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Block 5 > STIs > Flashcards

STIs Flashcards

1
Q

What is urethritis?

A

Inflammation of the urethra - can present with redness, soreness, discharge etc.

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2
Q

What is pelvic inflammatory disease?

A

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.)

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3
Q

What is epididymo-orchitis?

A

Inflammation of the epididymis and testes - can present with pain/tenderness and swelling

Can be caused by UTI, STI (Gonorrhoea, chlamydia), mumps

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4
Q

What bacteria causes gonorrhea?

A

Intracellular gram-negative diplococci - Neisseria Gonorrhoeae

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5
Q

What do NICE class as infertility?

A

1-2 years of attempting pregnancy

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6
Q

What bacteria causes syphilis?

A

Treponema pallidum

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7
Q

What are the major systemic viral diseases transmitted by sexual intercourse?

A

Hepatitis B + C

HIV

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8
Q

What are the principles of antimicrobial therapy?

A 
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)
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9
Q

What are the principles of identifying a microbial diagnosis?

A

See it, grow it, kill it

Detect pathogen and response to pathogen

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10
Q

What tests are done to aid a Gonorrhoea diagnosis?

A

Nucleic acid amplification test (NAAT)
M, C and S
Non-culture methods

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11
Q

What are the advantages and disadvantages of using an MCS to aid Gonorrhoea diagnosis?

A

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

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12
Q

What are the advantages and disadvantages of using non-culture methods to aid Gonorrhoea diagnosis?

A

Advantages: high sensitivity and specificity

Disadvantages: 24-48hr result; no antimicrobial susceptibility; not suitable for normal swabs (as requires a non-inhibitory specimen)

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13
Q

How is chlamydia diagnosed?

A

Nucleic acid amplification test

Obligate intracellular bacterium - will not grow on agar plate

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14
Q

How is syphilis diagnosed?

A 
Antibody detection (PCR) 
Serum IgM indicates recent infection
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15
Q

How can STIs be transmitted?

A

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.)

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16
Q

What are the principles for controlling STI transmission?

A

Remove source
Treat other infections/ sources of inflammation
Interrupt transmission
Increase host resistance

17
Q

What are the primary and secondary prevention strategies for controlling transmission of STIs?

A

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

18
Q

What is the clinical term for inflammation of the rectum?

A

Proctitis

19
Q

What is the clinical term for inflammation of the testes?

A

Orchitis

20
Q

What is the clinical term for inflammation of the head of the penis?

A

Balanitis

21
Q

What would the differential diagnoses be for someone presenting with urethritis?

A

Chlamydia trachomatis
Neisseria gonorrhoeae (or both!)
Mycoplasma genitalium

22
Q

What would the differential diagnoses be for someone presenting with vaginal discharge?

A

STI (Gonorrhoea, chlamydia, trichomonas)

Non-STI (candidiasis, bacterial vaginosis)

23
Q

What is Candidiasis?

A

Thrush

24
Q

What would the differential diagnoses be for someone presenting with painful genital ulceration?

A

STI (Herpes Simplex Virus, Syphilis)

Non-STI (e.g. Crohn’s, allergy, trauma, drug-induced etc.)

25
Q

What would the clinical presentation be like for someone with Herpes?

A

Painful genital ulcers
Headache
Myalgia
Painful dysuria

26
Q

What would the clinical presentation be like for someone with Syphilis?

A

(Usually) painless swelling with ulceration

27
Q

What infestations could a patient present with?

A

Scabies (skin rash, itching)

Pubic lice

28
Q

Which STIs can also present systemically?

A

With genital manifestations (secondary syphilis; gonorrhoeal arthritis; sexually acquired reactive arthritis; herpes meningitis or encephalitis)

Without genital manifestations (HIV, Hepatitis A/B/C)

Block 5 (25 decks)

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