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Reproductive System > STIs > Flashcards

STIs Flashcards

1
Q

Define a sexually transmitted organism

A

A virus, bacteria, protozoan, insect or arthropod which can be spread by sexual contact

  • Commensal
  • Pathogen
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2
Q

What makes a sexually transmitted infection and disease?

A

STI is a pathogen that invades and multiples on the body and is transmissable by sexual contact. While also unlikely to be transmitted otherwise.

  • Type 6 HPV STD is the disease caused by said STI
  • Genital Warts
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3
Q

Why are STIs so important?

A
  • They are unpleasant and can lead to death
  • A huge drain on resources
  • A massive psychosocial impact
  • Very common
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4
Q

The number of STI diagnoses has increased over time, why do you think this is?

A

May be more cases, due to increase number of parteners, anal sex and MSM

May be more diagnoses but not more cases as public and medical awareness increases as well as better tests

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5
Q

What models do we use to map spread of STIs?

A

Cores and Assortative mixing

Chains and random mixing

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6
Q

How does assortative mixing work for mapping spread of STIs?

A

A subpopulation (“Core”) have sex with each other (similar to them) but not the wider community i.e. a minority ethnicity

Therefore you see a high prevalence amongst the core but without spreading to the wider community i.e. Hep C infections amongst HIV +VE MSM

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7
Q

How does random mixing work for mapping the spread of STIs?

A

A very big population e.g. hetero men and women

Chains of sexual partners form rather than a tangled core and you get a disease of low prevalalence but a very wide dissemination along “chains”.

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8
Q

What questions about sexual history are important when investigating a possible STI?

A
  • Last Sexual Contact?
  • Casual or regular partner?
  • Nationality and gender of partner?
  • Nature of sexual contact?
  • Condom?
  • Contraception?
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9
Q

How do we go about notifying patients partner’s of their possible STI?

A

Client referral (patient does the telling)

Provider notification (NHS tells the contacts)

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10
Q

What further testing should be offered if an STI diagnosis is reached?

A
  • Most STIs are risk factors for HIV acquisition and transmission.
  • If someone has one STI (i.e. chlamydia) they could have another (i.e. HIV)
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11
Q

What areas of health promotion should we educate STI patients on?

A
  • Condoms prevent transmission of some STIs -
    • I.e. HIV, chlamydia, gonorrhoea
  • Condoms aren’t very good at preventing transmission of other STIs
    • I.e. herpes and warts
  • Oral sex carries risks too
    • Not as great as vaginal or anal sex
    • Fellatio more than cunnilingus
  • Alcohol and other drugs
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12
Q

Define a sexually transmitted infection (STI)

A

An infection by a pathogenwhich is sexually transmissible and which is unlikely to be transmitted by non-sexual means

  • Neisseriagonorrhoeae
  • HPV type 6
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13
Q

Define a sexually transmitted disease (STD)

A

A disorder of structure or function caused by a sexually transmitted pathogen

  • Pelvic inflammatory disease
  • Genital warts
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14
Q

What are the three venereal diseases of the VD Act of 1916?

A
  • Syphilis (Treponema pallidum pallidum)
  • Gonorrhoea (Neisseria gonorhoeae)
  • Chancroid (Haemophilus ducreyi)
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15
Q

Name three bacteria which are sexually transmitted organisms

A
  • Chlamydia trachomatis
  • Klebsiella granulomatis
  • Mycoplasma genitalium
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16
Q

Name three viruses which are sexually transmitted organisms

A
  • HSV
  • HIV
  • HPV
  • Molluscum contagiosum virus
17
Q

Name three parasites which are sexually transmitted organisms

A
  • Pthirus pubis
  • Sarcoptes scabei
  • Trichomonas vaginalis
18
Q

What are the two ways in which a sexually transmitted organism can cause an STD or STI and give examples?

A

Infection

  • Mycoplasmahominis
  • Ureaplasmaurealyticum

Colonisation

  • Bacterial vaginosis
  • Genital candidosis
19
Q

Name four characteristics of STIs

A
  • They’re transmissible
  • Asymptomatic most of the time
  • All manageable but not always curable
  • Avoidable
20
Q

What are the implications for a person with an STI?

A
  • Partner notification
  • So hard to eradicate from a population. Need to prevent.
  • Treatment & prevention of complications
  • Primary prevention - education
21
Q

What are the different types of sexual contact?

A

From top to bottom decreasing chance of catching an infection:

  • Group sex
  • Anal sex
  • Vaginal sex
  • Oral sex
  • Touching someone else’s genitals with your genitals
  • Mutual masturbation
22
Q

What infections can be transmitted through genital contact only?

A
  • Pubic lice (Pthiruspubis)
  • Scabies (Sarcoptesscabeii)
  • Warts (human papillomavirus types 6 &11)
  • Herpes (Herpes Simplex Virus types 1 & 2)
23
Q

What infections can be trasmitted through group sex?

A

Hepatitis C

24
Q

Why are STIs important?

A

They cause morbidity and they can kill.

  • Unpleasant symptoms
  • Psychological distress

They’re a drain on resources.

  • Managing infertility due to chlamydia: cost of IVF.
  • Cost of HIV medication/ management of HIV related health conditions
  • Taking time off work to get your warts frozen.

They’re common

  • More than 1M new STIs acquired every day.
  • More than 500M people have genital herpes
25
Q

What are two possible reasons for the number of cases of STIs increasing?

A

A true change in the number of cases

or

A change in diagnoses but no actual change in number of cases

26
Q

What are the systemic symptoms of STIs?

A
  • Fever
  • Rash
  • Lymphadenopathy
  • Malaise
  • Infertility
27
Q

What are the adverse outcome of STIs?

A
  • Cancer. 250,000+ deaths globally from cervical cancer
  • 300,000 adverse pregnancy outcomes from syphilis per year
28
Q

What is the equation to work out the change in the number of cases?

A

R0 = ßcD

R0 - reproductive number (average number of infections produced)

ß - likelihood of transmission

c - rate of acquiring new partners

D - duration of infectivity

  • If R0>1 then epidemic is sustained
  • If R0<1 then epidemic reduces
29
Q

Give a reason why the number of cases of STIs might be increasing?

A

NATSAL study:

  • Increased numbers of partners/person
  • Increased concurrent partners
  • More people having anal sex
  • More men reporting sex with men
  • (also increased condom usage)
30
Q

What are the reasons for a chnage in th enumber of diagnoses, but no change in no. of cases?

A

Greater awareness of STIs = more testing

  • More people asking for tests
  • More clinicians considering STIs and testing for them.

Better tests

  • I.e. nucleic Acid Amplification Tests vs. Enzyme immunoassays for chlamydia
31
Q

What are the four steps in the management of someone with symptoms suggesting an STI?

A
  1. A good history
  2. Partner notification
  3. HIV testing
  4. Health promotion
32
Q

What is the importance of taking a sexual history?

A
  • Determining possible cause of symptoms
  • Detecting high-risk behaviour and advising re reducing future risk
  • Tracing contacts
33
Q

What is asked about during the consutlation for a suspected STI?

A
  • Standard history
  • Gynae history
  • Need to ask direct questions about symptoms i.e. discharge from penis, pain in abdomen
34
Q

What question should you ask men to assess risk of STIs?

A
  • Have you ever had sexual contact with a man (MSM)?
  • Have you ever injected drugs?
  • Sexual contact with anyone
    • Who’s injected drugs?
    • Someone from outside the UK? (clarify)
  • Medical treatment outside UK? (clarify)
  • Involvement with sex industry. (had sex with prostitute)

Reproductive System (26 decks)

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