STIs Flashcards
What are the most common STIs?
- chlamydia
- genital warts
- gonorrhoea
- genital herpes
- syphilis
- HIV
What is the cause of chlamydia?
- chlamydia trachomatis (asymptomatic infection)
- serovars D-K
- serovars L1-3
What does serovar mean?
- distinct variation within bacteria/viral species/immune cells of different individuals
What does serovars D-K cause in males?
Urethritis, epididymitis, prostatitis
What does serovars D-K cause in females?
Cervicits
PID
Fitz-Hugh-Curits
What does serovars D-K cause in neonates?
Conjunctivitis
Pneumonia
What does serovars L1-L3 cause?
- lymphogranuloma venereum (chronic infection of lymphatic system)
= buboes (swollen inflamed lymph node)
= proctitis (inflammation of rectum/anus)
What are the complications of chlamydia trachomatis?
- reactive arthritis
- infertility
How is chlamydia trachomatis treated?
- azithromycin
- doxycycline
What causes genital warts?
- HPV (human papilloma virus)
- multiple sites
- some associated with carcinoma (16,18,31,33)
- mostly asymptomatic
How is HPV managed?
- vaccine
- genital warts = topical podophyllotoxin, imiquimod, cryotherapy
What causes gonorrhoea?
- Neisseria gonorrhoea
What does Neisseria gonorrhoea cause in males?
- urethritis
- prostatitis
- sore throat
- epididymitis
What does Neisseria gonorrhoea cause in females?
- cervicitis
- PID
- Peri-hepatitis
- Septic abortion
What does Neisseria gonorrhoea cause in neonates?
conjunctivitis
What are the complications of Neisseria gonorrhoea?
- septic arthritis (bacteria through joints)
- blindness
- infertility
- septicaemia (bacteria poisons blood) = meningitis/endocarditis
How is Neisseria gonorrhoea managed?
- ceftriaxone (antibiotic)
What are the types of HSV?
HSV -1 = oral
HSV -2 = genital
(blisters scabbing over)
What are the important features of HSV?
- latency: lives in trigeminal/sacral ganglia
- reactivation: symptomatic or asymptomatic
How is HSV treated?
- not cured
- aciclovir
- valaciclovir
- famciclovir
What causes syphilis?
- treponema pallidum
What are the types of syphilis?
- primary
- secondary
- latent
- tertiary
- congenital
How is syphilis treated?
- penicillin
- doxycycline
How does primary syphilis present?
- chancre (genital ulcer disease)
- lymphadenopathy
What is chancre?
- single painless ulcer
- anywhere at site of infection
- heals within few weeks
What are the symptoms of secondary syphilis?
- rash
- fever
- lymphadenopathy
- condyloma lata
How is the epidemiology of HIV changing?
- reducing incidence (risk of spread)
- increasing prevalence (number of people with disease)
What types of HIV testing is done?
- routine testing
- opportunistic testing of high risk individuals
- diagnostic testing when clinical indicators of the condition
What are the common features of a primary HIV infection?
- headache
- lymphadenopathy
- pharyngitis
- oral/genital ulceration
- nausea
- rash
- myalgias
- fever/fatigue
- weight loss/night sweats
(acute retroviral syndrome)
(wide differential diagnosis)
What is the mechanism of HIV?
- infections CD4+ T cells (T helper cells), macrophages and dendritic cells
- acute primary infection = massive CD4+ cell loss
- chronic HIV infection = ongoing CD4+ cell loss, immunosuppression, immune cell loss
What are the direct effects of HIV?
- wasting
- diarrhoea
- neurological problems
What are HIV opportunistic infections?
- viral/fungal/bacterial/mycobacterial/parasitic infections
What malignancies can occur from HIV?
Lymphoma
Cervix carcinoma
What is the significance of a CD4 count?
- HIV associated disease risk increases as CD4 cells fall
What is retroviral therapy?
HAART - highly active antiretroviral therapy
How are the classes of antiretroviral drugs?
- nucleotide reverse transcriptase inhibitors
- NNRTI
- PIs (protease inhibitors)
- fusion inhibitors
- integrase inhibitors
- co-receptor antagonists
How do antiretroviral drugs work?
- during viral replication cycle
- prevent production of new HIV particles
- combine at least 3 from 2 classes
- lifelong treatment
- adherence vital for success
What are the side effects of HAART?
ST: - nausea/vomiting - headache - sleep disturbance LT: - lipodystrophy - renal dysfunction - peripheral neuropathy - lactic acidosis
When may prophylactic measures be used?
- high risk sexual exposure <72 hours
- needles
- PrEP (pre-exposure prophylaxis)
- PEP (post exposure prophylaxis)
- PEPSE (PEP after sexual intercourse)`
How is HIV managed in pregnancy?
- early screening
- antiretroviral therapy for mother (if low CD4 immediately then continued, if high 2nd trimester then discontinued)
- elective C section (vaginal delivery possible if undetectable HIV load)
- antiretroviral therapy for infant
- no breastfeeding
