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J Repro > STIs > Flashcards

STIs Flashcards

1
Q

which 2 STIs are tested for together (same test)

A

chlamydia and gonorrhea

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2
Q

which test is used for chlamydia and gonorrhea

A

NAATs or PCR

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3
Q

what collection method is used for chlamydia and gonorrhea in males

A

first pass urine

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4
Q

what collection method is used for chlamydia and gonorrhea in females

A

vulvovaginal swab

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5
Q

after treatment complete for an STI, how long should you abstain from sex for

A

abstain for 1 week - condoms not 100% effective

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6
Q

normal vaginal flora

A

lactobacillus

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7
Q

what is the most common STI

A

chlamydia

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8
Q

what category of chlamydia causes STIs

A

chlamydia trachomatis D-K

DicK

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9
Q

what category of chlamydia causes trachoma eye infection

A

Chlamydia trachomatis A-C

then you cant see (C)

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10
Q

what category of chlamydia causes lymphogranuloma venereum (LGV)

A

chlamydia trachomatis L1-L3

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11
Q

which group of people get lymphogranuloma venereum

A

MSM (men who have sex with men)

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12
Q

presentation of chlamydia in females

A

asymptomatic
intermenstrual bleeding
lower abdo pain
painful sex

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13
Q

presentation of chlamydia in males

A

asymptomatic
painful peeing
watery urethral discharge

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14
Q

which test do you do for chlamydia

how is it sampled

A

PCR or NAATs

first pass urine in males
vulvovaginal swab in females

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15
Q

does chlamydia culture

A

no, hence need to do PCR/NAATs

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16
Q

which do you do first pass urine and not midstream urine when testing for chlamydia/gonorrhea in males

A

first pass = more likely to catch the bacteria

midstream = used for UTIs

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17
Q

why don’t you do endocervical swabs for chlamydia/gonorrhea in females

A

would get same result as vulvovaginal but is more invasive (cant do it themselves)

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18
Q

management of chlamydia

A

first line - doxycycline 100mg BD 7 days

second line - azithromycin 1g PO - only take once

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19
Q

complications of chlamydia

A

pelvic inflammatory disease (PID) = tubal damage and infertility

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20
Q

is chlamydia or gonorrhea more common

A

chlamydia

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21
Q

what is the most common STI in MSM

A

gonorrhoea

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22
Q

which bacteria causes gonorrhea

what is its gram stain

A

Neisseria gonorrhea

Gm-ve diplococci

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23
Q

how does gonorrhea present in males

A

dripping pus

dysuria (painful peeing)

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24
Q

how does gonorrhea present in females

A

white vaginal discharge
vulvar irritation
dysuria (painful peeing)

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25
Q

which test do you do for gonorrhea

how is it sampled

A

PCR or NAATs

first pass urine in males
vulvovaginal swab in females

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26
Q

if someone presents to GP with gonorrhea what do you do

A

refer to sexual health

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27
Q

management of gonorrhea

A

IM ceftriaxone

+ ?azithromycin for chlamydia??

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28
Q

what do you need to do 5 weeks after gonorrhea has been treated

A

test of cure - repeat PCR/NAATs to ensure infection has gone

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29
Q

why do you nee to do a test of cure after gonorrhea has been treated

A

high antimicrobial resistance

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30
Q

where else is gonorrhea common (other than STI)

A

gonococcal pharyngeal infection

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31
Q

who gets gonococcal pharyngeal infections

A

MSM (from oral sex)

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32
Q

what bacteria causes syphilis

A

treponema pallidum

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33
Q

how does the primary early infectious stage of syphilis present

A

painless chancre/ulceration

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34
Q

how does the late non-infectious stage of syphilis present

A

it is latent

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35
Q

how does the secondary early infectious stage of syphilis present

A

rash on soles of feet/hands

‘great imitator’ - generic rash

36
Q

painless penile ulcer/chancre

A

syphilis primary stage

37
Q

painful penile ulcer/chancre

A

HSV = genital herpes

38
Q

treponema pallidum

A

syphilis

39
Q

diagnostic test for syphilis

A

PCR

40
Q

what does syphilis look like on PCR

A

spirals

41
Q

screening test for syphilis

A

IgM and IgG ELISA

42
Q

tests for syphilis to measure response to therapy (by monitoring inflammation)

A

VDRL

RPR (rapid plasma regain)

