU benzathine penicillin x 1
late- 2.4MU benzathine penicillin x 3
what is the incubation period for genital herpes
3-6 days
how long does a primary herpes infection last
14-21 days
what are the clinical features of genital herpes
blistering and ulceration of external genitalia pain external dysuria vaginal or urethral discharge local lymphadenopathy - tender fever and myalgia
What HSV type is more commonly associated with recurrent episodes
HSV 2 milder- thrush like symptoms unilateral, small blisters minimal systemic upset resolves 5-7 days
How is HSV diagnosed
swab ulcer for PCR
how is HSV managed
oral acyclovir
lidocaine topical if pain
saline bathing
analgesia
what is the most common viral sti in the uk
HPV - 80 percent lifetime risk of infection
which types of HPV cause genital warts
6 and 11
what is the incubation period of hpv
3 weeks to 9 months
how is hpv warts treared
podophyllotoxin (warticon) - cytotoxic
imiquimod- can be used on all anogenital warts
cryothraphy
electoclautery
What is the normal vaginal flora
Lactobacillus spp. with lactic acid +/- hydrogen peroxide
Step viridans
Group B strp
Small numbers of candida
What predisposes to candidda
recent antibiotics
high oestrogen levels eg. pregnancy, certain contraceptives
diabetes
immunocompromised
How does candida presetn
itchy white vaginal sicharge
How Is candida diagnose
HVS for culture (usually c.albicans)
How is candida treated
Cltrimazole cream or pessary
Oral fluconazole
What causes bacterial vaginosis
Gardnerella vaginalis/mobiluncus sp.
What are the symptoms of BV
thin watery fishy smelling discharge
How is BV diagnosed
clinically
raised vaginal pH (more than 4.5)
HVS for microscopy - GLUE CELLS- subjective/inaccurate
What is the treatment of bacterial vaginosis
metronidazole
