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Sexual Health > STIs > Flashcards

STIs Flashcards

1
Q

What is the most common STI in the UK?

A

chlamydia

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2
Q

What organism causes chlamydia infections?

A

Chlamydia trachomatis

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3
Q

How do women present with chlamydia?

A

usually asx but if women gets symptoms: discharge, inflammed cervix, dysuria, IMB/PCB, dyspareunia, fever

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4
Q

How do men present with chlamydia?

A

Men tend to have either classical urethritis with dysuria and urethral discharge or epididymo-orchitis presenting as unilateral testicular pain ± swelling. Fever may also be a presenting feature in men.

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5
Q

Ix and mx for chlamydia?

A

investigate with a nucleic acid amplification tests

treat with 7 days doxycycline or stat azithrithromycin

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6
Q

How does gonorrhoea present?

A

similar presentation to chamydia

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7
Q

What is the mx for gonorrhoea?

A

ceftriaxone IM stat

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8
Q

What is PID (pelvic inflammatory disease)?

A

Infection of uterus/fallopian tubes/ovaries

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9
Q

What are the sx of PID?

A

Bilateral lower abdominal pain.
Deep dyspareunia.
Abnormal vaginal bleeding (postcoital, intermenstrual or menorrhagia).
Fitz Hugh Curtis
Vaginal or cervical discharge that is purulent.

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10
Q

What are the signs of PID?

A

Lower abdominal tenderness (usually bilateral).
Mucopurulent cervical discharge and cervicitis seen on speculum examination.
Cervical motion tenderness and adnexal tenderness on bimanual vaginal examination.
Fever above 38°C (but may be apyrexial).

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11
Q

What is the cause of PID?

A

STI

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12
Q

How is Non-Specific Urethritis diagnosed?

A

purulent discharge, urethral smear/ first pass urine shows positive for polymorphonuclear cells

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13
Q

What is epididymorchitis, and how is it caused?

A
  • inflammation of epididymis/ testis (hard to distinguish between inflammation of the two so name is used)
  • secondary to STI, UTI, mumps
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14
Q

What is the organism that causes genital warts?

A

HPV (Human papillomavirus)

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15
Q

Describe the presentation of a genital wart

A

flesh coloured, cauliflower top,keratinised appearance
painless
diagnosed via appearance

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16
Q

What is the mx of genital warts?

A

Manage with nitrous oxide or podophyllotoxin

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17
Q

What is the organism that causes herpes?

A

HSV (herpes simplex virus)

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18
Q

How does herpes present?

A

open, splits, painful sores
lymphadenopathy
discharge
erythema

19
Q

What are the two different types of herpes?

A

type 1 = cold sores- although in UK is now most common cause of genital infections, type 2 =anogenital association

20
Q

How is herpes diagnosed?

A

viral culture/ PCR swab

21
Q

What is the mx of herpes?

A

acyclovir

22
Q

Describe primary vs secondary vs tertiary syphilis?

A

-Primary syphilis (2-3 weeks to three months after contact with the germ) - one or more ulcers on your genital region or mouth, which are usually painless and go away on their own after about six weeks.

Secondary syphilis - a non-painful rash, especially on hands and feet; feeling generally unwell and tired; swollen glands; joint pains and warty lumps on the genitals.

Tertiary syphilis (many years after first infection) - serious complications affecting the nervous system, heart, blood vessels and skin.

23
Q

What organism causes syphilis?

A

Treponema pallidum

24
Q

mx of syphilis?

A

Treat with IM penicillin

25
Q

What is the pathophysiology of HIV?

A

HIV binds to CD4 receptors on helper T-lymphocytes, monocytes, macrophages and neural cells. CD4 cells migrate to the lymphoid tissue where the virus replicates and then infects new CD4-positive cells. As the infection progresses, depletion or impaired function of CD4 cells predisposes to the development of immune dysfunction.

26
Q

How may HIV present?

