STIs Flashcards
What is a commensal micro-organism?
A micro organism that derives food or other benefits from another organism without hurting or helping it.
What is pathogen?
A micro-organism that can cause disease.
What is an infection?
The invasion of all or part of the body by a micro-organism.
What is a sexually transmissible microbe?
A virus, bacteria or protozoan which can be spread by sexual contact.
What is a sexually transmitted infection?
An infection by a pathogen which is sexually transmissible and which is unlikely to be transmitted by non-sexual means.
e.g Neisseria gonorrhoea, HPV type 6
What is a sexually transmitted disease?
A disorder of structure or function caused by a sexually transmitted pathogen.
e.g pelvic inflammatory disease, genital warts
What are some examples of Venereal diseases?
Syphilis (treponema pallidum pallidum)
Gonorrhoea (tessera gonorhoeae)
Chancroid (haemophilus ducreyi)
What are some other sexually transmitted organisms in the UK?
Bacteria:
- Chlamydia trachomatis
- Klebsiella granulomatis
- Mycoplasma genitalium
Viruses:
- HSV
- HPV
- HIV
Parasites:
- Pthirus pubis
- Sacrcoptes scabei
- Trichomonas vaginalis
What are some features of STIs?
Transmissible
Asymptomatic most of the time
All manageable but not all curable
Avoidable.
What STIs are transmissible via genital contact only?
Pubic lice (pthirus pubis) Scabies (sarcoptes scabeii) Warts (human papilloma virus type 6&11) Herpes (herpes simplex virus types 1&2)
What are some systemic symptoms of STIs?
Fever Rash Lymphadenopathy Malaise infertility Cancer Adverse pregnancy outcomes
What are the management aims of someone with a suspected STI?
Good history
Partner notification
HIV testing
Health promotion
What are some genital symptoms?
Discharge from orifice Pain from somewhere Rashes Lumps and swellings Cuts Sores Ulcers Itching Change in appearance Vague sense of things not being right.
What are some possible causes of genital symptoms?
STD
Other microbial problem
Non-microbial
What are some examples of microbial conditions not regarded as STDs?
Vulvovaginal candidosis Bacterial vaginosis Balanoposthitis Tinea cruris Erythrasma Impetigo Cellulitis Infected sebaceous glands
What are some characteristics of vulvovaginal candidosis?
Usually acquired from bowel.
Often asymptomatic - changes in host environment can trigger pathogenicity.
If symptomatic then presents as ‘thrush’ - itch, thick cottage cheese discharge.
What are some risk factors for vulvovaginal candidosis?
Diabetes Oral steroids Immune suppression Pregnancy Reproductive age group
What is the treatment for Vulvovaginal candidosis?
Azole antifungals:
-Clotrimazole 500mg PV once
-Fluconazole 150mg PO once.
Maintain skin - avoid irritants, treat dermatitis.
What are the symptoms of bacterial vaginosis?
Asymptomatic in 50%
Watery grey/yellow ‘fishy’ discharge
May be worse after period/sex
Sometimes sore or itch from dampness.
What are some problems with bacterial vaginosis that forms a biofilm?
Usually asymptomatic or very mild symptoms but associated with endometritis and premature labour.
Increases risk of HIV acquisition.
What is the treatment for bacteria vaginalis?
Antibiotics - metronidazole (oral or gel), Clindamycin (vaginal)
Probiotics
Vaginal acidification
What are the genital symptoms of non-microbial origin?
Perceived problem only - normal findings
Dermatoses
Structural abnormalities - congenital or acquired.
What questions should you ask if there are no genital symptoms found on examination?
Regretted sexual encounter? Problems in life? Co-existing mental health issues? When did they notice the problem? When were things last normal? - fam/friend illness, media story etc.
What is vulvodynia?
Persistent burning or aching of the vulva.
