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Repro > STIs > Flashcards

STIs Flashcards

1
Q

Bacterial STIs?

A

Chlamydia
Gonorrhoea
Syphilis

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2
Q

Viral STIs?

A

Genital warts (HPV)
Genital herpes
Hepatitis and HIV

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3
Q

Parasitic STIs?

A

Trichomonas vaginalis
Pubic lice
Scabies

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4
Q

Predisposing factors for candida infection?

A

Recent antibiotic therapy
High oestrogen levels
Poorly controlled diabetes
Immunocompromised patients

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5
Q

Presentation of candida infections?

A

Itchy

White vaginal discharge

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6
Q

Diagnosis of candida infection?

A

Clinical

HVS for culture

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7
Q

Treatment of candida infection?

A

Topical clotrimazol pessary or cream

Oral fluconazole

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8
Q

What is prostatitis?

A

Rare complication of UTI in men

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9
Q

Symptoms of prostatitis?

A

Symptoms of UTI +/- lower abdo/ back/ perineal/ penile pain

Tender prostate

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10
Q

Diagnosis of prostatitis?

A

Clinical signs

MSSU for c and s

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11
Q

Treatment of prostatitis ?

A

Ciprofloxacin for 28 days

Trimethoprim for 28 days of high c diff risk

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12
Q

What does lactobacillus produce?

A

Lactic acid

Hydrogen peroxide

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13
Q

What are normal vaginal flora?

A

Lactobacillus spp.
Strep viridans
Group B beta haemolytic streptococcus
Candida in small numbers

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14
Q

What is the normal pH of vagina?

A

pH4-4.5

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15
Q

What happens in bacterial vaginosis?

A

Replacement of normal vaginal flora with gardnerella vaginalis and species of anaerobic bacteria

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16
Q

What is vaginal discharge like in bacterial vaginosis?

A

Homogenous

May contain bubbles

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17
Q

What is the whiff test??

A

Adding 10% potassium hydroxide to discharge. +ve test elicits fishy odour

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18
Q

Does bacterial vaginosis have a positive or negative whiff test?

A

Positive

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19
Q

Treatment of bacterial vaginosis?

A

Metronidazole for 7 days

No point treating male partners

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20
Q

What is the commonest bacterial STI in UK?

A

Chlamydia

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21
Q

What organism is chlamydia caused by?

A

Chlamydia trachomatis

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22
Q

Does chlamydia stain with gram stain?

A

No - doesn’t have peptidoglycan in cell wall

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23
Q

Diagnosis of chlamydia?

A 
14 days after exposure 
NAATs or PCR on:
Males - first pass urine sample 
Females - HVS or vulvo-vaginal swab 
Rectal or throat swabs 
Eye swabs
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24
Q

Treatment of chlamydia?

A

Azithromycin if uncomplicated

Doxycycline

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25
Q

What organism is gonorrhoea caused by?

A

Neisseria gonorrhoea

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26
Q

What type of bacteria is neisseria gonorrhoea?

A

Gram negative diplococcus- looks like 2 kidney beans.

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27
Q

Diagnosis of gonorrhoea?

A

NAATs or PCR
Microscopy of urethral/ endocervical swabs
Culture on selective agar plates

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28
Q

Treatment of gonorrhoea?

A

IM ceftriaxone

Oral azithromycin

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29
Q

Advantages of NAATs / PCR over culture

A

Less invasive specimens required
More sensitive
Positive even if organisms dead
Takes hours instead of days

30
Q

Disadvantages of NAATs/PCR over culture

A

Will detect dead organisms

Cannot test antibiotic sensitivities without culture so difficult to track antibiotic resistance

31
Q

What organism causes syphilis?

A

Treponema pallidum - a spirochaete

32
Q

Does treponema pallidum stain with gram stain?

A

No

33
Q

How many stages are in the syphilis illness?

A

4

34
Q

What are the stages of the syphilis illness?

A

Primary lesion - chancre - organism multiplies at inoculation site and gets into bloodstream
Secondary stage - large numbers bacteria circulating in blood with manifestations in different sites
Latent stage - low level multiplication of spirochaete in intima of small blood vessels
Late stage - CVS or neuro complications many years later

35
Q

Diagnosis of syphilis?

