Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MD3002 > STIs > Flashcards

STIs Flashcards

1
Q

Define veneral disease.

A

STD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Identify the main STI symptoms.

A
  • Genital discharge
  • Genital warts/ ulcers
  • Pelvic pain
  • bloodborne viruses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Identify the top 10 STIs, along with their causative pathogen.

A
  • Chlamydia trachomatis (Urethritis)
  • Human papilloma virus (Genital warts)
  • Neisseria gonorrhoeae (Gonorrhoea)
  • Herpes simplex virus (Genital herpes)
  • Treponema pallidum (Syphilis)
  • Candida albicans (Vaginal thrush)
  • Trichomonas vaginalis (Vaginitis)
  • Human immunodeficiency virus (AIDS)
  • Hepatitis B (Hepatitis)
  • Haemophilus ducreyi (Chancroid)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Identify the average number of new heterosexual partners in the previous 5 years in 16-24 year olds (in men and women).

A

The average number of new heterosexual partners in the previous 5 years was 3.8 for men and 2.4 for women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What proportion of men, and women, have reported at least 10 sexual partners so far ?

A

1/3 men and 1/5 women reported at least 10 partners in life ‘so far’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What proportion of men and women have reported same sex sexual relationships ?

A

5.4% of men and 4.9% of women reported having sex with a member of the same sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What proportion of men, and women, have reported heterosexual anal sex in the preceding year ?

A

12% of men and 11% of women reported heterosexual anal sex in the preceding year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Identify the main risk factors for STIs.

A
  • Young age
  • Failure to use barrier contraceptives
  • Non-regular sexual relationships
  • Men who have sex with Men (MSM)
  • Intravenous drug use
  • African origin (Sub-Saharan Africa)
  • Social deprivation
  • Sex workers
  • Poor access to advice and treatment of STIs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the determinants of risky sexual behavior ?

A

1) Individual factors: low self-esteem, lack of skills, lack of knowledge of the risks of unsafe sex
2) External influences: peer pressure, attitudes and prejudices of society
3) Service provision: accessibility of sexual health services and/or lack of resources such as condoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Identify the main lab investigations for STIs.

A

Three basic microbial testing for STIs:

1) NAATs
2) Microsopy, culture and sensitivity;
3) Blood tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

NAAT

  • Which STIs is this used for
  • How does it work ?
A

NAAT
-Which STIs is this used for:
• Used for Chlamydia and n. gonnorhoea
• PCR can also be used for herpes

-How does it work ?
• Nucleic acid amplification testing
• Rely on the detection of DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Microsopy, culture and sensitivity

-Which STIs is this used for ?

A

Microsopy, culture and sensitivity;

• For N. gonorrhoeae, candida, bacterial vaginosis (BV), trichomonas vaginalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the medium used for gonococci ?

A

• Charcoal swab the medium used for gonococci (but also useful for transporting other organisms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Blood tests

-Which STIs us this used for ?

A

Blood tests
• Syphilis, HIV, Hepatitis (bloodborne viruses)
• Testing window (Syphilis and Hepatitis, can only tell you if e.g. 3 months ago you had it or not. HIV, 1 month)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Identify pathogens which cause discharge.

A

Chlamydia trachomatis
Neisseria gonorrhoeae
Candida Albicans
(Treponema pallidum?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

State the main classifications of Chlamydia trachomatis.

A

• Obligate, intracellular, Gram negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Identify the main Chlamydia tachomatis serotypes, and the pathologies associated with each.

A
  • A, B, C: trachoma
  • D-K: genital infection
  • L1, L2, L3: lymphogranuloma venereum cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Identify the main symptoms of Chlamydia in females.

A 
Three quarters of infected women have no symptoms. But if they do occur, do so within 1-3 weeks of exposure.
FEMALE
-Vaginal / anal discharge
-Post-coital bleeding
-Abdominal tenderness
-Pelvic tenderness
-Infertility
-Reiter’s syndrome (arthritis, cervicitis, urethritis and conjunctivitis)
-Proctitis
-Pharyngitis
-Perihepatitis – upper abdominal pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Identify the main symptoms of Chlamydia in males.

