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NMF: Obs & Gynae > STIs > Flashcards

STIs Flashcards

1
Q

Which is the most commonly reported bacterial infection in STI clinic?

A

chlamydia

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2
Q

What % of people are asymptomatic in chlamydia?

A

WOMEN: 70-80% MEN: 50%

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3
Q

Which STI stains as a gram negative intracellular diplococcus?

A

gonorrhoea

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4
Q

Give some complications of chlamydia

A

-PID (affects 9% of women) - tubal disease - chronic pelvic pain - transmission to neonates - Reiter’s: conjunctivitis, reactive arthritis and urethritis

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5
Q

How does chlamydia present in females?

A
  • abnormal bleeding eg PCB and IMB - lower abdominal pain - dyspareunia - mucopurulent cervicitis
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6
Q

How do men present with chlamydia?

A
  • milky discharge - urethritis
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7
Q

What are the complications of PID?

A

It increases the risk of ectopic pregnancy by 10x and carries a 15-20% risk of tubal factor infertility

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8
Q

When can you test chlamydia?

A

14 days post sexual

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9
Q

How do you test chlamydia and gonorrhoea?

A

female- HVS or vulvovaginal swab

male - first void urine also: rectal, throat, and eye swabs

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10
Q

Can you culture chlamydia?

A

no

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11
Q

By which method are chlamydia and gonorrhoea test samples tested?

A

NAAT - nucleic acid amplification testing

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12
Q

How to treat chlamydia?

A

1st line = doxycycline 100mg BD for 7 days

azithromycin 1g

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13
Q

When is test for cure done in chlamydia?

A

pregnancy

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14
Q

How long should patients abstain from sex after completing their treatment for chlamydia?

A

1 week (once course has finished)

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15
Q

Which serotypes of chlamydia are associated with lymphogranuloma venereum infection in MSM?

A

Serotypes L1,L2 &L3

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16
Q

What % of people with gonorrhoea are asymptomatic?

A

men - 10% women - 50%

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17
Q

How does gonorrhoea present in men?

A

mucopurulent urethral discharge, dysuria

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18
Q

How does gonorrhoea present in women?

A

inc/altered vaginal discharge, dysuria, pelvic pain

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19
Q

How do you treat gonorrhoea?

A

ceftriaxone 500mg IM and test for cure at 2 weeks

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20
Q

Which sub-species of herpes simplex is more likely to cause genital herpes?

A

HSV-2 - also has higher viral shedding so more likely to be transmitted

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21
Q

Describe symptoms of primary genital herpes

A

up to 3 weeks of blistering and ulceration of external genitalia + pain + external dysuria + discharge + local tender lymph nodes + fever + myalgia

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22
Q

How long does a secondary genital herpes attack tend to last?

A

5-7 days

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23
Q

How do we treat genital herpes?

A

Antiviral PO eg aciciclovir 400mg 3x/day for 5 days

24
Q

What is the most common viral STI?

A

HPV

25
Q

Name some clinical presentations of HPV

A

anogenital warts, palmar and plantar warts, cellular dysplasia/ intraepithelial neoplasia

26
Q

Give 2 treatments for HPV warts

A

podophyllotoxin imiquimod

27
Q

What is the infective organism in syphilis?

A

treponema pallidum

28
Q

In which type of syphilis is a chancre seen?

A

primary

29
Q

Describe some symptoms of secondary syphilis

A
  • Maculopapular rash on palms and soles
  • snail track mouth ulcers
  • generalised lymphadenopathy
  • alopecia
  • condylomata lata (ulcer)
30
Q

How do you diagnose syphilis?

A

viral swab for PCR

31
Q

How do you treat syphilis?

A

long-acting IM penicillin once if early, 3x if late

32
Q

Which STIs do we follow-up?

A

syphilis at 3, 6 and 12 months, all in pregnant women, gonorrhoea 2 weeks after treatment

33
Q

Where can chlamydia infect?

A

urethra, rectum, endocervix, eyes and throat

34
Q

How does trichomonas vaginalis present?

A
  • yellow/green vaginal discharge
  • offensive smell
  • irritation
  • strawberry cervix
35
Q

how do you treat trichomonas vaginalis?

A

oral metronidazole

36
Q

How does bacterial vaginosis present?

A
  • grey fishy vaginal discharge
  • pH >4.5
37
Q

What risks are associated with bacterial vaginosis?

A

pre-term labour, intra-amniotic infection in pregnancy, susceptibility to HIV and post-termination sepsis

38
Q

Which organism causes bacterial vaginosis?

A

gardnerella vaginalis

39
Q

Which genital infections is indicated by the presence of “Clue cells” on microscopy?

A

bacterial vaginosis

40
Q

How do you treat pubic lice?

A

malathion lotion

41
Q

In which condition, are genital lesions described as looking like cauliflower seen?

A

genital warts caused by HPV

42
Q

Which condition is this, how would you test it and treat it? “ A 28 yr-old woman presents with several attacks of painful small blisters that turn into pustules. She also describes difficulty passing urine”

A
  • genital herpes ( most likely caused by HSV-2) - swab deroofed lesions for viral PCR - antiviral eg aciclovir
43
Q

Which condition is this, how would you test it and treat it? “ A 30-year-old male with ulcerated penis and enlarged lymph nodes following unprotected sex in Thailand” ?

A

Syphilis (treponema pallidum) Swab lesion for PCR Penicillin IM long-acting

44
Q

Which condition is this, how would you test it and treat it? “ A 28-yr-old male with pain when passing urine and a yellowy urethral discharge after having sex with a prostitute. “

A

Gonorrhoea PCR IM ceftriaxone

45
Q

Which condition is this, how would you test it and treat it? “ A 19-yr-old female with thick white vaginal discharge and intense vulval itch”.

A

candida albicans infection (NOT AN STI) no test topical clotrimazole

46
Q

Which condition is this, how would you test it and treat it? “ A 28 year old woman with yellow vaginal discharge and vulval irritation. Slide looks like strawberry vagina.”

A

trichomonas vaginalis no test treat: metronidazole and also treat partner

47
Q

Which infections are treated with metronidazole?

A

Bacterial vaginosis Trichomonas vaginalis

48
Q

When can you test for a) chlamydia b) gonorrhoea c) HIV d) syphilis post-exposure?

A

a) 14 days b) 14 days c) 3 months d) 3 months

49
Q

Which STIs are viral?

A

HPV

HSV

50
Q

Which STIs are bacterial?

A
  • chlamydia
  • gonorrhoea
  • syphilis
  • bacterial vaginosis
51
Q

What is trichomonas vaginalis?

A

a parasite

52
Q

Select the organism that causes a sexually transmitted infection. It does not stain with Gram stain. It is an intracellular organism that produces both elementary bodies and reticulate bodies during its reproductive cycle. It is diagnosed by PCR.

A

chlamydia

53
Q

Which organism is an STI that does not stain with gram-stain and is a spirochete?

A

treponema pallidum

54
Q

How does late stage syphilis present?

A

cardio or neuro complications

55
Q

what is HAART?

A

A combination of 3 drugs from at least 2 different drug classes to which the virus is susceptible

NMF: Obs & Gynae (12 decks)

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