43
Q

management of syphilis

A

first line - penicillin long acting IM

second line - doxycycline

44
Q

why might someone with syphilis accidentally treat themselves

A

syphilis is treated with penicillin = used for lots of things

45
Q

what type of herpes simplex virus causes STIs

A

HSV1 or HSV2

46
Q

which type of HSV causes cold sores

A

HSV1

47
Q

which type of HSV has more viral shedding (more expulsion of virus after replication)

A

HSV2

48
Q

which microorganism causes genital herpes

A

HSV

49
Q

presentation of genital herpes

A 
asymptomatic 
painful blisters (= ulceration) 
dysuria 
vaginal discharge 
'strawberry vagina' from inflammation
50
Q

‘strawberry vagina’

A

genital herpes (HSV)

strawberry vagina from inflammation

51
Q

testing method for genital herpes

how do you get sample

A

PCR (bc virus)

deroof blister - ie needs to be symptomatic to sample

52
Q

which STI is recurrent (not curable)

how does it present upon recurrence

A

genital herpes (HSV)

less severe than initial infection when it recurs

53
Q

management for genital herpes

A 
probs nothing, just symptomatic 
acyclovir PO (bc virus) - doesn't always work
54
Q

symptomatic management of genital herpes

A

topical lidocaine - pain relief
saline bath
pee in bath/shower

55
Q

which micro organism causes genital warts

A

HPV 6 + 11

56
Q

is there a connection between genital warts and cervical cancer

A

no - need to reassure patient

HPV 6+ 11 causes genital warts
HPV 16 + 18 causes cervical cancer

57
Q

cauliflower appearance

A

genital warts (HPV)

58
Q

is genital warts (HPV) painful

A

no

59
Q

presentation of genital warts

A

painless

cauliflower appearance

60
Q

diagnosis of genital warts

A

clinical diagnosis - don’t need biopsy

61
Q

management of genital warts

A

nothing

cryotherapy

62
Q

does HPV vaccine cover against genital warts

A

yes!

covers 6, 11, 16 + 18

63
Q

which microorganism causes vaginal thrush

A

candida albicans

64
Q

what type of microorganism is candida albicans (causes vaginal thrush)

A

fungi

65
Q

presentation of vaginal thrush

A

intense vaginal itch

white vaginal discharge

66
Q

diagnosis of vaginal thrush

A

clinical diagnosis

67
Q

risk factor for vaginal thrush

A

uncontrolled diabetes

68
Q

management of vaginal thrush

A

symptomatic only! not curative (bc not an STI)
topical clotrimazole - OTC antifungal cream
keep area clean/cool/dry

69
Q

is vaginal thrush an STI

A

no

70
Q

how does candida balanitis present on penis

A

spotty rash

71
Q

fish smelling discharge
frothy bubbles
brown discharge

A

bacterial vaginosis

72
Q

fish smelling discharge differentials (2)

which is more common

how do they differ

A

bacterial vaginosis - more common
trichomonas vaginalis

trichomonas = itch, inflammation (red)
bacterial vaginosis = no itch, no inflammation (red)

73
Q

which microorganism causes bacterial vaginosis

A

gardnerella vaginalis

74
Q

‘clue cells’ on microscopy

A

bacterial vaginosis

75
Q

bacterial vaginosis management

A

metronidazole 7 days

76
Q

is bacterial vaginosis an STI

A

no

77
Q

is trichomonas vaginalis an STI

A

yes

78
Q

which 2 vagina problems are treated with metronidazole

A

bacterial vaginosis
trichomonas vaginalis

both also present with fishy discharge!

79
Q

what type of microorganism does metronidazole treat

A

anaerobe (hence bacterial vaginosis and trichomonas vaginalis)

80
Q

what type of microorganism is trichomonas vaginalis

A

parasite

81
Q

what does trichomonas vaginalis look like on microscopy

A

it moves ! bc parasite

aka flagellated protozoa (has a tail)

82
Q

investigation for trichomonas vaginalis

how is the sample collected

A

wet film microscopy

from vaginal swab

83
Q 
fish smelling discharge 
bubbly
vaginal irritation (sore) 
strawberry cervix (form irritation)
A

trichomonas vaginalis

diff from bacterial vaginosis bc irritation bc infection (STI)!

84
Q

strawberry cervix

A

trichomonas vaginalis

85
Q

management of trichomonas vaginalis

A

PO metronidazole

same as bacterial vaginosis

86
Q

management of phthirus pubis (pubic lice)

A

malathion lotion (to sooth itch)

J Repro (28 decks)

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