STIs Flashcards
List the most common STIs (descending order).
Chlamydia Genital warts Gonorrhea Genital herpes Syphilis HIV
What causes chlamydia? What symptoms do Serovars D-K and Serovars L1-3 cause?
Caused by chlamydia trachomatis
Serovars D-K:
- Males = urethritis, epididymitis, prostatitis
- Females = cervicitis, PID, Fitz-Hugh Curtis
- Neonate = conjunctivitis + pneumonia
Serovars L1-3:
- lymphogranuloma venereum (chronic infection of lymphatic system)
- Buboes = swollen inflamed lymph nodes
- Proctitis = inflammation of the rectum/anus
What are the complications and treatment options for chlamydia?
Complications:
- reactive arthritis
- infertility
Treatment options:
- Azithromycin
- Doxycycline
- Tetramycine
What causes genital warts? Which strains of the virus are carcinogenic? What is the treatment?
Human papilloma virus Carcinogenic strains = 16, 18, 31, 33 Treatment: HPV vaccine - topical podophyllotoxin - imiqimod (cream) - cryotherapy
What causes gonorrhoea? What are the S+S in males, females and neonates?
Cause: Neisseria gonorrhoea
Males: urethritis, prostatitis, sore throat, epididymitis
Females: cervicitis, PID, peri-hepatitis, septic abortion
Neonate: conjunctivits
What are the complications associated with gonorrhoea? How it is treated?
Complications:
- septic arthritis
- blindness
- infertility
- septicaemia (meningitis, endocarditis)
Treatment:
Ceftriaxone
What is the difference between HSV 1 + 2? What are the important features of Herpes virus? How is it managed?
HSV1 = oral
HSV2 = genital
Important features:
- there is a latency phase - virus lives in trigeminal/sacral ganglia
- reactivation phase (ill, stressed etc) - symptomatic, lesion can appear on mouth + genitals
- or asymptomatic
Management (no cure!!):
- aciclovir
- famciclovir
- valaciclovir
What causes syphilis? What is the treatment?
Treponema pallidum
Treatment:
- penicillin
- doxycycline
What are the signs + symptoms of primary syphilis and secondary syphilis?
Primary:
- Chancre (genital ulcer disease) - usually a single, painless ulcer; can occur anywhere at site of infection; heals within a few weeks = no scar
- Lymphadenoapthy
* Dark ground/Dark field microscopy will be positive - will show lil’ squiggly worm thingies
Secondary:
- rash
- fever
- lymphadenopathy
- condyloma lata (genital warts)
- serology will be +ve
What is primary HIV? How quickly do symptoms arise? What is the differential diagnosis?
Known as acute retroviral syndrome
there will be increased viral replication and reduced CD4 count
75% of patients will develop symptoms within 2-6 weeks of infection
Differential diagnosis: glandular fever, flu-like illness
What are the common features of primary HIV?
- Headache
- Lymphadenopathy
- Oral/genital ulceration
- Pharyngitis
- Nausea
- Rash
- myalgia
How does HIV cause disease?
HIV infects CD4+ cells (t helper), macrophages + dendritic cells
- in acute HIV there is massive loss of CD4+ cells
- in chronic HIV there is ongoing loss of CD4+ cells, reduced immune function and progressive immunosuppression
What are the direct and indirect effects of HIV?
Direct: wasting, diarrhoea, neurological problems
Indirect: allow invasion by opportunistic infection:
can cause malignancies: lymphoma, cervical carcinoma
What are the different forms of antiretroviral drugs?
- Nucleoside reverse transcriptase inhibitors (NRTIs)
- Non-NRTIs
- Protease inhibitors (PIs)
- Fusion inhibitors
- Integrase inhibitors
- Co-receptor antagonists
*always combine at least 3 from 2 classes
these drugs act during viral replication - prevent production of new HIV particles
What are the short-term and long-term issues with HAART?
Short-term:
- Nausea
- Vomiting
- Headache
- Sleep disturbance
Long-term:
- Lipodystrophy
- Renal dysfunction
- Renal dysfunction
- Peripheral neuropathy
- Lactic acidosis
