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Y3 Reproduction > STIs > Flashcards

STIs Flashcards

1
Q

what four STIs are tested for in a regular STI screen?

A

chlamydia
gonorrhoea
HIV
syphilis

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2
Q

besides STIs, what other conditions should be considered in a female presenting with vaginal discharge?

A

BV
candida
thichomonas vaginalis

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3
Q

what is the ideal test for GC/CT in females?

A

vulvovaginal swab (VVS) for GC/CT NAAT

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4
Q

what is the ideal test for GC/CT in males?

A

first void urine NAAT

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5
Q

what other swabs may be performed for GC/CT depending on the sexual history?

A

throat swab

rectal swab

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6
Q

what does GC/CT mean?

A

gonorrhoea and chlamydia

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7
Q

how are HIV and syphilis tested for?

A

blood tests

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8
Q

what symptomatic sampling is done for chlamydia?

A

cervical microscopy
vaginal microscopy + pH
urethral microscopy

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9
Q

when is an Amies swab done?

A 
recurrent or persistent discharge 
vaginitis of unknown cause 
pregnant 
postpartum 
post gynae surgery 
suspected PID
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10
Q

what can high white cell count at the cervix suggest?

A

PID

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11
Q

what is the management of chlamydia?

A

doxycycline 100mg BD for one week

OR

azithromycin 1G stat followed by 500mg daily for two days

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12
Q

how is PID due to chlamydia treated?

A

cerftriaxone 1G IM
doxycycline 100mg BD for two weeks
metronidazole 400mg BD for two weeks

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13
Q

what is the most commonly reported bacterial STI?

A

chlamydia

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14
Q

what percentage of chlamydia cases are asymptomatic?

A

female - 70-80%

male - 50%

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15
Q

what tissue is infected in chlamydia?

A

columnar epithelium at mucosal sites

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16
Q

how is chlamydia transmitted?

A

vaginal, oral or anal sex

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17
Q

what age group has the highest incidence of chlamydia?

A

20-24 year olds

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18
Q

what do chlamydia serovars A-B cause?

A

ocular infectious

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19
Q

what do chlamydia serovars D-K cause?

A

genital infection

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20
Q

what do chlamydia serovars L1-L3 cause?

A

lymphogranuloma venereum (LGV)

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21
Q

what are the symptoms of chlamydia?

A

milky urethral discharge
irregular vaginal bleeding
abdominal pai
dysuria

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22
Q

what are the signs of chlamydia?

A

urethritis
cervicitis
epididymo-orchitis
proctitis

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23
Q

what are some possible complications of chlamydia?

A

PID
ectopic pregnancy
reactive arthritis
conjunctivitis

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24
Q

when should females be tested for chlamydia?

A

14 days following exposure

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25
Q

in which group are cases of LGV mainly seen?

A

MSM

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26
Q

what are the symptoms of LGV?

A

rectal pain
discharge
bleeding

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27
Q

what are the four possible locations for gonorrhoea infection?

A

urethra
pharyngeal
rectal
endocervical

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28
Q

how does urethral gonorrhoea present?

A

discharge

dysuria

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29
Q

how does pharyngeal and rectal gonorrhoea present?

A

usually asymptomatic

30
Q

how does endocervical gonorrhoea present?

A

discharge
irregular bleeding
external dysuria

31
Q

what investigations can be done for gonorrhoea?

A

NAATs
microscopy
culture

32
Q

what is the first line management of gonorrhoea?

A

cerftriaxone 1G IM

33
Q

what is the second line management for gonorrhoea?

A

cefixime 400mg oral plus azithromycin 2G

34
Q

when is second line treatment for gonorrhoea given?

A

if IM injection is contraindicated or refused

35
Q

what needs to be done for all patients with gonorrhoea after treatment?

A

test of cure

36
Q

what type of bacteria is gonorrhoea?

A

gram negative intracellular diplococcus

37
Q

what are the primary sites of infection of gonorrhoea?

A

mucous membranes of the urethra, endocervix, rectum and pharynx

38
Q

what is the incubation period for gonorrhoea in males?

A

2-5 days

39
Q

what are some possible lower genital tract complications of gonorrhoea?

A 
bartholinitis 
tysonitis 
periurethral abscess
rectal abscess 
epididymitis 
urethral stricture
40
Q

what are some possible upper genital tract complications of gonorrhoea?

A 
endometritis 
PID 
hydrosalpinx 
infertility 
ectopic pregnancy 
prostatitis
41
Q

what is mycoplasma genitalium associated with?

A

non gonococcal urethritis

PID

42
Q

what test is done for mycoplasma genitalium?

A

NAAT test

43
Q

what is the management for genital herpes?

A

oral acyclovir 400mg TDS x5/7

saline bathing

analgesia

44
Q

what can be given for genital herpes if very painful?

A

topical lidocaine 5% ointment

45
Q

what are the three possible presentations of genital herpes?

A

primary infection
non-primary first episode
recurrent infection

46
Q

what is the incubation period for a primary infection of genital herpes?

A

3-6 days

47
Q

how long does a primary infection with genital herpes last?

A

14-21 days

48
Q

how does primary genital herpes infection present?

A 
blistering + ulceration 
pain 
external dysuria 
discharge 
lymphadenopathy 
prodromal symptoms
49
Q

which type of HSV is more commonly associated with recurrent episodes of genital herpes?

A

HSV 2

50
Q

how do recurrent episodes of genital herpes present?

A

unilateral small blisters and ulcers

minimal systemic symptoms

51
Q

how long do recurrent episodes of genital herpes last?

A

5-7 days

52
Q

what causes syphilis?

A

treponema pallidum

53
Q

how is syphilis transmitted?

A

sex (acquired)

trans-placental/during birth (congenital)

54
Q

what are the five stages of syphilis?

A 
primary 
secondary 
early latent 
late latent 
tertiary
55
Q

what stages of syphilis are “early infectious”?

A

primary
secondary
early latent

56
Q

what stages of syphilis are late non infectious?

A

late latet

tertiary

57
Q

what is the incubation period for primary syphilis?

A

9-90 days

mean = 21

58
Q

what is the lesion in primary syphilis called?

A

primary chancre

painless

59
Q

where do lesions appear in primary syphilis?

A

at the site of inoculation

90% genital

60
Q

what is the incubation period of secondary syphilis?

A

6 weeks - 6 months

61
Q

what is the most highly infectious lesion in syphilis?

A

condylomata lata

62
Q

how can syphils be detected?

A

dark field microscopy
PCR
serological testing

63
Q

what is the treatment for early syphilis?

A

2.4 MU benzathine penicillin stat

64
Q

what is the treatment for late syphilis?

A

2.4 MU benzathine penicillin weekly for three weeks

65
Q

when should serological follow up be done for syphilis?

A

until PRP is negative or serofast

66
Q

what is the most common viral STI in the UK?

A

HPV

67
Q

what are the most oncogenic types of HPV?

A

16

18

68
Q

what is the incubation period of HPV?

A

3 weeks - 9 months

69
Q

what type of HPV causes the majority of anogenital warts?

A

6

11

70
Q

what are the four treatment options for HPV?

A

podophyllotoxin
imiquimod
cryotherapy
electrocautery

Y3 Reproduction (49 decks)

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