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GOSH > STIs > Flashcards

STIs Flashcards

1
Q

What is the treatment for Chlamydia?

A

Doxycycline 100mg BD for 1 week
OR
Azithromycin 1mg oral stat

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2
Q

What is the treatment for Gonorrhoea?

A

Ceftriaxone 500mg STAT IM &

Doxycycline 100mg BD 1week/ Azithromycin 1mg oral STAT

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3
Q

What is the treatment for PID?

A

Doxycycline 100mg BD 1week
& Metronidazole 400mg oral BD 1 week &
Ceftriaxone 500mg IM STAT

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4
Q

What is the treatment for Trichomoniasis?

A

Metronidazole 400mg BD 5days

alt: 2mg oral STAT

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5
Q

Which STIs are notifiable diseases?

A

Hep A, B & C

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6
Q

What are major complications of STIs (& which ones)?

A
  • SARA= Chlamydia

- DGI= Gonorrhoea

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7
Q

What is SARA & how is it managed?

A

Sexual acquired reactive arthritis

Abx, NSAIDs, topical steroids for skin, contact tracing

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8
Q

What are RF for SARA/Reiter’s?

A

Psoriasis
Ankylosing spondylitis
Male

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9
Q

What 3 things make up Reiter’s syndrome?

A

Balanitis/urethritis (may see circinate balanitis- erythematous lesions on the penis)
Conjunctivitis
Arthritis

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10
Q

In GUM clinics, what measures are in place to protect confidentiality?

A
  • Caldicott guardians
  • Use of number rather than name
  • No routine communication with GPs
  • No requirement to give name/address/GP details
  • Trace contacts without identifying index case
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11
Q

Do you have to tell a patient you are going to break confidentiality/disclose information?

A

Only disclose if harms likely to arise from non-disclosure are greater than possible harm both to patient and public trust in doctors that may arise from disclosure`

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12
Q

What organism causes chlamydia?

A

Chlamydia Trachomatis

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13
Q

What are the signs & symptoms of Chlamydia?

A 
70% W & 50% M asymptomatic
Cervical motion tenderness
Pelvic pain/tenderness
Dysuria
Purulent discharge
PCB/IMB
Deep dyspareunia
Epididymo-orchitis
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14
Q

How is Chlamydia investigated?

A

NAAT swabs
M: FCU & urethral swab
W: Endocervical/vulvovaginal swab

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15
Q

What are the causes of Gonorrhoea?

A

Exposure to cervical exudates during birth

N. Gonorrhoeae

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16
Q

What are the signs & symptoms of gonorrhoea?

A

Babys: Infection (Conjunctivitis) 2-5days after birth
M: Mucopurulent urethral discharge, dysuria
F: 50% asymptomatic, inc/altered vaginal discharge, dysuria, IMB, dyspareunia
Rectal: Anal discharge, acute proctitis, (peri)anal pain, tenesmus, rectal bleeding

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17
Q

How long does it take from infection to symptoms in Gonorrhoea?

A

10days

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18
Q

How is gonorrhoea investigated?

A 
No earlier than 3days after sex with infected partner
NAAT swabs
Swab for cultures
FPU for men
Endocervical swab for women
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19
Q

What causes Syphilis?

A

Treponema Pallidum

20
Q

What are the signs & symptoms of Syphilis?

A

CHANCRE- non-tender ulcers
Lymphadenopathy
Diffuse rash macules & papules
Neuro: Ataxia, Charcot’s joints

21
Q

What are the signs of congenital syphilis?

A 
Mental retardation
Saddle nose
Sabar teeth
Rhinitis
Hepatosplenomegaly
22
Q

How is Syphilis investigated?

A

Serology: 10mL clotting sample for syphilis screen
Virology swab fro active lesions for PCR
Darkfield microscopy: Visualisation of bacteria= immediate treatment

23
Q

How is Syphilis treated?

A

Partner notification
Benzathine Benzylpenicillin 1.8g IM Single dose
Congenital: IV aqueous Benzylpenicillin
Neuro: Benzylpenicillin Sodium 10.8g/day IV/4hourly & Prednisolone 40mg orally for 3 days
24hours before Penicillin

24
Q

What are the cause of genital warts?

A

HPV 6 & 11

25
Q

What is the incubation time of genital warts?

A

3months

26
Q

How are genital warts treated?

A

No treatment
Self applied: Podophyllotoxin
Specialist: Tricholoracetic acid
Ablative methods: Cryotherapy, excision, electrocautery

27
Q

What do you need to warn women about when using Podophyllotoxin?

A

Teratogenic

28
Q

What is the prognosis for genital warts?

A

No cure
Goal is to eliminate visible lesions
Left alone 10-30% resolve on their own

29
Q

What causes genital herpes?

A

HSV-2

30
Q

What are the signs & symptoms of genital herpes?

A

Multiple painful bilateral blisters
Local oedema
Tingling/neuropathic pain in genital area/lower back/legs/buttocks

31
Q

How is herpes investigated?

A

Swab from base of a lesion for viral culture
PCR
Vulvovaginal swab

32
Q

How is genital herpes treated?

A

Commence within 5days of start of episode
Acyclovir 400mg TDS for 5-10days
Analgesia
Salt water bathing

33
Q

What is bacterial vaginosis?

A

Inflammation caused by overgrowth of natural vaginal bacteria upsetting the natural balance

34
Q

What bacteria can cause vaginosis?

A

Gardnerella vaginalis
Prevotella spp
Mycoplasma
Mobiluncus

35
Q

What is the Amsel criteria diagnostic for & what are the components?

A 
For bacterial vaginosis
>3 of the following:
- Homogenous discharge
- pH >4.5
- Fishy odour
Microscopy showing vaginal epithelial cells coated with large no. of bacilli

Other investigations: High vaginal swab

36
Q

How is bacterial vaginosis treated?

A

Metronidazole 400mg BD for 5-7days

37
Q

What parasite causes public lice?

A

Pthyris Pubis

38
Q

What are the signs & symptoms of pubic lice?

A

Itchy red papules
Blue macule visible at feeding sites (thighs/lower abode)
Scatterings of minute dark-brown specks (louse excreta) on skin & underwear

39
Q

What is the management for pubic lice?

A

Partner notification in the past 3 months
2 applications of Malathion 0.5% aqueous lotion/ Permethrin 5% dermal cream
7 days apart

40
Q

What is scabies?

A

Infestation with the ectoparasite Sarcoptes scabiei, a mite that burrows through the human stratum corneum.

41
Q

What are the signs & symptoms of scabies?

A

ITCH!
Blue spots
Perifollicultits
Track/burrow marks

42
Q

What is crusted scabies a sign of?

A

Immunodeficiency

43
Q

How is scabies investigated?

A

Skin scrapping

Ink burrow test: Ink tracks into burrow marks

44
Q

What is the management for scabies?

A

Within 24hours treat all members of the household, close contact, sexual contacts with topical insecticide
Machine wash at 50degrees
Partner notification within 2months
Topical Permethrin 5% apply twice one week apart

45
Q

How is thrush treated?

A

Fluconazole 1tablet STAT

46
Q

How is epididymitis treated?

A

GC suspected: Ceftriaxone 500mg IM STAT & Azithromycin & Doxycycline
Epididymitis alone: Doxycycline 100mg oral BD 2weeks

47
Q

How is NSU treated?

A

Heterosexual: Azithromycin 1mg oral STAT
MSM: Doxycycline 100mg oral BD 1week

GOSH (17 decks)

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