STIs Flashcards
What is urethritis?
Inflammation of the urethra - can present with redness, soreness, discharge etc.
What is pelvic inflammatory disease?
Infection of the female upper genital tract (incl. womb, fallopian tubes and ovaries) - can present with pain around pelvis or lower abdomen, discomfort during sex, pain when urinating, bleeding (between periods, after sex, heavy periods etc.)
What is epididymo-orchitis?
Inflammation of the epididymis and testes - can present with pain/tenderness and swelling
Can be caused by UTI, STI (Gonorrhoea, chlamydia), mumps
What bacteria causes gonorrhea?
Intracellular gram-negative diplococci - Neisseria Gonorrhoeae
What do NICE class as infertility?
1-2 years of attempting pregnancy
What bacteria causes syphilis?
Treponema pallidum
What are the major systemic viral diseases transmitted by sexual intercourse?
Hepatitis B + C
HIV
What are the principles of antimicrobial therapy?
Right drug (guidelines; check for allergy, contraindications and interactions) Right dose Right time (asap) Right duration (single dose if possible as increases concordance and minimises side effects)
What are the principles of identifying a microbial diagnosis?
See it, grow it, kill it
Detect pathogen and response to pathogen
What tests are done to aid a Gonorrhoea diagnosis?
Nucleic acid amplification test (NAAT)
M, C and S
Non-culture methods
What are the advantages and disadvantages of using an MCS to aid Gonorrhoea diagnosis?
Advantages: rapid (can give result in clinic); gives antimicrobial susceptibility; useful for individual patient treatment and for epidemiological surveillance; used when patient is asymptomatic
Disadvantages: less sensitive than NAAT; requires skilled microscopist
What are the advantages and disadvantages of using non-culture methods to aid Gonorrhoea diagnosis?
Advantages: high sensitivity and specificity
Disadvantages: 24-48hr result; no antimicrobial susceptibility; not suitable for normal swabs (as requires a non-inhibitory specimen)
How is chlamydia diagnosed?
Nucleic acid amplification test
Obligate intracellular bacterium - will not grow on agar plate
How is syphilis diagnosed?
Antibody detection (PCR) Serum IgM indicates recent infection
How can STIs be transmitted?
Sexual contact: oral, anal, vaginal, sharing of sex toys, skin to skin contact etc.
Non-sexual contact: in utero (e.g. syphilis); peripartum; blood-borne virus exposure (e.g. occupational, recreational drug use etc.)
What are the principles for controlling STI transmission?
Remove source
Treat other infections/ sources of inflammation
Interrupt transmission
Increase host resistance
What are the primary and secondary prevention strategies for controlling transmission of STIs?
Primary = safe sexual behaviour; barrier contraceptive methods; immunisation (e.g. HPV); PrEP
Secondary = detection (screening, access to services, targeted information); prompt effective treatment; partner notification/ contact tracing
What is the clinical term for inflammation of the rectum?
Proctitis
What is the clinical term for inflammation of the testes?
Orchitis
What is the clinical term for inflammation of the head of the penis?
Balanitis
What would the differential diagnoses be for someone presenting with urethritis?
Chlamydia trachomatis
Neisseria gonorrhoeae (or both!)
Mycoplasma genitalium
What would the differential diagnoses be for someone presenting with vaginal discharge?
STI (Gonorrhoea, chlamydia, trichomonas)
Non-STI (candidiasis, bacterial vaginosis)
What is Candidiasis?
Thrush
What would the differential diagnoses be for someone presenting with painful genital ulceration?
STI (Herpes Simplex Virus, Syphilis)
Non-STI (e.g. Crohn’s, allergy, trauma, drug-induced etc.)
