STIs Flashcards

Question

Risk factors for BV?

Answer 1

Black race Unprotected sex with male partner Female partner HIV

Answer 2

Greyish discharge PH >4.5 Clue cells Amine odor on addition to KOH POC tests not very reliable

Answer 3

Metronidazole orally BD or Metronidazole applicator or Clindamycin cream In pregnancy generally oral treatments preferred, women should absolutely be treated. Avoid tinidazole

Answer 4

Sexually transmitted parasite Prevalence increases with age

Answer 5

Strawberry cervix Dysuria, vaginal discharge, itching, burning, dyspareunia

Answer 6

NAAT Saline wet mount and culture possible

Answer 7

Metronidazole BD for 7/7 Or 2g PO for men Treat partners! Repeat tests in 3 months to ensure its gone

Answer 8

LBW Preterm delivery

Answer 9

Candida albicans

Answer 10

Erythema of labia Clumpy white discharge Pruritis most common symptom Sattelite lesions like nappy rash Wet prep with pesudohyphae

Answer 11

PH is usually normal, if >4.5, consider concurrent BV or TV Cultures not useful Can sometimes see yeast on KOH prep

Answer 12

Immunocompetent host not had recurrent infections Mild to moderate symptoms Tx: It responds to shorter courses such as fluconazole single dose or creams such as clotrimazole

Answer 13

7 days of vaginal imidazoles such as clotrimazole (NO fluconazole)

Answer 14

Seen in estrogen deficiency such as postpartum, postmenopausal, In younger women assoc with breast feeding, female athletes who are not menstruating, women on tamoxifen or with ovarian dysfunction

Answer 15

Thin, scanty often bloody discharge

Answer 16

Relatively rare cause of purulent vaginitis Typically seen in pre-pubertal females – Vulvar erythema – Purulent vaginal discharge, itching, pain – PMN’s, cocci on vaginal wet prep Recurrent vaginitis in older women Associated carriage (rectal, oral) of identical GAS strains in male partners Eradication of carriage in partners and patients effected cure of vaginitis recurrence

Answer 17

Syphillis typically Painless whereas chancroid is painFUL

Answer 18

It won't prevent you getting it but it does mean outbreaks of HSV-2 less severe

Answer 19

The first year is the worst, outbreaks will be roughly 4x a year After this will get better

Answer 20

PCR or culture PCR preferred Step 1: IgG assay Step 2: Confirm with a 2nd test that uses a different antigen

Answer 21

Acyclovir TDS for 7-10 days

Answer 22

Avoid sex with lesions Condoms will reduce transmission by 30% Suppressive antiviral therapy

Answer 23

First episode is severe Outbreaks much less frequent Shedding much less frequent

Answer 24

A prodorme of fevers, chills, malaise Umbilicated lesions start on face and spread outward to palms and soles and can be painful

Answer 25

PCR Tx is mostly supportive care as is mild in immunocompetent Can use Tecovirimat

Answer 26

Treat anyone immunocmpromised, extremes of age, pregnancy, people with atopic dermatitis Tx the severe cases infection which involves eye, mouth or other anatomic areas

Answer 27

6 and 11 cause warts 14 and 16 cause cancer

Answer 28

Generalised rash Condyloma lata Fever, malaise, generalized, lymphadenophathy, alopecia, interstitial keratitis, uveitis, liver/kidney involvement

Answer 29

Seen in secondary syphillis NOT Condyloma acuminata Look like warts, but are fleshy and soft topped not verrucous Indicative of high number of treponemes Highly contagious Occur at moist body sites

Answer 30

This is the positive treponema serology in the absence of clinical manifestations <1yr is early latent >1yr is late latent 2/3 of people with untreated syphillis will remain in the latent stage

Answer 31

Meningitis, chronic or acute meningitis Meningovasuclar, think about this when stroke in young person Parenchymatous disease Posterior column (tables dorsalis) which is ataxia, charcot joint, lightening pain in the legs and optic nerve degeneration

Answer 32

Non treponema tests, not specific to T Pallidum Can quantify the titre Used to follow treatment response RPR is 1 to 2 dilutions higher that VDRL, therefore always use the same test when monitoring

Answer 33

TP-PA and FTA-ABS are qualitative tests, not quantitative EIA: treponemal test often used for screening

Answer 34

Early syphilis (primary, secondary, early latent) – BZN PCN (L-A) single dose IM 2.4 million units Late latent – BZN PCN (L-A) IM 2.4 million units weekly x 3 doses (7.2 million units) Neuropsyphilis -Aqueous PCN G 18-24 million units/day x 10-14 days • Procaine PCN G 2.4 million units/day PLUS probenecid 500 mg PO qid x 10- 14 days • Ceftriaxone 2 g IV daily x 10-14 days (alternative)

Answer 35

• Risk increases with age • Acute conditions: – recent viral illness/immunization – pregnancy (uncommon) • Chronic conditions: – autoimmune disease (SLE, RA) – hypergammaglobulinemia – IDU