STIs Flashcards
What are the common bacterial STIs?
Chlamydia
Gonorrhea
LGV (lymphogranuloma venereum)
Syphillis
What is Lymphogranuloma venereum?
STD caused by L1L2 and L3 strains of chlamydia trachomatis.
In the area of sex. Eg vaginal or penis will get inguinal abscesses. Anus will get rectal/proctocolitis symptoms.
Primary - ulcer most don’t see. Then secondary - lymph.
Dx- serology
Rx - Abx or drainage. Doxycycline or erythromycin.
Which are the common parasitic STDs?
Trichomonas vaginallis
Which are the common viral STDs?
HSV
HPV
HIV
Molluscum contagiosum
What’s the difference is testing in asymptomatic and symptomatic women in a GU clinic?
As- self-swab of vagina (NAAT for GC and CT) and mouth/rectum if required. Blood for hiv/hep and syphilis
Above plus these for symptomatic cervical swab (NAAT for gc and ct) and Wet slide for TV. And DGM/HSV swabs if required.
What are the different methods of emergency contraceptives?
1) 1.5mg levonorgestrel (upostelle) taken within 72 hours (sooner the better)
2) ulipristal acetate (ellaOne). 30mg within 120hrs.
3) copper coil (IUD) - within 5 days.
Chlamydia in women:
Signs
Dx
Rx
80% asymmptomatic. Or - cervicitis, purulent discharge, bleeding, tenderness, PID.
Dx- Swab NAAT
Rx- azithromycin 1g stat or doxycycline 100mg bd 7d or erythromycin 500mg bd 10-14d.
Chlamydia in men:
Signs
Complications
50% asymp.
Discharge, dysuria, pain in testis, proctitis.
Complications- epididymitis
Gonorrhoea:
Signs
Dx
Rx
Mucoid purulent discharge and inflammation
Dx- NAAT and culture. and micro showing gram negative diplococci.
Rx- Ceftriaxone 500mg IM stat and azithromycin 1g PO stat.
Genital warts:
Signs
Dx
Rx
Lumps either solitary or multiple. Bleeding, itch, hyperpigmentation can occur.
Dx - clinical. If atypical biopsy for ?ca.
Rx - 1’podophyllotoxin cream or solution (avoid in pregnancy). 2’ cryotherapy.
Which HPV commonly cause genital warts?
6 and 11
Pelvic inflammatory disease:
Signs
Dx
Rx
Pelvic pain, deep dyspareunia, irregular menses, IMB/PCB, vaginal discharge. Cervical excitation- motion tenderness, Adnexal discomfort, pyrexia.
Dx- cervical swab - NAAT. Cervical swab for micro. Bi-manual is necessary. Not responding to therapy US or laparoscopy.
Rx - doxycycline, or ofloxacin.
In preg- azithromycin, and metronidazole.
Herpes simplex virus
Signs
Dx
Rx
First episode 2-12 days post virus contact - febrile illness, dysuria, painful lymphadenopathy, tingling/neuropathic pain in genitals bum or legs, painful blisters/ulcers (multiple).
Recurrent episodes- neuropathic prodrome (tingling/burning), erthyma, blisters, ulcers. Last 3-4 days.
Dx- PCR HSV swabs.
Rx- 5 days aciclovir, valaciclodar, famciclovir. Bath in salt water.
Causes on genital ulceration?
Herpes Syphillis LGV Donovanosis Chancroid Bechets syndrome
Urethritis (NSU)
Signs
Dx
Rx
Dysuria, discharge, urinary freq
Dx - of exclusion, need to rule out balanitis, penile herpes, warts, cystitis.
NSU - more than 5 leucocytes per high-powered field, on gram stained urethral smear.
Rx- doxycycline or azithromycin.