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Y3 - Repro > STIs > Flashcards

STIs Flashcards

1
Q

What organism causes candida?

A

Candida albicans

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2
Q

What are risk factors for candida?

A

Antibiotic use
COCP/pregnancy - raised oestrogen
Diabetes
Immunocompromised

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3
Q

What is the presentation of candida?

A

Thick white discharge (‘curd-like’)

Very itchy

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4
Q

How is candida diagnosed?

A

Clinically

High vaginal swab isf unsure

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5
Q

What is the treatment for candida?

A

Topical clotrimazole

Oral fluconazole

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6
Q

What organism causes bacterial vaginosis?

A

Gardenella vaginali or anaerobes - imbalance of flora

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7
Q

How is bacterial vaginosis diagnosed?

A

Clinically
High vaginal swab - clue cells on microscopy
Increased pH (>4.5)

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8
Q

What is the management for bacterial vaginosis?

A

Oral metronidazole

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9
Q

What organism causes pubic lice?

A

Phthirus pubis

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10
Q

What is the presentation of pubic lice?

A

Itchy pubic area

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11
Q

What is the management of pubic lice?

A

Malathion lotion

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12
Q

What are the sexually transmitted bacterial infections?

A

Chlamydia
Gonorrhoea
Syphilis

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13
Q

What are the sexually transmitted viral infections?

A

HPV
Herpes simplex
HIV
Heb B or C

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14
Q

What are the sexually transmitted parasitic infections?

A

Trichomonas vaginalis
Scabies
Crabs

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15
Q

What organism causes chlamydia?

A

Chlamydia trachomatis

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16
Q

What gram is chlamydia trachomatis?

A

Gram negative

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17
Q

What is the most common bacterial STI?

A

Chlamydia

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18
Q

Where in the body does chlamydia infect?

A

Endocervix

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19
Q

What is the presentation of chlamydia?

A 
80% asymptomatic
Male
- urethritis
- urethral milky discharge
- dysuria
- orchiditis/proctitis
Female 
- mucopurulent cervicitis
- dyspareunia
- abnormal bleeding
Abdominal Pain
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20
Q

What are signs of upper genital disease?

A

Suprapubic tenderness
Mucopurulent cervicitis and contact bleeding on bimanual examination
Dyspareunia

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21
Q

What are the complications of chlamydia?

A

Pelvic inflammatory disease
Neonatal conjunctivitis
Reiter’s syndrome
Fitz-Hugh-Curtis syndrome

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22
Q

What is Reiter’s syndrome?

A

Reactive arthritis

Triad of: uveitis, urethritis, arthitis

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23
Q

What is Fitz-Hugh-Curtis syndrome?

A

Adhesions and inflammation of he liver capsule

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24
Q

What investigations are done for chlamydia?

A

Male - first pass urine sample
Female - endocervical swab
Combined NAATs/PCR

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25
Q

What is the management for chlamydia?

A 
Oral doxycycline (100mg BD 7 days)
Second line - azithromycin
Cover for PID if signs of upper genital disease - ceftriaxone, doxycycline and metronidazole
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26
Q

How should contacts of someone with chlamydia be managed?

A

Treat without need to test

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27
Q

What is lymphogranuloma venerium?

A

STI caused by chlamydia trachomatis types LGV 1, 2 and 3

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28
Q

Where is lymphogranuloma venerium most common?

A

Africa, India, SE asia

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29
Q

What are risk factors for lymphogranuloma venerium?

A

HIV positive MSM

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30
Q

What is the presentation of lymphogranuloma venerium?

A

Rectal symptoms and genital ulceration
Stage 1 - painless ulcerating papule on genetalia 7-21 days after exposure
Stage 2 - regional lymphadenopathy - fixed and painful with overlying erythema
Stage 3 - nodes become fluctuant and can rupture

31
Q

How is lymphogranuloma venerium diagnosed?

A

Nucleic acid amplification for LGV serovar

32
Q

What is the management for lymphogranuloma venerium?

A

Doxycycline or erythromycin

33
Q

What is the complication of lymphogranuloma venerium?

A

Chronic infection can result in extensive scaring, abscess and sinus formation

34
Q

What organism causes gonorrhoea?

A

Neisseria gonorrhoea

35
Q

What is the description of the organism neisseria gonorrhoea?

A

Gram positive diplococci (kidney bean shaped)

36
Q

Where does gonorrhoea infect?

A

Intracellular, infects the epithelium of the urogenital tract, rectum, pharynx and conjuntivae

37
Q

What is the incubation period of gonorrhoea?

A

2-14 days

38
Q

What is the presentation of gonorrhoea?

A

Purulent urethral discharge
Dysuria
Rectal infection - proctitis with pain, discharge and itch
Can be asymptomatic

39
Q

What are the complications of gonorrhoea?

A 
Infection of epididymis, prostate
Bartholin's abscess
Neonatal conjunctivitis
Disseminated gonorrhoea 
Upper genital infection
40
Q

What is the presentation of disseminated gonorrhoea?

