STIs Flashcards
What are RF for STIs?
<25y/o
Unprotected sex
Sexually active
IV DU
Partner with STI
Immunosuppression
Low socioeconomic status
MSM/Anal
What is the Diagnosis screen for catching STI in men?
first catch Urine mc+s
What is the Diagnosis screen for catching STI in women?
Triple swab (high vaginal NAAT, endocervical NAAT + endocervical charcoal)
What age is a sexual health screen done and how often?
What do they test for?
16-25 y/o
sexually active people annual elective testing
Neisseria Gonorrhoea and Chlamydia trachomatis
If someone is found to have CT or NG, how far back do they contact trace?
CT = contact trace 6 months
NG = Contact trace 2 months
offer test
what is the MC STI in the UK?
Chlamydia
What type of organism is Chlamydia?
gram Negative cocci
What are Sx of chlamydia?
-Dysuria (pain urinating)
-Purulent discharge (smelly)
-cervicitis (PC + IM)
-Proctitis (inflammation of rectum lining)
-Fever
Dx of chlamydia?
NAAT
High vaginal swab
What is the Tx for chlamydia?
10mg PO BD Doxycycline for 7 days
Tx for chlamydia in pregnancy?
1g azithromycin 1 day then 2 days 500mg BD
What is Doxycycline CI and why?
CI in breastfeeding as it can cause fetal teeth discolouration
What are some complications of chlamydia?
-PID
-Lymphogranuloma venerum
-Opthalmia neonatorum (purulent discharge 1-2 weeks post birth)
-Infertility
-Reactive arthritis
What type of organism is gonorrhoea?
gram negative diplococcus
Sx of gonorrhoea?
dysuria
green odourless urethral DC
Cervicitis
proctitis
fever
Dx and Tx of gonorrhoea?
Dx = NAAT
Tx = IM Ceftriaxone 1g stat
Complications of gonorrhoea?
-Opthalmia neonatorum - emergency eye care <48h birth
-Infertility
-Reactive arthritis
-Gonococcal sepsis
-Disseminated gonococcal infection (2^ care, skin and joint involvement)
What is the MC STI worldwide?
Trichomonas vaginalis
What type of organism is trichomonas?
pear shaped flagellated Protozoa
Sx of TRICHV?
Urethritis
yellow frothy DC
Strawberry cervix (colpitis macularis)
cervicitis
Dx of TrichV?
speculum = strawberry cervix
Triple swab - need to do a wet mount swab
may also show high pH like BV (>4.5ph)
Tx for TrichV?
PO 400mg BD Metronidazole 7 days
What want be taken with metronidazole and why?
don’t drink alcohol as it induces severe hypotension and N+V
What does HSV 2 stand for?
Herpes simplex virus
What does HSV 2 cause?
Sx?
Genital ulcers + herpes whitlow (painful infection on finger), and keratitis
+/- LNadenopathy (inguinal)
Dx and Tx for HSV 2?
Dx = PCR
Tx = PO Acyclovir 400mg TDS for 5 days
how is HSV 2 spread?
mucus membranes contact
what is the physiology of HSV and what Sx does it cause as a result?
viral infection - latent in sensory nerve ganglia
trigeminal - cold sores
sacral - genital
Which strains of human papilloma virus (HPV) cause genital issues?
6 + 11
What are the Sx of HPV 6 + 11?
Genital warts (painless)
Tx for HPV 6+11 Genital warts?
Podophyllotoxin cream
Imiquimod cream
Can HPV be prevented and with what?
Gardasil HPV vaccine
What other HPVs are there and what are they associated with?
HPV 16+18 = cervical Ca
What type of organism is syphillus from?
Treponema Pallidum (-ve spirochaete)
What are stage 1 syphillus Sx?
Painless chancre (lesion) - ulceration at genitals, over vulva
What are stage 2 syphillus Sx?
Chancre resolves then:
-snail track ulcers
-diffuse rash (macular pop)
-condyloma lata
-patchy alopecia
What are stage 3 syphillus Sx?
Severe, advanced:
Gummatous lesions = benign hamartous, widespread
CV = AAA, AD
Neuro = Tabes dorsalis (locomotor ataxia - DCML + Cerebellar)
Psychosis, depression, dementia
Argyll Robertson pupils (accommodate but don’t react)
Dx of syphillis?
serology = VDRL, EIA, TPPA
Triple swab and PCR
Tx for syphillis?
stage 1 and 3
IM Benzathine penicillin (penV)
1 = 1.8g stat
3 = 3 x 1dose/week
Complications of syphillis?
High HIV transmission risk
Garish herxheimer reaction (<24hr acute Sx worsening after Tx - likely contents spilling into blood)
