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Repro > STIs 2 > Flashcards

STIs 2 Flashcards

1
Q

commonest bacteria STI

A

chlamydia

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2
Q

mocopurulent discharge from the penis and painful urination is what

A

gonorrhoea

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3
Q

chancre develops at what stage of syphilis

A

primary

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4
Q

which infection leads to PID in women

A

chlamydia

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5
Q

which STI is known as the great imitator because its symptoms resemble other infections

A

syphilis

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6
Q

when is the HPV vaccine recommended for females

A

11-13

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7
Q

viral shedding is higher with which type of genital herpes simplex virus

A

HSV 2

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8
Q

chlamycida - GS
transmission
age

A

GN bacterium
vaginal, oral, anal
20-24s

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9
Q

pathogenesis of chlamydia

A

unclear
chlamydia can cause PID in 50%
PID increases risk of ectopic preg by 10% and carries a risk of tubal factor infertility of 15-20%

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10
Q

presentation of chlamydia in a female

A

post coital or inter menstrual bleeding
lower abd pain
dyspareunia
mucopurulent cervicitis

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11
Q

male presentation of chlamydia

A

urethral discharge
dysuria
urethritis
epididymis-orchitis

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12
Q

cx of chlamydia

A

PID
tubal damage
chronic pelvic pain
tranmission to neonate (17% conjunctivitis, 20% pneumonia)
adult conjunctivitis - occaisionally
sexually acquired reactive arthritis /reiters - commoner in men
Fitz - high - curtis syndrome (perihepatitis)

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13
Q

dx and rx of chlamydia

A

test 14 days following exposure
NAAT - females (vulvovaginal swab), males - first void urine
MSM - add real swab if receptive anal sex

azithromycin 1g stat
doxycycline 100mg BD x 1 week if rectal chlamydia

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14
Q

gonorrhoea GS

sites of infection

A

GN intracellular diplococcus

mucous membranes of urethra, endocervix, rectum and pharynx

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15
Q

incubation/transmission of G

A

incubation period of urethral infection in men is shorter (2-5days)
20% of risk from infected women to male partner
50-90% risk from infected man to female partner

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16
Q

presentation in males - G

A

asymp in less than 10%
urethal discharge - purulent and green/yellow
dysuria
pharyngeal/rectal infections which are mostly asymp

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17
Q

females presentation - G

A

asymp in almost 50%
increased/altered vaginal discharge in 40%
dysuria
pelvic pain in <5%
pharyngeal and rectal infection are usually asymp

18
Q

cx of G

A

3% in females and <1% in males

lower genital trat - bartholinitis, tysonitis, periurethral anscess, rectal abscess, epididymitis, urethral stricture

upper genital tract - endometritis, PID, hydrosalpinx, infertility, ectopic pregnancy, prostatitis

19
Q

cx of G

A

3% in females and <1% in males

lower genital trat - bartholinitis, tysonitis, periurethral anscess, rectal abscess, epididymitis, urethral stricture

upper genital tract - endometritis, PID, hydrosalpinx, infertility, ectopic pregnancy, prostatitis

20
Q

dx of G

A

microscopy - urethral 90-95% sensitivity, endocervical 37-50% sensitivity

culture >95% sensitivity (male urethra), 80-92% sensative (female endocx)

NAATs>96% sensitiivty (both in symp and asymp)

21
Q

rx of G

A

ceftriaxone 500mg IM 1st line
cefixime 400mg PO - if IM injection contra indicated or refused

azithromycin 1g given regardless of chlamydia result

test of cure in all px

22
Q

genital herpes pattern

A

primary infection
non primary first episode
recurrent infection

23
Q

GH primary infection incub
duration
symptoms

A

3-6 days
14-21 days

blistering and ulceration of the external genitalia
pain
external dysuria
vaginal or urethral discharge
local lymphadenopathy
fever and myalgia
24
Q

recurrent episodes GH
more common with what
mis dx as what
symptoms

A

more common with HSV2

thrush

unilateral small blisters and ulcers, minimal systemic symptoms

resolves within 5-7 days

25
Q

management of GH

A 
swab base of ulcer for HSV PCR
oral acyclovir
consider topical lidocaine if painful 
saline bathing 
analgesia
26
Q

viral shedding common with which type
when
who
reduced by what

A

following HSV 2 is commoner than for HSV 1

more frequent in the first year of infection

more individuals with frequent recurrences

reduced by suppressive therapy

27
Q

HPV is the commonest what

life time risk of acquiring it

A

viral STI in the UK

80%

28
Q 
HPV genotypes
total
certain 
low risk
high risk
A

> 170
40 infect anogenital epithelium
6, 11, 42, 43, 44
16, 18, 31, 33, 35, 45, 51, 52, 66

29
Q

HPV transmission

incub

A

80% of the population are exposed
10% harbour detectable infection
1% develop anogentail warts

likely to have acquired form asymp partner

incub 3 weeks to 9 months

30
Q

HPV immunology

A

spontaneous clearance of warts 20-34%
clearance with treatment 60%
persistence despite treatment 20%

31
Q

anogenital warts caused by which type of HPV

A

> 90% by 6/11

32
Q

HPV treatment

A

podophyllotoxin (wart icon) - cytotoxic, not licensed for extra genital warts

iminquimod - immune modifier, for all anogenital warts

cryotherapy - cytolytic can require repeat treatments

electrocautery

33
Q

HPV vaccination

A

MSM and HIV+ included

34
Q

syphillis transmission

classification

A

sexual contact, transplacental/during birth, blood transfusions, non sexual contact

congenital, acquired

35
Q

acquired syphilis types of infections

A

early have primary, secondary and early latent

late non infectious have late latent and tertiary

36
Q

primary syphilis incub period
lesion
sites
other signs

A

9-90 days (mean of 21days)
lesions - primary chancre - painless, appear at site of inoculation
sites are genital 90% of the time

non tender local lymphadenopathy

37
Q

secondary syphilis
incub period
signs

A

6 weeks - 6 months

skin - macular, follicular/pustular rash on palms and soles
lesions of mucous membranes
generalised lymphadenopathy
patchy alopecia
condylomata lata (most infectious lesion in syphilis)

38
Q

dx of syphilis

A

demonstration of trepnonema palladium from lesions of infected LNs - dark field microscopy, PSCR

serological testing - detects AB to pathogenic treponemes

39
Q

serological testing in syphilis

A

non-treponema - VDRL, RPR (rapid plasma reagin)

treponema - TPPA, ELISA/EIA (screening test), INNO-LIA, FTA abs

40
Q

rx and follow up in syphilis

A

early - 2.4 MU benzathine penicillin x1

late 2.4 MU benzathine pencilline x3

until RPA is negative to serofast
tires should decrease fourfold by 3-6 months in early
serological relate/reinfection if titres increase by fourfold

Repro (56 decks)

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