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General practice 2023 > STIs 2 > Flashcards

STIs 2 Flashcards

1
Q

gonorrhea

A

reduced susceptibility to first line treatment is emerging in urban australia
caused by neisseria gonorhhoae

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2
Q

clinical presentation of gonorrhea

A

anal and pharyngeal infections are usually asymptomatic
penile urethral gonorrhea is usually symptomatic
causes penile urethral discharge, dysuria, vaginal discharge, dyspareunia with cervicitis, conjunctivitis, anorectal symptoms

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3
Q

complications of gonorrhea

A

epidydimo-orcitis (uncommon)
prostatitis
PID
bartholin gland abscess
disseminated disease (rarely)
meningitis or endocarditis (raarely)

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4
Q

diagnosis for gonorrhea

A

always collect samples when treating to contribute to antimicrobial reesistance surveillence but never delay treatment while waiting for these culture results
first pass urine NAAT - less sensitive
penile urethral swab
clinician collected or self collected vaginal swab
for men who have sex with men, always aalso collect an anal and pharyngeal swab

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5
Q

gonoccoccal culture

A

high specificity and allows for antibiotic susceptibility testing
much less sensitive than NAAT
clinicians must specify ‘gonococcal culture’ rather than general culture

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6
Q

treatment for uncomplicated genital and anorectal infection gonorrhea

A

ceftriaxone 500mg stat
PLUS
azithromycin 1g PO stat

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7
Q

is gonorrhea notifiable

A

yes

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8
Q

other management for gonorrhea

A

no sexual contact for 7 days after treatment is commenced, or until the course is complete and symptoms resolved, whichever is later
no sex with partners from the last 2 months until they have all been tested and treated
recommend partner notification
provide patient fact sheet
notify the state

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9
Q

test of cure for gonorrhea

A

TOC by NAAT should be performed 2 weeks after treatment is completed

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10
Q

hepatitis A

A

acute infection of the liver
usually from contaminated food and water but faecal-oral transmission can occur during sex, especially in men who have sex with men
care is supporrtive, infection confers lifelong immunity

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11
Q

people at risk of hep A

A

men who haave sex with men
people who inject drugs
aboriginal and torres strait islander people
people in custodial settings
sex workers

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12
Q

symptoms of hep A

A

acute hepatitis: lethargy, nausea, fever, anorexia, jaundice, pale stools and dark urine
usually aysmpomatic in children, more severe illness in elderly and pregnant people
usually resolves in one month

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13
Q

tests for hep A

A

AST, ALT, bilirubin - raised in acute hep
Anti-HAV IgM - raised in acute illness and persists for 3-6 months
anti-HAV Ig- total - previous infection or vaccination

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14
Q

is hep A notifiable

A

yes

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15
Q

hepatitis B

A

anyone with positive hep B surface antigen (HBsAg) needs ongoing monitoring and needs to be considered for treatment
infection causes acute hepatitis, which may progress to chronic infection

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16
Q

hep B clinical presentation

A

asymptomatic infection is common
acute hepatitis - rght upper quadrant pain, lethargy, nausea, fever, anorexia for a few days then jaundice

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17
Q

is hep B notifiable

A

yes

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18
Q

interpreting Hep B serology

A

positive HBsAg - acute or chronic infection
positive anti-HBc - current or past infection
positive ant-HBs - immunity due to past infection or vaccination

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19
Q

how to tell the difference between acute or chronic hep B

A

acute hep B will have highh titre of anti-HBc IgM

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20
Q

HIV

A

treated with anti-retroviral therapy rehardless of CD4+ T cell count
people who achieve and maintain an undetectable HIV viral load cannot sexually transmit the virus

21
Q

symptoms of HIV

A

acute infection - fever, rash, lymphadenopathy, pharyngitis, myalgia, diarrhoea
immune deficiency - multiple symptoms related to declining CD4 T cell couth such as oral thrush, diarrhea, weight loss, skin infections, herpes zoster

22
Q

PEP

A

post exposure prophylaxs can be offered 72 hours after potential HIV exposure

23
Q

PrEP

A

prevention option for HIv negative people

24
Q

lymphogranuloma venerum is caused by

A

chlamydia trachomatis

25
Q

ssymptoms of lymphogranuloma venereum

A

primary: small ulcer/nodule on penis/vulva/anus
secondary: inguino-femoral lympph node swelling
tertiary: chronic proctitis, fistulae, strictures, genital oedema, scarring

26
Q

proctitis is cahacterised by

A

rectal ppain, bleedings, rectal discahrge, tenesmus and changed bowel habit

27
Q

diagnosis of LGV

A

rectal swab: chlamydia NAAT, if positive then LGV specific NAAT

28
Q

treatment of LGV

A

doxycycline 100mg BD for 21 days

29
Q

test of cure for LGV

A

should be perfomed 3 weeks after treatment completion

30
Q

mycoplasma genitalium

A

often asymptomatic
may cause dysuriaa, urethral discharge, urethral discomfort, PID and cervicitis

31
Q

complications of mycoplasma genitalium

A

PID
possible role in tubal factor infertility

32
Q

diagnosis of mycoplasma genitalium

A

FPU, anorectal swab, vaginal swab, endocervical swab and send for NAAT
throat swabs not recommended as pharyngeal infection is uncommon

33
Q

clinical indications for mycoplasma genitaalium testing

A

acute, persistaant non-gonococcaal urethritis
cervicitis
PID
post coital bleeding

34
Q

treatment of mycoplasma genitlaium

A

doxycycline and azithromycin
OR if suspected to be macrolide resistant
doxycycline and moxifloxacin
if PID: moxifloxacin

35
Q

is m genitalium notifiable

A

no

36
Q

syphilis

A

high prevelance in MWHSWM
caaused by treponema pallidum

37
Q

clinical presentation of syphilis

A

50% will hve no symptoms
primary: genital, anal or oral ulcer
realtievly painless with well defined border and firm base

38
Q

seconadary syphilis

A

secondary: systemic illness with fever, malaise, headache, rash and lymphadenopathy
alopecia, mucous patches and condyloma lata
neurological signs of visual changes, tinnitus, deafness and cranial nerve palsies

39
Q

early latent syphilis

A

latent stage
postive serology with no symptoms

40
Q

late latent syphilis

A

infection of more than 2 years
no longer infectious to sexual partners
still able to be transmitted in pregnancy

41
Q

tertiary syphilis

A

complicaations include destructive skin lesions (gammas), cardiovascularr and neurological disease

42
Q

diagnosis of syphilis

A

blood serology, swab of ulcer using PCR swab

43
Q

treatment for sypphilis

A

benzathine benzylpenicillin IMI stat
garish-herxheimer reaction is a common reaction to treatment 6-12 hours after commencing treatment and consists of fever, headache, malaise, rigors and joint pains. treated with analgesics and rest

44
Q

is syphilis notifiable

A

yes

45
Q

trichomoniasis

A

more common in older people
uncommon cause of vaginal discharge or penile urethritis in urban settings
caused by trichomonas vaginalis

46
Q

trrichomonas clinical presentation

A

urethritis
urethral discharge
dysuria
maloderous vaginal dischagre - typically profuse and frothy
vulval itch/soreness
cervicitis

47
Q

diagnosis of trichomonas

A

high vaginal swab or firsst pass urine NAAT

48
Q

treatment of trichomoniasis

A

metronidazole
only notifiable in NT

49
Q
A

General practice 2023 (49 decks)

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