A

Arthritis (monoarticular)
Papular or pustular rash with erythematous base
Fever and malaise

41
Q

What is the investigation for gonorrhoea?

A

Male - first pass urine
Female - endocervical swab
Combined NAAT/PCR

42
Q

What is the management for gonorrhoea?

A

IM ceftriaxone

Second line - cefixime and azithromycin (if IM injection contraindicated or refused)

43
Q

What is the management for contacts of someone with gonorrhoea?

A

Treat with ceftriazone without need to test

44
Q

What organism causes syphilis?

A

Treponema pallidum (a spirochete)

45
Q

What is the incubation period for syphilis?

A

9-90 days

46
Q

What are stages of presentation of syphilis?

A 
Stage 1 (primary)
- chancre (painless ulcer)
- local lymphadenopathy
- heals without treatment
Stage 2 (secondary)
- 4-10 weeks after appearance of primary lesion
- copper palmar-plantar rash
- snail track mouth ulcers
- patchy alopecia
- flu-like illness
- generalised lymphadenopathy
Stage 3 (latent)
- no symptoms
Stage 4 (tertiary)
- neurosyphilis
- Argyll-Robertson pupil (miotic - accomodates but doesn't react)
- CVS effects
- Cardiovascular - aortic aneurysm, aortic regurgitation
- 4-20+ years after initial infection
47
Q

How is syphilis diagnosed?

A

Swab of stage 1 or 2 lesion
Spirochetes on dark ground microscopy (PCR)
Serology specific tests fo diagnosis (IgM and IgG ELISA for screening, TPPA)

48
Q

What is the management of syphilis?

A

Benzathine penicillin IM

For pen allergy - doxycycline or erythromycin

49
Q

What strain of herpes simplex virus causes genital herpes?

A

HSV2 majority

50
Q

Who is more severely affected by genital herpes?

A

Immunocompromised

51
Q

What is the presentation of genital herpes?

A 
Ulcers/blisters on external genitalia
Painful
Dysuria
Local lymphadenopathy - tender
Systemic symptoms - fever, myalgia, headache
52
Q

What are the complications of genital herpes?

A

Neurological - aseptic meningitis, involvement of sacral plexus leading to retention of urine

53
Q

How is genital herpes diagnosed?

A

Swab vesicles - PCR

54
Q

What is the management of genital herpes?

A

Oral acyclovir + lidocaine topical
If lesions already crusting antivirals won’t do anything
Secondary bacterial infection - rest, analgesia, antipyretics
Supportive - saline bathing, analgesia

55
Q

What is the risk of genital herpes in pregnancy?

A

Transplacental infection or infection via birth canal causing neonatal HSV

56
Q

What is the management of genital herpes in pregnancy?

A

Acyclovir can b given in 1st or 2nd trimester depending on clinical condition
Acyclovir can be given during the last 4 weeks of pregnancy to prevent recurrence at term
Primary acquisition in 3rd trimester or term with high levels of viral shedding - c-section

57
Q

Are condoms effective in preventing genital herpes?

A

May not be - lesions may occur outside areas covered

58
Q

Which strains of HPV cause genital warts?

A

HPV 6 and 11

59
Q

How is HPV spread?

A

Skin contact

60
Q

What is the presentation of HPV?

A

Anogenital warts that are:

  • white
  • rough
  • raised
  • not painful
61
Q

How is HPV diagnosed?

A

Clinically

62
Q

What is the management of HPV?

A

Cryotherapy
Podophyllotoxin cream
Imiquimod cream

63
Q

What organism causes trichomonas vaginalis?

A

Protozoal parasite

64
Q

What is the presentation of trichomonas vaginalis?

A

Discharge - purulent, green, frothy, musty odour
Irritation and itch
Strawberry spots
Males are usually asymptomatic but may have urethritis

65
Q

What are strawberry spots?

A

Multiple small haemorrhagic areas on the cervix

Sign of trichomonas vaginalis

66
Q

How is trichomonas vaginalis diagnosed?

A

High vaginal swab for microscopy - motile trophozoites

No test for males

67
Q

What is the management for trichomonas vaginalis?

A

Oral metronidazole

68
Q

What is the lookback period for contact tracing for chlamydia?

A

Male urethral - 4 weeks

Endocervix, anal, oral - 6 months

69
Q

What is the lookback period for contact tracing for gonorrhoea?

A

Male urethral - 2 weeks

Endocervix, anal, oral - 3 months

70
Q

What is the lookback period for contact tracing for syphilis?

A

Primary - 90 days

Secondary - 2 years

71
Q

What is the lookback period for contact tracing for trichomonas vaginalis?

A

4 weeks

72
Q

What is the lookback period for contact tracing for PID?

A

6 months

73
Q

What is the lookback period for contact tracing for HIV?

A

3 months

74
Q

What conditions is contact tracing not needed for?

A

Genital warts
Genital herpes
Thrush
Bacterial vaginosis

Y3 - Repro (13 decks)

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