A 
Half of infected men have no symptoms. But if they do occur, do so within 1-3 weeks of exposure.
MALE
-Urethral / anal discharge
-Epididymal tenderness
-Prostatitis
-Reiter’s syndrome (arthritis, urethritis and conjunctivitis)
-Proctitis
-Pharyngitis
-Perihepatitis – upper abdominal pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Identify possible complications of Chlamydia.

A

1) Pelvic inflammatory disease (PID); (40 percent of women with untreated chlamydia)
• Symptomatic PID associated with infertility, ectopic pregnancy, chronic pelvic pain

2) Sexually acquired reactive arthritis;
• Pain, swelling, stiffness in joints (ankles + feet)
• (Reiter Syndrome- urethritis, arthritis, conjunctivitis)

3) Epididymo-orchitis
4) Peri-hepatitis (“inflammation of the peritoneal coat of the liver and the surrounding tissue”)
5) Women infected with chlamydia are up to five times more likely to become infected with HIV, if exposed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the estimated risk of pelvic inflammatory disease as a complication of Chlamydia ? What is the proportion of patients affected by tubal infertility as a result of Pelvic Inflammatory Disease (as a result of Chlamydia) ?

A

• est. risk 1-30%

• tubal infertility 1-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Identify the main investigations for Chlamydia.

A

• Women;
- Vulvo-vaginal swab (VVS) self taken (NAAT tested)

• Men;
- First catch urine (FCU) (not pass urine for hour or so, then pass urine, catch the first part of it because full of organisms)

• Extra genital sites:
- Rectal/ pharyngeal (e.g. if anal, oral sex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe treatment for Chlamydia.

A

♦ Doxycycline 100mg bd for 7/7

♦ Avoid sexual contact for duration of treatment (and partner) (including oral sex)

♦ Partner notification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is LGV ? How does it present ? What is the treatment for it?

A

• Lymphogranuloma venerum, caused by one of three invasive serovars (L1, L2 or L3) of Chlamydia
trachomatis.

• Presentation;

  • Solitary genital lesion
  • Proctitis
  • Lymphadanopathy

• Doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

State the main classifications of Neisseria gonorrhoeae.

A
  • Gram negative
  • Intracellular diplococcus
  • Humans only host
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which cells does Neisseria gonorrhoeae target ?

A

• Infects epithelial cells of mucous membrane of GU tract or rectum (localised infection)

  • Penile urethra (males)
  • Urethra (females)
  • Endocervical
  • Rectal
  • Pharyngeal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Describe the symptoms of Gonorrhoea.

A

(may be asymptomatic carriage in women)

1) Penile Urethral Infection
- Mainly symptomatic (muculopurulent)

2) Urethral Infection (Females)
- Dysuria +/- increased frequency

3) Endocervical Infection
- 50% increased/ altered vaginal d/c
- 25% lower abdominal pain
- Occasionally inter-menstrual bleeding (IMB)

4) Rectal Infection
- Mostly asymptomatic but can present with anal d/c / pain/ discomfort (esp. males)

5) Pharyngeal Infection
- Mostly asymptomatic but can present with a sore throat

Other more or less frequent symptoms include:
-Post-coital bleeding (females)
-Epididymal tenderness (males)

28
Q

Identify possible complication of Gonorrhea.

A
  • Salpingitis, PID (F)
  • Septic arthritis (both M and F)
  • Ophthalmia neonatorum - blindness (babies, if delivered vaginally and Gonorrhea present)
29
Q

Describe the main investigations used for Gonorrhea.

A 
• Light microscopy of Gram-stained genital specimens to look for Gram-negative diplococci
• NAAT - can use urine or swabs
-Men;
 FPU
-Women;
VVS
-Men who have Sex with Men (MSM);
Take rectal and pharyngeal samples as routine
30
Q

Describe the treatment used for Gonorrhea.

