STIs Flashcards
presentation of LGV chlamydia?
rectal pain
discharge
bleeding
proctitis
who gets LGV chlamydia?
MSM
profuse mucopurulent discharge from the penis and painful urination…
gonorrhoea
what STI can cause PID?
chlamydia
highest age incidence of chlamydia?
20-24
female presentation of chlamydia?
post-coital/intermenstrual bleeding
lower abdo pain
dyspareunia
mucopurulent cervicitis
main red flag for chlamydia in women?
post coital/intermenstrual bleeding
male presentation of male chlamydia?
urethral discharge dysuria urethritis epididymoorchitis proctitis
complications of chlamydia?
PID tubal damage chronic pelvis pain neonatal transmission conjunctivitis reiters
Ix for chlamydia and when should it be done?
vulvovaginal swab 14 days after exposure
first void urine in men +/- rectal or oral swab if MSM
Tx of chlamydia
doxycycline 100mg bd for 7 days
mycoplasma genitaliun is associated with what symptoms?
non gonoccocal urethritis
PID
Ix of mycoplasma genitalium
vulvovaginal swab (f) first void urine (m) \+/- rectal or oral swab
gonorrhoea presentation?
urethral discharge ++
dysuria
CAN BE ASYMPTOMATIC
gonorrhoea where can particularly be asymptomatic?
rectal gonorrhoea
primary sites of infection of gonorrhoea?
mucous membranes of: urethra endocervix rectum pharynx
incubation period of gonorrhoea?
2-5 days
female presentation of gonorrhoea?
asymptomatic
increased/altered discharge
dysuria
pelvic pain
how common is asymptomatic gonorrhoea in women?
50%
lower GU complications of gonorrhoea?
bartholinitis
tysonitis
periurethral abscess
epididymitis
upper GU complications of gonorrhoea?
endometritis PID infertility ectopic prostatitis
Ix of gonorrhoea
screening swabs for microscopy +/- culture
2nd line treatment of gonorrhoea?
cefixime 400mg oral
incubation period of genital herpes?
3-6 days
duration of genital herpes?
2-3 weeks
presentation of herpes?
blistering and ulceration of the external genitalia pain external dysuria vaginal/urethral discharge local lymphadenopathy fever and myalgia (prodrome)
prodromal features of genital HSV
fever
myalgia
how many recurrent attacks will you get from genital HSV1
1 attack every 12-18 months
how many recurrent attacks will you get for genital HSV2
4-6 per year
herpes gets less severe over time T or F
T
describe the distribution of recurrent herpes?
unilateral, small blisters and ulcers
when should recurrent episodes of GHSV resolve?
5-7 days
Ix herpes
swab base of ulcer for HSV PCR
Tx of herpes (include dose and duration)
oral aciclovir 400mg TDS for 5 days
saline bathing
analgesia
viral shedding is common in HSV_
2
what prophylactic medication is given for HSV?
aciclovir 400mg bd for a year
when would you qualify for recurrent HSV?
if youre having 6 or more attacks per year
Ix of suspected herpes in 3rd trimester of pregnancy?
specific serology + HSV NAAT
most common viral STI in the UK?
HPV
name the low risk strains of HPV
6 and 11
name the high risk strains of HPV
16 and 18
what strains of HPV cause anogenital warts?
6 and 11
what strains of HPV cause palmoplantar warts?
1 and 2
incubation period of HPV?
3 weeks to 9 months
transmission of more than one HPV type is common T or F
T
how successful is genital warts treatment?
60% success
lower success rate in immunosuppressed
Tx of genital warts
- podophyllotoxin
- imiquimod (except if anal warts, 1st line)
- cryotherapy
1st line Tx for anal warts?
imiquimod
Tx for genital warts in a pregnant woman?
cryotherapy only
what stages of syphilis are symptomatic?
primary
secondary
how long after onset of disease do you fall into the late latent category of syphilis?
2yrs
mean incubation period of syphilis
3 weeks
chancres are always painful T or F
F, can sometimes be sore
describe systemic symptoms of primary syphilis?
non-tender local lymphadenopathy
incubation period of secondary syphilis?
6 weeks - 6 months
presentation of secondary syphilis?
wart like lesions that ooze clear fluid generalised LNs lesions of mucous membranes skin rash on palms and soles patchy alopecia
Ix for primary syphilis
- viral swab for PCR
2, serological testing (TTPA) and RPR (non treponemal)
what do non-treponemal serological tests do?
measure of the activity of the disease to see how well its responding to treatment
Tx of early syphilis
2.4 mu benzathine penicillin x1
Tx of late syphilis
2.4mu benzathine penicillin x3
when should you stop measuring RPR?
when it becomes negative
signs of chlamydia infection in babies?
conjunctivitis
