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Year 3: Reproduction > STI's - an introduction > Flashcards

STI's - an introduction Flashcards

1
Q

What is a commensal micro-organism

A

A micro-organism that derives food or other benefits from another organism without hurting or helping it.

Pathogen

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2
Q

What is a Pathogen

A

micro-organism that can cause disease

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3
Q

different types of infection

A

No symptoms sub-clinical

Symptoms clinical

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4
Q

give examples of sexually transmissible organisms - how do they spread

A

A virus, bacteria, protozoan, insect or arthropod which can be spread by sexual contact

  • Commensal
  • pathogen
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5
Q

Sexually transmitted infection (STI) - is caused by?

give 2 examples

A

pathogen spreading through sex

  • Neisseria gonorrhoeae
  • HPV type 6
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6
Q

Sexually transmitted disease (STD) - what is this?

Give 2 examples

A

A disorder of structure or function caused by a sexually transmitted pathogen

  • Pelvic inflammatory disease
  • Genital warts
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7
Q

Venereal Diseases (3)

A
  • Syphilis (Treponema pallidum pallidum)
  • Gonorrhoea (Neisseria gonorhoeae)
  • Chancroid (Haemophilus ducreyi)
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8
Q

Bacteria infections (3) - organisms

A

Chlamydia trachomatis
Klebsiella granulomatis
Mycoplasma genitalium

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9
Q

Virus infections (4)

A

HSV
HIV
HPV
Molluscum contagiosum virus

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10
Q

parasite organisms (3)

A

Pthirus pubis
Sarcoptes scabei
Trichomonas vaginalis

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11
Q

most common infections that are controversial?

A
  • Mycoplasma hominis
  • Ureaplasma urealyticum
  • Bacterial vaginosis
  • Genital candidosis
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12
Q

Features STI’s share? (4)

A
  • They are all infectious/contagious
  • Asymptomatic most of the time
  • Unpredictable minority suffer significant complications
  • Totally avoidable
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13
Q

implications/management of STI’s? (4)

A

Sexual contact tracing

Can’t eradicate just by treating the symptomatic

Early detection and treatment needed
Primary prevention is the goal

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14
Q

Most likely to cause STI’s - list of sexual contact (8)

A 
Group sex
Anal sex 
Vaginal sex
Oral sex - cunnilingus
Oral sex - fellatio
Touching someone else’s genitals with your genitals.
Mutual masturbation
‘Pants on’ cuddling
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15
Q

Skin contact only conditions (4)

A 
pubic lice (Pthirus pubis)
Scabies (Sarcoptes scabeii)
Warts (human papilloma virus types 6 &11)
Herpes (Herpes Simplex Virus types 1 & 2)
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16
Q

Common group sex condition

A

hep c

17
Q

Why are STIs important? (3)

A

STDs cause morbidity and can even kill.
Unpleasant symptoms – grouped in to syndromes
Psychological distress

18
Q

Ulceration often seen in (2)

A

secondary syphillis

herpes sv

19
Q

lumps often seen in?

A

genital wards

malloscum contagiosum

20
Q

genital discharge

A

Gonorrhoea

chlamydia

21
Q

Non-genital discharge

A
  • chlamydia in the eyes

- Gonorrhoea in the eyes

22
Q

rashes can occur with (

A

scabies
syphillis
HIV
crab lice

23
Q

Systemic symptoms (5)

A 
Fever
Rash
Lymphadenopathy
Malaise
Arthralgia and arthritis
24
Q

Late complications of chlamydia?

A

Infertility

25
Q

late complications of sti’s?

A

Cancer. 250,000+ deaths globally from cervical cancer - HPV

300,000 adverse pregnancy outcomes from syphilis per year.

26
Q

R0=cD - applies to?

A

every disease - the reproductive number

if R> 1, epidemic is sustained

27
Q

Rate of acquiring new partners? (5)

A 
increased numbers of partners/person
increased concurrent partners
more people having anal sex
more men reporting sex with men
(also increased condom usage).
28
Q

cores meaning

A

likely to have sex with someone like them

- leads to high prevalence within a subpopulation (core) but limited spread through the wider community.

29
Q

chains and random mixing?

A

Some ‘cores’ are very big – eg heterosexual men and women.
Random mixing leads to lower prevalence but wider dissemination along ‘chains’.
Most people have few sexual contacts over a given period of time and so chains are quite short

30
Q

Principles of a consultation in someone with a possible STI? the 4 elements

A

a good history
partner notification
HIV testing
health promotion

31
Q

important things to ask in consultation?

A

Presenting complaint
History of presenting complaint
PM/SHx
DHx
Include a gynae history.
Need to ask direct questions about symptoms
Eg “discharge from the penis/pain in abdomen?”

32
Q

The sexual history

A
  • Determining possible cause of symptoms
  • Detecting high-risk behaviour and advising on risk reduction.
  • Tracing contacts
33
Q

sexual history questions? (9)

A
  • When did you last have sexual contact?
  • Casual contact vs ‘regular’ partner?
  • How long were you going out with them for?
  • Were they male or female?
  • Asking about nature of sex act sometimes useful
    anxiety about a specific incident
  • If it’s going to alter where you swab from eg MSM
  • Did you use condoms?
  • Other contraception used
  • Nationality of contact
34
Q

Assessment of longer-term sexual risks (men) (7)

A 
Have you ever had sexual contact with another man?
Have you ever injected drugs?
Sexual contact with 
	anyone who’s injected drugs?
	someone from outside the UK? (clarify)
Medical treatment outside UK? (clarify)
Paid for sex or been paid?
35
Q

Partner notification (‘contact tracing’) - what are the 2 ways of doing this?

A

Patient tells contacts “client referral”

NHS tells contact “provider referral”

36
Q

Offer/recommend further testing -why/when may you do this?

A
  • Most STIs are risk factors for HIV acquisition and transmission.
  • If someone has one STI (eg chlamydia) they could have another (eg HIV)
37
Q

Health promotion for STI’s? (5)

A 
- Condoms prevent transmission of some STIs - 
Eg HIV, chlamydia, gonorrhoea
- Not so good at preventing transmission of other STIs; eg herpes and warts
- Oral sex carries risks too
Not as great as vaginal or anal sex
fellatio more than cunnilingus
Address hazardous drug use.
Vaccination
HIV pre-exposure prophylaxis

Year 3: Reproduction (40 decks)

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