A

seroconversion illness: fever, malaise, myalgia, pharyngitis, headaches, diarrhoea, neuralgia or neuropathy, lymphadenopathy and/or a maculopapular rash
persistent generalised lymphadenopathy
symptomatic infection: fever, night sweats, diarrhoea, weight loss
AIDs: opportunistic infections

27
Q

How may heptatitis B present?

A

jaundice, anorexia, RUQ pain, fever, progressive dark urine and pale faeces, ascites, encephalopathy

28
Q

What is candidiasis?

A

Caused by fungal infection, present with soreness, redness and discharge
treat with azoles

29
Q

What is bacterial vaginosis presenting sxs?

A

unpleasant fishy smelling discharge, thin and white/ grey, sometimes pain

30
Q

What is lichen sclerosus?

A

white, thick patches
itches
Pain can occur if there are fissures or erosions, leading to dyspareunia.
linked to vulval cancer

31
Q

What is asked in a sexual health history?

A

HPC, past GUM, sexual history of last 3-12 months, abx? - can give false positives, last intercourse, regular or casual partner, male or female, condom use, type of infection

Menstrual cycle, pregnancy, contraception, cervical

Last voided urine- men

If have HIV or syphilis go back further in hx of partners

32
Q

when should you examine in sexual health?

A

if symptomatic

33
Q

What investigations are done for a symptomatic vs asx woman?

A

asx: Vaginal chlamydia and gonorrhoea swab
Bloods for HIV and syphilis

sx: Same as asymptomatic plus high vaginal swab for bacterial vaginosis, trichomonas vaginalis and candida
Cervical swab for slide and gonorrhoea
Dipstick urinalysis

34
Q

Presentation of T. vaginalis?

A

-discharge- frothy, yellow, bad smell
-itching
-dysuria
-strawberry cervix
(men usually asx)

35
Q

What investigations are done for a symptomatic vs asx hetero men?

A

asx: First void urine for chlamydia and gonorrhoea
Bloods for syphilis and HIV

sx: same as asx plus Urethral swab for slide and gonorrhoea

36
Q

What investigations are done for asx MSM?

A

First void urine for chlamydia and gonorrhoea
Bloods for syphilis and HIV
pharyngeal swab for chlamydia and gonorrhoea
rectal swab for chlamydia and gonorrhoea
Plus blood for hep B

37
Q

What ix are done for symptomatic MSM?

A

asymptomatic tests plus:
Urethral and rectal slides
Urethral, rectal and pharyngeal culture plates

38
Q

Who else is Hep B testing done for (apart from MSM)?

A

Also do Hep B for sex workers, IVDU, and those from Africa, Asia and eastern Europe (or their partners have these risk factors)

39
Q

What is the mx for Trichomoniasis?

A

metronidazole

40
Q

What is the mx for Bacterial Vaginosis?

A

Metronidazole is the antibiotic of choice for treating bacterial vaginosis. Metronidazole specifically targets anaerobic bacteria. This is given orally, or by vaginal gel. Clindamycin is an alternative but less optimal antibiotic choice.

41
Q

What is seen on microscopy for BV?

A

Bacterial vaginosis gives “clue cells” on microscopy. Clue cells are epithelial cells from the cervix that have bacteria stuck inside them, usually Gardnerella vaginalis.

42
Q

WHat is the sx for PID?

A 
Sepsis
Abscess
Infertility
Chronic pelvic pain
Ectopic pregnancy
Fitz-Hugh-Curtis syndrome
43
Q

What is Fitz-Hugh-Curtis Syndrome?

A

Fitz-Hugh-Curtis syndrome is a complication of pelvic inflammatory disease. It is caused by inflammation and infection of the liver capsule (Glisson’s capsule), leading to adhesions between the liver and peritoneum.

Fitz-Hugh-Curtis syndrome results in right upper quadrant pain that can be referred to the right shoulder tip if there is diaphragmatic irritation.

Sexual Health (5 decks)

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