STIs Flashcards
Male who don’t sex men STI specimen collection guidelines
First pass urine for PCR - gonorrhoea and chlamydia
Urethral swab
Serology for syphilis, HIV, Hep B ONLY if risk factors
Female STI specimen collection guidelines
First pass urine for PCR - gonorrhoea and chlamydia
Urethral swab
Vaginal swab
Endocervical swab (usually also done w/ pap smears)
Serology for Syphilis, HIV, Hep B only if risk factors
STI specimen collection guidelines for men who have sex with men
First pass urine for PCR - gono, chlamydia
Urethral swab
Anal swab
Throat swab
Serology: HIV, Hep B, Syphilis
What constitutes ‘risk’ indicating serology should be taken for HIV, HepB, Syphilis?
Men who have sex with men IVDU Sex with sex workers Sex workers Tattoos abroad Blood transfusions in some cases
Characteristics of candida infection
White vaginal discharge, cottage cheese consistency
No odour
Normal pH
Itchy, sore, red
Characteristics of Trichomonas vaginalis
Yellow green, malodourous fishy smell, pH elevated
Sore (no itch)
Bacterial vaginosis characteristics
Grey discharge, often profuse and bubbly
Malodourous, fishy
Sometimes irritated
Elevated pH
Characteristics of cervicitis
Thivk yellow-green discharge (will see coming from cervix if VE) Variable smell, but usually malodourous Normal pH Often signs of PID
Features of herpes simplex genital virus,
sx and signs of a first attack
Typically small genital ulcers that are superficially ulcerated, scabbed, red-edged and multiple in number
First onset usually heralded by tingling/burning genital area
Crop of small vesicles then appear, bursting after ~24 hours, leaving sore scabbed ulcerated red lesions
Patient may have fever and feel unwell. FIrst attack typically lasts 2 weeks
Testing for genital herpes?
Swab from deroofed ulcers –> for PCR testing
Advice for herpes?
Dx of herpes can be very distressing for patients
Recurrent disease, with no cure
Symptomatic relief - painkillers, warm compress, warm baths, relax as much as possible, keep lesions dry (can use hairdryer etc), cotton underwear
Aciclovir / valciclovir / famciclovir can be sued, especially in first attack, to reduce length of symptoms and severity of lesions
Advise abstinence during active lesion phase
Recommend support group / services for education and psychological suppor
Condoms offer good but not absolute protection in general
Presentations of syphilis - primary
Primary - chancre lesion that is painless, accompanied by regional lymphadenopathy
Secondary syphilis presentation
Coarse, non-itchy macropapular rash
Constitutional symptoms
Mucous membrane lesions
Condylomata Lata (multiple genital lesions resembling genital warts but with exudate)
Features of early latent, late latent syphilis
No clinical features but positive serology
Features tertiary syphilis
Rare these days
CV issues
Neurosyphilis
