STIs Flashcards
HPV presentation and investigations
Human papilloma virus
Epidemiology: most common STI
Presentation: muscosal and anogenital warts, vaginitis, painless anywhere in genital area- don’t ulcerate
IX and dx: clinical, biopsy genome analysis, normally spontaneously resolves.
HPV
Pathophysiology
Virus ds DNA
Many strains
HPV 16&18 most severe and most common
18&28 predispose to cervical cancer
HPV treatment
Resolves spontaneously.can relapse
Prevention: screening cervical Pap smear (papanicoloau) to identify women aged 21 and over every 3 years, every 5 years after 30 until age 65
Vaccine protects against 6 11 16 18
Second most common STI? Name and type of pathogen
Chlamydia trachomatis
Obligate aerobe gram negative
Intracellular so replicates inside host forming an infective body and infecting other cells
Presentation of chlamydia
Trachomatis
Men: urethritis, stinging, effect erection, can affect other regions eg. Prostate, conjunctivitis, epididymus urethra
Women: asymotomatic,
urethritis (dysuria and frequency) if affected urethra. Can bypass and spread to Fallopian tubes without symptoms
Cervicalis: mucopurelent cervicalis
Salpingitis (fallopian) perihepatitis (referred pain to liver and shoulder)
Bleeding, post coital/intermittent. Lower abdominal pain, discharge
Complications of chlamydia
Men: acute epididymitis : reiters syndrome. - urethritis -Conjunctivitis -Arthritis
Females: PID
Neonates can also be affected leading to pneumonia
Diagnosis of chlymadia
Endocervical and urethral swab–> nucleic acid amplification test- often with gonnorrhea (no pus!)
Urine sample, less sensitive clubs bars
Conjuctivial swab in neonates
Treatment of chlymadia
Doxycycline (tetracycline)
Azithromycin (macrolides) give to children and tetras stain teeth or to those who won’t complete course
Systemic if conjunctivitis
Name infections that commonly causes genital skin warts and urtethritis
HSV: herpes simplex, extensive PAINFUL ulcers. Recurr
HPV: painless, non ulcerating
Syphyllis causes warts but not urethritis
Full name for HSV
Commin strains
Pathophysiology
Presentation
Herpes simplex virus
Encapsulated ds DNA
Genital ulcers, painful, can cause inguinal lymphadenopathy, fever and malaise, recurrent - relapse and can cause dorsal root ganglia problems
Ivx: PCR of fluid or ulcer
Treat: acidclovir (prophylaxis if recurrent)
Neisseria gonorhea
Type of pathogen
Presentation and complications
Gram negative diplococci
Intracellular
Males: urethritis, with complications as can spread
Females: asymptomatic
acute cervicitis, with DISCHARGE and urethral syndrome, pain or burning when pee. Post coital/intermittent bleeding, like chlymadia
Comps: can cause pelvic inflammatory disorder, Rubio ovarian abscess, bartholinitis
Both: disseminated gonococcal infections causing joint pain tenosynovitis and rash
Complications And presentation is similar to chlaymadia test both
Diagnosis of Neisseria gonnorrhea
Treat
Fragile pathogen so bedside
NAAT (urine)
Swab
Treat: cefriaxone
Syphillis
Full name
Epidemiology
Treponema palladium
MSM>women
Syphyliss presentation treatment and diagnosis
1) Painless ulcer
2) fever rash lymphadenopathy
3) neuro symptoms: cvs adhesions (gummas- local destruction)
Diagnosis: can’t be grown and cultured so microscopy
Serology screening and antibody/antigen tests
- rapid plasma reagin (RPR titre)
TP particle agglutination
Response to treatment
Pcomplications:
Thin frothy smelly discharge Condition Causative organism Other symptoms Treatment
Trichimonas vaginalis
Motile flagella protozoa
Thin frothy smelly discharge
Irritation dysuria inflammation
Culture and treat with metronidazole
