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Year 3 > STIs > Flashcards

STIs Flashcards

1
Q

define and give examples of STIs

A

A ‘Sexually transmitted infection’ (STI) is an infection which is predominantly sexually transmitted; for example Chlamydia trachomatis or HIV. Other infections can be sexually transmissible but aren’t usually classed as STIs eg hepatitis A, hepatitis C, Zika and giardiasis.

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2
Q

define and give examples of STDs

A

An STI is the infection, eg Human Papilloma Virus, whereas an STD is the disease(s) it causes; eg warts.

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3
Q

gonorrhoea: organism

A

neisseria gonorrhoeae

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4
Q

gonorrhoea: symptoms men

A

10% asymptomatic but may have clinical signs
thick, profuse yellow discharge
dysuria
rectal and pharyngeal infection often asymptomatic

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5
Q

gonorrhoea: symptoms women

A

> 50% asymptomatic
vaginal discharge
dysuria
intermenstrual/post-coital bleeding

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6
Q

gonorrhoea: complications

A

epididymitis - male
female - pelvic inflammatory disease, bartholin’s abscess (gonococcal ophthalmia neonatorum)

both
acute monoarthritis usually elbow or shoulder
disseminated gonococcal infection - skin lesions, pustular with halo

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7
Q

gonorrhoea: incubation period

A

5-6 days average

2 days - 2 weeks

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8
Q

gonorrhoea: diagnosis

A

Nucleic Acid Amplification Test (NAAT) on urine or swab from an exposed site – vagina, rectum, throat. Could be self-obtained or clinician-obtained.
Gram stained smear from urethra/cervix/rectum in symptomatic people.
Culture of swab-obtained specimen from an exposed site using highly selective lysed blood agar in a 5% CO2 environment. Should be done for all confirmed cases to assess antibiotic sensitivity.

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9
Q

gonorrhoea: treatment

A

Blind treatment with ceftriaxone 500mg im once plus Azithromycin 1g. Can also treat according to antibiotic sensitivities.

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10
Q

gonorrhoea: follow up

A

Test of cure at 2 weeks and test of reinfection at 3 months

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11
Q

chlamydia: organism

A

Chlamydia trachomatis serovars D to K

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12
Q

chlamydia: symptoms

A 
Men: >70% asymptomatic
Slight watery discharge, dysuria,
Women: >80% asymptomatic
vaginal discharge, dysuria, intermenstrual/post-coital bleeding.
Both: Conjunctivitis
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13
Q

chlamydia: complications

A

Men Epididymitis.
Women: PID and hence ectopic pregnancy, pelvic pain and infertility. Probably only ~1% of women who get chlamydia will develop a problem with their fertility
Both: Reactive arthritis/ Reiter’s syndrome – urethritis/cervicitis + conjunctivitis + arthritis

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14
Q

chlamydia: diagnosis

A

First void urine in men. Self-taken or clinician-taken swab from cervix, urethra, rectum as appropriate.
All specimens tested using a NAAT

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15
Q

chlamydia: treatment

A

Azithromycin 1g po once.

Doxycycline 100mg bd 1 week if rectal infection.

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16
Q

chlamydia: follow up

A

Test for reinfection at 3-12 months. Earlier test of cure not needed unless symptoms persist.

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17
Q

herpes: organism

A

HSV 1 + 2

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18
Q

herpes: symptoms

A

80% have no symptoms. The rest have recurring symptoms – monthly, annually.
Burning/itching then blistering then tender ulceration.
Tender inguinal lymphadenopathy. Flu-like symptoms.
Dysuria, Neuralgic pain in back, pelvis and legs,

19
Q

herpes: complications

A

Autonomic neuropathy (urinary retention), neonatal infection, secondary infection.

20
Q

herpes: incubation period

A

About 5 days to months.

21
Q

herpes: diagnosis

A

Clinical impression.

Swab from lesion tested using PCR.

22
Q

herpes: treatment primary outbreak

A

Aciclovir: various regimens – eg 400mg tds for 5 days

Lidocaine ointment

23
Q

herpes: treatment infrequent recurrences

A

Lidocaine ointment. Aciclovir 1.2g once daily until symptoms gone (1-3 days)

24
Q

herpes: treatment frequent recurrences

A

Aciclovir 400bd long-term as suppression.

25
Q

trichomoniasis: organism

A

trichomonas vaginalis

26
Q

trichomoniasis: symptoms

A

Men: usually asymptomatic
Women: 10-30% asymptomatic
Profuse thin vaginal discharge - greenish, frothy and foul smelling. Vulvitis

27
Q

trichomoniasis: complications

A

miscarriage and preterm labour

28
Q

trichomoniasis: diagnosis

A

PCR on a vaginal swab. NB not on urine yet so no test for men.
Point of Care - Microscopy of wet preparation of vaginal discharge

29
Q

trichomoniasis: treatment

A

Metronidazole 400mg po bd for 5 days or 2g single dose.

30
Q

anogenital warts: organism

A

Human Papilloma Virus types 6 and 11 (and occasionally type 1). (NB different strains from those that cause cervical cancer.

31
Q

anogenital warts: symptoms

A

Lumps with a surface texture of a small cauliflower. Occasionally itching or bleeding especially if perianal or intraurethral.

32
Q

anogenital warts: complications

A

None common. Neonatal laryngeal papillomatosis.

33
Q

anogenital warts: diagnosis

A

Appearance. Biopsy if unusual – to exclude intraepithelial neoplasia, but this is rarely needed

34
Q

anogenital warts: treatment

A

Podophyllotoxin (brands warticon and condyline), imiquimod (brand Aldara). Both home treatments.
Others – cryotherapy
Bulky warts – diathermy, scissor removal.

35
Q

syphilis: organism

A

Treponema pallidum subspecies pallidum

36
Q

syphilis: symptoms primary

A

Local ulcer (chancre)

37
Q

syphilis: symptoms secondary

A

Rash, mucosal ulceration, neuro symptoms, patchy alopecia, other symptoms.

38
Q

syphilis: symptoms early latent

A

no symptoms but <2years since caught.

39
Q

syphilis: symptoms late latent

A

no symptoms but >2 years since caught.

40
Q

syphilis: symptoms tertiary

A

Neurological, cardiovascular or gummatous – skin lesions, (all v rare).

41
Q

syphilis: complications

A 
neurosyphilis – cranial nerve palsies are commonest, cardiac or aortal involvement.
Congenital syphilis (extremely rare in Scotland).
42
Q

syphilis: incubation period

A

9 to 90 days until appearance of chancre. But can be asymptomatic.

43
Q

syphilis: diagnosis

A

Clinical signs
Serology for TP IgGEIA, TPPA and RPR
PCR on sample from an ulcer

44
Q

syphilis: treatment

A

Early (<2 yrs and no neurological involvement):
Benzathine penicillin 2.4 MU im once
Or Doxycycline 100mg bd po 2 weeks
Late (>2 years) and no neurological involvement
Benzathine penicillin 2.4MU im weekly for 3 doses
Doxycycline 100mg bd po 28 days

Year 3 (164 decks)

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