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Repro > STI's > Flashcards

STI's Flashcards

1
Q

Describe chlamydia?

A

Gram negative bacterium
Trasmission: Vaginal, orally, anal
Highest incidence: 20-24 years

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2
Q

What is the chlamydia presentation in a female?

A

post coital or intermenstrual bleeding
Lower abdo pain
Dyspareunia
Mucopurulent cervicititis

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3
Q

What is the chlamydia presentation in a male?

A

urethral discharge
Dysuria
Urethritis
Epidiymo-orchitis

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4
Q

How do you diagnose Chlamydia?

A

Test 14 days following exposure
NAAT - females (vulvovaginal swabs)
First void urine (males)
MSM and rectal swab if anal intercourse occured

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5
Q

How do you treat chlamydia?

A

Azithromycin 1G stat

Doxycycline 100mg BD x 1 week

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6
Q

Describe gonorrhoea?

A

Gram negative intracellular diplococcus

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7
Q

Where are the primary sites of a gonorrhoea infection?

A

Mucous membranes of urethra, endocervix, rectum and pharynx

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8
Q

What is the incubation period of urethral infections in a male?

A

2-5 days (short)

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9
Q

Whats more likely, male to female transmission or female to male transmission?

A 
F-->M = 20%
M-->F = 50-90%
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10
Q

How does gonorrhoea present in males?

A

Asymptomatic in

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11
Q

How does gonorrhoea present in females?

A

Asymptomatic in up to 50%
Dysuria
Pelvic pain
Pharngeal/rectal infections, mostly asymptomatic

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12
Q

What are lower genital tract complications of gonorrhoea?

A 
Bartholinitis
Tysonitis
Periurethral abscess
Epididymitis
Urethral stricture
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13
Q

What are the upper genital tract complications of gonorrhoea?

A 
Endometritis
PID
Hydrosalpinx
Infertility
Ectopic pregnancy
Prostatitis
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14
Q

How do you diagnose gonorrhoea?

A

Microscopy- urethral (90-95% sensitivity) endocervical (37-50% sensitivity)
Culture
NAAT

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15
Q

What is the treatment for gonorrhoea?

A

IM ceftriaxone 500mg

Azithromycin 1g

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16
Q

What is the second line treatment for gonorrhoea?

A

Cefixime 400mg oral

17
Q

What is the incubation period of genital herpes?

A

3-6 days

18
Q

What is the duration of genital herpes primary infection?

A

14-21 days

19
Q

What are the symptoms of genital herpes?

A 
Blistering and ulceration of external genitalia
Pain
External dysuria
Vaginal/urethral discharge
Local lympohadenopathy
Fever + myalgia
20
Q

Describe recurrent episodes of genital herpes?

A

Common with HSV-2
Often misdiagnosed as thrush
Usually unilateral, small blisters and ulcers
Minimal systemic symptoms, resolves within 5-7 days

21
Q

What is the management of genital herpes?

A 
Swab base of ulcer for HSV PCR
Aciclovir orallly
Topical lidocaine 5% 
Saline bathing
Analgesia
22
Q

What is viral shedding?

A

Higher occurrence with HSV2 as opposed to HSV1

More frequent in first year of infection

23
Q

How do you treat Human Papilloma virus (genital warts)

A

Podophyllotoxin (warticon)
Imiquimod (Aldara) - immune modifier
Cryotherapy
Electocautery

24
Q

What organism causes Syphilis?

A

Treponema pallidum

25
Q

How can syphilis be transmitted?

A

Sexual contact
Trans-placental/during birth
Blood transfusions
Non-sexual contact - healthcare workers

26
Q

What is the incubation period of Primary Syphilis?

A

9-90 days (mean of 21

27
Q

What is primary chancre?

A

Painless lesions

28
Q

What else is seen with syphilis?

A

non-tender local lympohadenopathy

29
Q

What is the incubation period of Secondary Syphilis?

A

6wks to 6 months

30
Q

What are the features of secondary syphilis?

A 
Skin lesions
Mucous membrane lesions
Generalised lymphadenopathy
Pathcy alopecia
Condylomata Lata (highly infectious lesion, exudes a serum teeming with treponemes)
31
Q

How do you diagnose syphilis?

A

From lesions or infected lymph nodes
Dark field microscopy
PCR
Serology for antibody to pathogenic treponemes

32
Q

What are non-treponemal serology tests?

A

VDRL - Venereal Disease Research Lab

RPR - Rapid Plasma Reagin

33
Q

What are Treponemal tests?

A

TPPA - Treponemal Pallidum Particle Agglutination
ELISA/EIA - Enzyme Immunoassay (screening test)
INNO-LIA - Line immunoassay
FTA abs - Flourescent Treponemal Antibody absorbed

34
Q

What is the treatment for early syphilis?

A

2.4 MU Benzathine penicillin x1

35
Q

What is the treatment of late syphilis?

A

2.4 MU Benzathine penicillin x3

36
Q

What follow up serology tests are there for syphilis?

A

Until PRP is negative or serofast:

  • Titres should decrease fourfold by 3-6 months in early syphilis
  • Serological relapse/reinfection if titres increase by fourfold

Repro (46 decks)

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