A

• Treatment for confirmed, uncomplicated gonococcal infection in adults is one of the following (all given as a single dose):

  • Ceftriaxone 1g IM (most strains respond to ceftriaxone)
  • Ciprofloxacin 500mg orally (when antimicrobial susceptibility is known since increasing resistance to it)
  • Doxycyline also given to patients who have have concomitant chlamydial infection
  • Partner notification
  • Partner treatment;
  • Don’t treat everyone!
  • If > 14 days after exposure. Test and then treat if +ve • If <14 days, clinical risk assessment (since NAAT testing will not necessary be positive even if organism present, because no time to develop yet) +/- antibiotics
31
Q

True or false: Azithromycin resistance increasing

A

True

32
Q

True or false: Azithromycin resistance increasing

A

True

33
Q

Define Thrush. What pathogen usually causes it ?

A

Acute dermatitis of vulva/vagina caused by invasion of commensal yeasts – usually candida albicans

34
Q

Describe presentation of a thrush.

A
  • Itch
  • Vulval pain
  • Superficial dyspareunia (“pain on attempted penetration”)
  • Curd like white vaginal discharge
35
Q

How is diagnosis of thrush made ?

A
  • Clinical

* Microscopy

36
Q

Describe treatment of thrush.

A

Topical Clotrimazole – different formulations

37
Q

State the classification of Treponema pallidum. What STI does it cause ?

A

Gram negative spirochete

Syphilis

38
Q

Identify the main stages of syphilis.

A

• Primary – hard genital or oral ulcer (painless chancre) at site of infection after about 3 weeks
– Asymptomatic for up to 24 weeks

• Secondary (if primary goes untreated, occurs in 25%)– red maculopapular rash anywhere plus pale moist papules in urogenital region and mouth (condyloma lata)
– Latent for 3 - 30 years

• Tertiary (if secondary goes untreated)– degeneration of nervous system, aneurysms and granulomatous lesions in liver, skin and bones (gummas)

39
Q

Identify some complications which can arise in syphilis.

A

Most things involved in tertiary stage including degeneration of NS, aneurysms, granulomatous lesions in liver, skin and bones (gummas)

40
Q

How is Syphilis diagnosed ?

A
  • From lesions or infected lymph nodes in early syphilis
  • Dark field microscopy
  • Direct fluorescent antibody (DFA) test
  • NAAT
  • EIA - can be for immunoglobulin M (IgM) for early infection or immunoglobulin G (IgG) (the latter becomes positive at 5 weeks) or both
41
Q

How is Syphilis treated ?

A

• Early syphilis (primary, secondary or early latent);
- Benzathine penicillin

• Late latent, cardiovascular and gummatous syphilis
- Benzathine penicillin more doses

•Neurosyphilis including neurological/ophthalmic involvement in early syphilis

  • Procaine penicillin plus probenecid
  • Benzylpenicillin
42
Q

Identify pathogens associated with lumps and bumps.

A
  • HPV

- HSV

43
Q

What is the mode of action of HPV ?

A

Induces hyperplastic epithelial lesions

44
Q

What are the main types of HPV ? Why is the distinction between these important ?

A

• HPV types 6, 11, 16, 18 most important of the 120 types

Types exhibit tissue/cell specificity

45
Q

State the incubation period of HPV.

A

Incubation period 3 weeks – 8 months

46
Q

Identify possible presentations of HPV.

A
  • cervical carcinoma (types have varying potential to cause malignancy, types 16 and 18 especially associated with cancer)
  • urogenital warts
  • laryngeal papillomas
  • common, flat and plantar warts
47
Q

How may HPV be diagnosed ?

A

Virus can be seen on colposcopy after staining

48
Q

Describe treatment for HPV.

A 
For the warts part of HPV:
• Podophyllum (topical cream)
• Cryotherapy (freezing warts off)
• Laser
• Surgery (e.g. if vaginal or cervical warts)
49
Q

Which of the pathogens causing STIs have vaccines ?

A

HPV

50
Q

Identify the main vaccines available for HPV. What types of vaccine are they ?

A
  • Cervarix® (bivalent)
  • Gardasil® (quadrivalent)

Both killed vaccines (against types 16 and 18 of HPV)

51
Q

Which molecule is the HPV vaccine based on ?

