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Urology/Renal > STIs > Flashcards

STIs Flashcards

1
Q

what is the peak age range that chlamydia is diagnosed?

A

18-27

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2
Q

what is the peak age range that gonorrhoea is diagnosed at?

A

for women it is similar to chlamydia ie 17-21 but for men it is 21-33

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3
Q

what are the full names for the bacteria that cause chlamydia and gonorrhoea?

A

Chylamydia trachomatis

Neisseria gonorrhoeae

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4
Q

which parts of the body do chlamydia and gonorrhoea affect in the adult?

A 
urethra
endocervical canal 
rectum 
pharynx
conjunctivia
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5
Q

which parts of the body does chlamydia and gonorrhoea affect in the neonate?

A 
conjunctiva 
atypical pneumonia (specifically chlamydia)
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6
Q

how does CT and GC present in men?

A

dysuria (painful or difficult urination)

urethral discharge

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7
Q

what percentage of people are asymptomatic with GC and CT?

A

gonorrhoea - 10%(M), 50% (W)
chlamydia - 50% (M), 70% (W)
so chlamydia is more likely to be asymptomatic
gonorrhoea is more likely to be asymptomatic in women

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8
Q

what are the complications of chlamydia in men?

A

epididymo-orchitis

reactive arthritis

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9
Q

how does CT and GC present in women?

A

discharge
menstrual irregularity
dysuria

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10
Q

what are the complications of CT and GC in women?

A

pelvic inflammatory disease which leads to:
• tubal factor infertility
• ectopic pregnancy
• chronic pelvic pain

neonatal transmission that causes opthalmia neonatorum or atypical pneumonia on CT

Fitz Hugh Curtis syndrome - liver capsule inflammation leading to the creation of adhesions = peri-hepatitis

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11
Q

How is chlamydia diagnosed?

A

Nucleic Acid Amplification Tests (NAAT) obtained by vaginal swab (best option), endocervical swab, first void urine in women and first void urine in men (best option for men)

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12
Q

how is chlamydia treated?

A

• partner management
• test for other STIs
• azithromycin 1 gram stat or Doxycycline 100mg bd for 7 days
• Erythromycin 500mg bd for 14 days or Azithromycin 1 gram stat in pregnancy (as can’t use tetracyclines in pregnancy eg doxycycline)
review the pt 3 months after treatment

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13
Q

how is gonorrhoea diagnosed?

A

there are more ways to diagnose gonorrhoea than chlamydia:
• microscopy of smears on selective media of genital secretions from the male urethra, endocervical swab, rectum
• culture on selective medium to ensure that it is N. gonorrhoea and not N. meningitidis etc
• sensitivity testing
• Nucleic Acid Amplification Tests (NAAT)

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14
Q

what does gonorrhoea look like under microscopy?

A

gram negative diplococci within the cytoplasm of polymorphs

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15
Q

how is gonorrhoea treated?

A

partner notification
test for other STIs
Continuous surveillance of antibiotic sensitivity
Ceftriaxone (a cephalosporin) 500mg IMI WITH Azithromycin 1 gram orally stat

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16
Q

why is partner notification important in CT and GC?

A
  • Prevent re-infection of index patient

* Prevent complications in asymptomatic contacts

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17
Q

which is more common chlamydia or gonorrhoea?

A

chlamydia (C comes before G)

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18
Q

which has more common asymptomatic carriage GC or CT?

A

chlamydia

19
Q

which of GC or CT has more florid presentation?

A

gonorrhoea

20
Q

which of GC and CT is more common in recent partner change rather than an established relationship?

A

gonorrhoea

21
Q

what is the organism that causes syphilis?

A

Treponema pallidum

22
Q

what is early infectious syphilis?

A 
within 2 years of infection 
there are three types: 
•primary 
•secondary 
•Early latent
23
Q

what is late syphilis?

A 
over 2 years since infection 
there are 4 types:
•late latent 
•CNS
•CVS
•gummatous
24
Q

what should you suspect if you find a genital ulcer?

A

Any genital ulcer is syphilis until proved otherwise

25
Q

Why is gonorrhoea more common in men?

A

due to MSM

26
Q

Which has a shorter incubation period, GC or CT?

A

gonorrhoea

27
Q

for which of gonorrhoea and chlamydia are you less likely to present with complications and why?

A

gonorrhoea as it presents with symptoms and less likely to be asymptomatic so pts are more likely to seek medical help for gonorrhoea

28
Q

why is chlamydia hard to grow in artificial media?

A

it is INTRACEULLULAR

29
Q

which of gonorrhoea and chlamydia imply recent partner change?

A

gonorrhoea

30
Q

how and when does opthalmia neonatorum present?

A

12-24 hours after delivery

large amount of oedema, discharge

31
Q

give two causes of genital ulcers

A

syphilis

herpes simplex

32
Q

why would someone develop early latent syphilis?

A

if their syphilis was not treated when they had the primary and secondary stage

33
Q

give examples of presentations of CNS syphilis

A

dementia
strokes
tabes dorsalis

34
Q

what is tabes dorsalis?

A

demyelination of the dorsal column tracts that normally are involved in fine touch, vibration and proprioception
leads to weakness,diminished reflexes,paresthesias, joint damage due to loss of proprioception

35
Q

give an example of presentations of CVS syphilis

A

Syphilitic aortitis leading to aortic anyeurism and heart failure

36
Q

what is gummatous syphilis?

A

fibrotic ulcers on any part of the body

37
Q

is syphilis more common in men or equal incidence between men and women?

A

more common between men due to MSM transmission

38
Q

what are the features of primary syphilis?

A

generalised systemic infection before primary chancre
primary chancre - in genital skin, nipples or mouth
incubation period 3-5 weeks (9-90 days)
affects regional lymph nodes 1-2 weeks after the primary chancre if not treated
heals without scarring after 4-8 weeks
painless (or less painful than herpes)

39
Q

what are the features of secondary syphilis?

A

onset is 6-8 weeks after initial infection
primary chancre may be present at the same time, or may have no history of primary chancre
most common presentation is a rash - all over the body including palms and soles
mucous membrane lesions, lymphadenopathy, alopecia, hoarseness, bone pain, hepatitis, nephrotic syndrome, meningitis etc

40
Q

how is syphilis transmitted to an unborn child?

A

transplacental transmission

41
Q

what is the transmission rate of syphilis that is primary/secondary and early latency?

A

primary/secondary - 90%

early latency - 40%

42
Q

how is syphilis diagnosed?

A
  • early moist lesions - soft warts, can collect fluid from these and do microscopy
  • SEROLOGY - is maintstay though
  • rash can confirm or refute diagnosis
43
Q

what are the different types of serological tests for syphilis?

A

screening enzyme immunoassay
confirmatory tests for a positive screening result is the treponema pallidum particle agglutination test TPPA
to see how active the disease is do: non-treponemal test VDRL or RPR

44
Q

what is the treatment and management of syphilis?

A

penicillin by injection
follow up pt
partner notification

Urology/Renal (14 decks)

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