A

Dark ground microscopy
Swab for PCR
Serology tests for antibodies

36
Q

Treatment for syphilis?

A

Penicillin

37
Q

What causes genital herpes?

A

Herpes simplex virus type 1 and type 2

38
Q

How is genital herpes spread?

A

Genital/ genital contact or oropharyngeal/ genital contact

39
Q

Diagnosis of genital herpes?

A

Swab deroofed blister for PCR

40
Q

Treatment of genital herpes?

A

Aciclovir

Pain relief

41
Q

What does trichomonas vaginalis cause?

A

Vaginal discharge and irritation

42
Q

Diagnosis of trichomonas vaginalis?

A

HVS for microscopy

PCR

43
Q

Treatment for trichomonas vaginalis?

A

Oral metronidazole

44
Q

How long does a make louse live for?

A

22 days

45
Q

How long does a female louse live for?

A

17 days

46
Q

Treatment of pubic lice?

A

Malathion lotion

47
Q

Presentation of chlamydia in females?

A

Post coital or intermenstrual bleeding
Lower abdo pain
Dysparaneuria
Mucopurulent cervilitis

48
Q

Presentation of chlamydia in males?

A 
Urethral discharge 
Dysuria 
Urethritis 
Epididymo-orchitis
Proctitis
49
Q

Complications of chlamydia?

A

PID
Tubal damage - can lead to infertility and ectopic pregnancy
Chronic pelvic pain
Transmission to neonate
Adult conjunctivitis
Sexually acquired reactive arthritis (SARA) / reiters syndrome
Fitz Hugh Curtis syndrome

50
Q

Incubation period of gonorrhoea in men - (urethral infection )

A

About 2-5 days

51
Q

What is the risk of transmission of gonorrhoea from female to male?

A

20%

52
Q

What is the risk of transmission of gonorrhoea from male to female?

A

50-90%

53
Q

Presentation of gonorrhoea in males?

A

<10% asymptomatic
Urethral discharge
Dysuria
Pharyngeal/rectal infection

54
Q

Prevention of gonorrhoea in females?

A 
<50% asymptomatic 
Increased/ altered vaginal discharge 
Dysuria 
Pelvic pain 
Pharyngeal / rectal infection
55
Q

Lower genital tract complications of gonorrhoea?

A 
Bartholinitis 
Tysonitis 
Periurethral abscess 
Rectal abscess 
Epididymitis 
Urethral stricture
56
Q

Upper genital tract complication of gonorrhoea?

A 
Endometritis 
PID
Hydrosalpinx 
Infertility
Ectopic pregnancy 
Prostatitis
57
Q

Classification of genital herpes ?

A

Primary infection
Non-primary first episode
Recurrent infection

58
Q

Presentation of genital herpes primary infection ?

A 
Blistering and ulceration of external genitalia 
Pain 
External dysuria
Vaginal or urethral discharge 
Local lymphadenopathy 
Fever and myalgia
59
Q

Incubation period of syphilis primary infection

A

3-6 days

60
Q

Duration of syphilis primary infection?

A

14-21 days

61
Q

What is the most common viral STI in UK?

A

HVP

62
Q

How many of the 170 HVP infect anogenital epithelium?

A

40

63
Q

List some low risk HPV types?

A 
6
11
42
43
44
64
Q

List some high risk HPV types?

A 
16
18
31
33
35
45
51
52
66
65
Q

What is the HPV incubation period ?

A

3 weeks - 9 months

66
Q

Treatment of HPV?

A 
Podophyllotoxin 
Imiquimod
Cryotherapy 
Electrocautery
HPV vaccination
67
Q

Incubation period of primary syphilis?

A

9-90 days - mean 21 days

68
Q

Incubation period of secondary syphilis?

A

6 weeks - 6 months

69
Q

Presentation of secondary syphilis?

A 
Skin - macular, follicular or pustular rash on palms and soles 
Lesions of mucous membranes 
Generalised lymphadenopathy 
Patchy alopecia 
Condylomata lata
70
Q

What is condylomata lata?

A

Highly infectious lesion in syphilis

Exudes a serum teeming with treponemes

Repro (39 decks)

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