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STIs Flashcards

1
Q

Define commensal micro-organism

A

Micro-organism that derives food/benefits from another organism without harming or benefiting it

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2
Q

Define pathogen

A

A micro-organism that causes disease

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3
Q

Define infection

A

Invasion/multiplication of the body by an organism that is not usually found on it

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4
Q

Define sexually transmissible micro-organism

A

Virus, bacteria, parasite which is spread by means of sexual contact (can be commensal or pathogenic)

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5
Q

Define STI

A

An infection caused by a pathogen which is spread by sexual contact and is unlikely to be spread by other means

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6
Q

Define STD

A

Disease resulting from an STI e.g. genital warts, PID

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7
Q

What bacteria are considered STIs?

A 
Neisseria gonorrhoea
Chlamydia trachomatis
Klebsiella granulomatis
Mycoplasma genitalium 
Treponema pallidum
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8
Q

What viruses are considered STIs?

A

Molluscum contagiosum
HSV
HIV
HPV

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9
Q

What parasites are considered STIs?

A

Pthirus pubis
Sacroptes scabei
Trichomonas vaginalis

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10
Q

What are some common features of STIs?

A

Transmissible, manageable, often asymptomatic and avoidable

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11
Q

List the different types of sexual contact from highest risk of catching an STI to lowest risk

A 
Fisting/traumatic sex
Group sex 
Anal sex 
Vaginal sex
Oral sex
Touching someone's genitals with your own 
Mutual masturbation
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12
Q

What can be spread from genital contact only?

A

Pthirus pubis (public lice)
Scabies (sacroptes scabeii)
Warts (HPV 6 and 11)
HSV types 1 and 2

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13
Q

What tends to be spread through blood transmission/group sex?

A

Hep C

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14
Q

Why are STIs important?

A

They can kill, cause unpleasant symptoms, psychological distress and are costly and v. common

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15
Q

What are symptoms of STIs?

A

Ulceration (syphilis, herpes, chancroid)
Lumps (HPV 6 and 11)
Discharge (penis, rectum, vagina, eye)
Rashes (itchy/non-itchy, genital or trunk in HIV)
Systemic symptoms: fever, rash, lymphadenopathy, malaise, infertility, cervical cancer, adverse pregnancy outcomes

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16
Q

Why do diagnoses of STIs change over time?

A
  1. true change in no of cases (e.g. more condom use, more MSM, more sex and more partners, vaccination)
  2. change in no of diagnoses without change in no of cases (more awareness –> more tests –> more diagnoses) & better tests
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17
Q

Explain cores and assertive mixing

A

Some people have sex only with people similar to them
–> high prevalence in a certain group but limited spread

E.g. syphilis in those who exchange sex for drugs

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18
Q

Explain chains and random mixing

A

Some groups are v. large, e.g. heterosexual men and woman –> low prevalence but wider dissemination along chains

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19
Q

What is important to do in managing STIs?

A

Partner notification
Diagnosis and treatment
Health promotion

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20
Q

What are the two forms of partner notification?

A

Patient tells contact - client referral (preferred)

NHS tells contact - provider referral

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21
Q

What causes gonorrhoea?

A

Neisseria gonorrhoeae

22
Q

What are the symptoms of gonorrhoea?

A

M: asymptomatic or thick, yellow discharge
W: asymptomatic, vaginal discharge, dysuria, IMB/PCB

23
Q

What are the complications of gonorrhoea?

A

M: epididymitis
W: PID/Bartholin’s abscess
B: acute monoarthritis

24
Q

How do you diagnose gonorrhoea?

A

Nucleic acid amplification test

25
Q

What is the treatment for gonorrhoea?

A

500mg ceftriaxone IM + 1g azithromycin

26
Q

What causes chlamydia?

A

Chlamydia trachomatis

27
Q

What are the symptoms of chlamydia?

A

M: asymptomatic mostly, or watery discharge, dysuria
W: mostly asymptomatic, vaginal discharge, dysuria, IMB/PCB
B: conjunctivitis

28
Q

What are the complications of chlamydia?

A

M: epididymitis
W: PID, ectopic, infertility
B: reactive arthritis/Reiter’s syndrome (urthritis/cervitis, arthritis, conjunctivitis)

29
Q

How do you diagnose chlamydia?

A

NAAT

30
Q

How do you treat chlamydia?

A

Azithromycin 1g po 1x

Doxycycline 100mg bd 1xwk if rectal infection

31
Q

What causes herpes?

A

HSV 1 and 2

32
Q

What are the symptoms of herpes?

A

Asymptomatic, recurrent symptoms monthly/annually
Burning/tingling –> blistering and tender ulceration
Inguinal lymphadenopathy flu like symptoms, dysuria, neuralgic pain in back, pelvis and legs

33
Q

What are complications of herpes?

A

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

34
Q

How do you diagnose herpes?

A

Clinical or swab from lesion and PCR

35
Q

What is the treatment for herpes?

A

1st outbreak - acyclovir 400mg tds 5 days, lidocaine ointment
Infrequent outbreaks - lidocaine, acyclovir 1.2g 1-3d
Frequent outbreaks - acyclovir 400bd long term suppression

36
Q

What causes trichomoniasis?

A

Trachomonas vaginalis

37
Q

What are the symptoms of trichomoniasis?

A

Usually asymptomatic in men

W: profuse, thin, watery discharge - green, frothy, smelly, vulvitis

38
Q

What are the complications of trichomoniasis?

A

Miscarriage/preterm labour

39
Q

How do you diagnose trichomoniasis?

A

PCR on swab

40
Q

How do you treat trichomoniasis?

A

Metronidazole 400mg bd 5d/2g single dose

41
Q

What causes anogenital warts?

A

HPV 6 and 11

42
Q

What is the appearance of anogenital warts?

A

Cauliflower lumps with itching and bleeding

43
Q

How do you diagnose anogenital warts?

A

Appearance

Can biopsy if they look unusual

44
Q

How do you treat anogenital warts?

A

Podophyllotoxin, imiquimoid, cryotherapy, diathermy, scissor removal

45
Q

What causes syphilis?

A

Treponema pallidum

46
Q

What is the presentation of syphilis?

A

Primary - chancre
Secondary - rash, mucosal ulceration, neuro symptoms, patchy alopecia
Early latent - no symptoms <2y
Late latent - no symptoms >2y
Tertiary - neurological, CV, gummatous disease & skin lesions

47
Q

In which group of people is syphilis most common?

A

MSM

48
Q

What are the complications of syphilis?

A

Neurosyphilis - cranial nerve palsies

Cardiac/aortic involvement

49
Q

How do you diagnose syphilis?

A

Serology for TP

PCR from ulcer sample

50
Q

How do you treat syphilis?

A

Early (<2y + no neuro involvement) - benzathine penicillin 2.4MU IM once or doxycycline 100mg bd po 2wks

Late (>2y + no neuro involvement) - benzathine penicillin 2.4MU x3 or doxycycline 100mg bd po 28 days

Reproduction (28 decks)

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