STIs

Question 1

List 8 factors affecting genital tract infection prevelence and explain what is the most common of each.

Answer 1

Age - 15-24
Ethnicity - black most likely 
Socioeconomic status - low bc condoms are expensive, society. 
Sexual partners - more 
Sexual orientation - MSM
Age at first intercourse - lower means more risky behaviour 
Condom use - less use is more likely 
Menstrual cycle - some can be cyclical.

Question 2

Explain the burdens of STIs to the health service and society. (7)

Answer 2

Stigma
Costs to healthcare services
Complications - PID, infertility, ectopic pregnancy, epididymitis.
HPV cancer risk
Syphillis complications - CVS, neuro, opthalmic.
Vertical transmission
Increasing risk of antimicrobial resistance.

Question 3

Describe chlamydia. (4)

Answer 3

Chlamydia trachomatis is an obligate intracellular bacteria that is not seen on gram staining because it has no cell wall. Most common STI in the UK.

Question 4

Describe the symptoms of chlamydia infection in men. (4)

Answer 4

Mild urethritis
Dysuria
Epididymitis
Prostatitis

Question 5

Describe the symptoms of chlamydia infection in women. (4)

Answer 5

Typically asymptomatic
Vaginal discharge
Dyspareuria
Post-coital bleeding

Question 6

Describe possible complications of chlamydia infection. (3)

Answer 6

PID
Conjunctivitis
Reactive arthritis
“Can’t pee, can’t see, can’t bend at the knee.”

Question 7

Describe how chlamydia is investigated. (3)

Answer 7

NAAT - nucleic acid amplification test.
Urine in men
Vulvovaginal swab in women.

Question 8

Describe the treatment of chlamydia (2)

Answer 8

Doxyciclin

Erythromycin in pregnancy

Question 9

Describe gonorrhoea. (2)

Answer 9

Neisseria gonorrhoeae is a gram negative intracellular diplococcus.

Question 10

Describe symptoms of gonorrhoea in men. (2)

Answer 10

Discharge

Dysuria

Question 11

Describe symptoms of gonorrhoea in women. (3)

Answer 11

Asymptomatic often
Vaginal discharge
Lower abdominal pain.

Question 12

Describe complications seen in gonorrhoea (2)

Answer 12

Epididymo-orchitis

PID

Question 13

Describe treatments for gonorrhoea (2)

Answer 13

Ceftriaxone

Azithromycin to “boost effectiveness” because resistance is high.

Question 14

Describe how gonorrhoea is diagnosed. (3)

Answer 14

NAAT - nucleic acid amplification test
Vulvovaginal or endocervical swab in women
Urine in men.

Question 15

Describe syphilis. (5)

Answer 15

Treponema pallidum is a spirochete bacteria that has 3 stages:
Primary - painless ulcer on site of contact. Very infective but not permanently visible.
Secondary - associated rash or other symptoms that disappear.
Tertiary - latent infection that can be reactivated.

Question 16

Describe the treatments for syphilis. (1)

Answer 16

Very strong penicillin

Question 17

Describe the diagnosis of syphilis. (2)

Answer 17

Blood tests or swabs of the primary ulcers.

Question 18

Describe anogenital warts. (2)

Answer 18

Most common viral STI caused by HPV, most often strains 6+11.

Question 19

Describe the presentation and treatment of anogenital warts. (3)

Answer 19

Typically presents with painless genital warts on the penis, vulva, vagina, cervix, or perianal skin. They usually go away with no treatment, although topical creams are available.

Question 20

Describe herpes(4)

Answer 20

Two strains of the herpes simplex virus:
HSV-1: oral and genital herpes
HSV-2: typically genital herpes which is often recurrent. Especially dangerous in pregnancy.

Question 21

Describe trichomonas vaginalis (1)

Answer 21

A sexually transmitted Protozoa.

Question 22

Describe the symptoms of trichomonas vaginalis in men. (3)

Answer 22

Asymptomatic
Dysuria
Discharge

Question 23

Describe the symptoms of trichomonas vaginalis in women. (2)

Answer 23

Vaginal discharge that is often yellow and irritates the vagina and vulva.

Question 24

Describe how trichomonas vaginalis is diagnosed. (2)

Answer 24

High vaginal swabs in women.

Mid stream urine culture in men.

Question 25

Describe how trichomonas vaginalis is treated. (1)

Answer 25

Metronidazole