A

Based on VLP1 (papillomavirus-like particle) a major capsid protein

52
Q

Which populations is the HPV vaccine given to ?

A
  • Being given to girls of 12-13 years of age in order to immunize them before they become sexually active (protection against most cases of cervical cancer)
  • Also going to be given to boys (? From 2020?)
  • Given to MSM <45 years of age
53
Q

What effect has HPV vaccine had on prevalence of HPV16/18 ?

A

Dramatic decrease

54
Q

Identify the main types of HSV viruses. Where does each type infect ?

A

• HSV type 1 (HSV-1) - usually affects the oral region and causes cold
sores
• HSV type 2 (HSV-2) – associated with genital infection (penis, anus, vagina)
• However, both can infect the mouth and/or genitals due to oral sex or autoinoculation

55
Q

What are the main symptoms of HSV infection ?

A

Commonly asymptomatic but still shedding virus and infectious (responsible for most new infections)

56
Q

What are the mains stages of HSV infection ?

A

1) Primary infection

2) Recurrence

57
Q

Identify symptoms of HSV primary infection.

A

Mostly asymptomatic BUT, possible symptoms:
• Febrile flu-like prodrome (5-7 days).
• Tingling neuropathic pain in genital area/buttocks/legs.
• Extensive bilateral crops of painful blisters/ulcers in the genital area including the vagina and cervix in women
• Tender lymph nodes (inguinal)
• Local oedema
• Dysuria
• Vaginal or urethral discharge

58
Q

Describe the treatment for HSV primary infection.

A
  • Saline bathing (helps blister symptoms)
  • Local anesthetics (may help pass urine)
  • Aciclovir – if within 5 days of the start of the episode (will not stop natural course of disease, may stop severety and possibly length by a little)
59
Q

Describe the reccurence phase of HSV infection.

A

Following primary infection, virus becomes latent in local sensory ganglia. Periodic reactivation which can cause symptomatic lesions or asymptomatic, but
still infectious, viral shedding.

60
Q

How long are HSV episodes usually after the symptomatic first episode (i.e. recurring episodes) ?

A

Episodes are usually shorter (≤10 days)

61
Q

State the median recurrence rate after a symptomatic first episode for HSV-1 and HSV-2.

A

• Median recurrence rate after a symptomatic first episode:

  • HSV-2: approx. 4 attacks in the subsequent 12 months.
  • HSV-1: approx. 1 attack in the subsequent 12 months.

• Attacks usually become less frequent over time.

62
Q

Describe the diagnosis process for HSV.

A
  • Clinical appearance
  • Viral culture
  • DNA detection using NAAT of a swab from the base of an ulcer / vesicle fluid
  • Serology occasionally to identify those with asymptomatic infection and can distinguish between the two types of HSV (BUT may take up to 12 weeks to become antibody positive after primary infection)
63
Q

Identify a recent advance in Sex Health in Scotland.

A

PrEP (Pre-exposure prophylaxis): Scotland the first of the UK nations to aprove PrEP on the NHS

64
Q

Identify the main eligibility criteria for PrEP in Scotland.

A

• Aged 16 or over.
• Have a confirmed HIV negative test in a sexual health clinic.
• Able to attend for regular 3 month reviews.
• Willing to stop taking PrEP when no longer eligible.
• Resident in Scotland.
• Plus, one or more of the following criteria:
- Current sexual partners, irrespective of gender, of people who are HIV positive who have a detectable viral
load.
- Cis and transgender gay and bisexual men, other men who have sex with men, and transgender women with a documented bacterial rectal sexually transmitted infection in the last 12 months.
- Cis and transgender gay, bisexual men and other men who have sex with men, and transgender women reporting condomless penetrative anal sex with two or more partners in the last 12 months and likely to do so again in the next three months.
- Individuals, irrespective of gender, at an equivalent highest risk of HIV acquisition, as agreed with another specialist clinician.

65
Q

Who are the main users of PrEP ?

A

99% are MSM (having condomless penetrative sex with 2 or more partners in the last year)

MD3002 (95 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions