STIs Flashcards

1
Q

What is a commensal micro-organism?

A

A micro-organism that derives food or other benefits from another organism without having an impact on it

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2
Q

What is a pathogen?

A

A micro-organism that can cause disease

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3
Q

What is an infection?

A

The invasion of all or part of the body by a micro-organism

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4
Q

What is a sexually transmissible organism?

A

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

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5
Q

What is a sexually transmitted infection?

A

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

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6
Q

What are examples of organisms causing STIs?

A

Neisseria gonorrhoeae

Human papilloma virus

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7
Q

What is a sexually transmitted disease?

A

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

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8
Q

What are examples of sexually transmitted bacteria?

A

Chlamydia trachomatis - chlamydia
Klebsiella granulomatis - Granuloma inguinale
Mycoplasma genitalium

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9
Q

What are examples of sexually transmitted viruses?

A

HSV - herpes simplex virus
HIV - Human immunodeficiency virus
HPV - human papilloma virus
Molloscum contagiosum virus

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10
Q

What are examples of sexually transmitted parasites?

A

Pthirus pubis
Sarcoptes scabei
Trichomonas vaginalis

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11
Q

What are characteristics of STIs?

A

Transmissible
Asymptomatic most of the time
All manageable but not always curable
Avoidable

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12
Q

What are examples of sexual contact in order of increasing risk of infection?

A
Mutual masturbation
Touching someone else's genitals with your own
Oral sex
Vaginal sex
Anal sex
Group sex
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13
Q

What are general symptoms of STIs?

A

Fever
Rash
Lymphadenopathy
Malaise

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14
Q

What are adverse outcomes of STIs?

A

Infertility
Cancer
Adverse pregnancy outcomes

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15
Q

Why may STI reports be increasing?

A
Increased number of partners per person
Increased concurrent partners
More people having anal sex
More MSM
More people being tested and more accurate tests
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16
Q

Why is sexual history necessary?

A

Determining possible cause of symptoms
Detect high-risk behaviour and advice to reduce future risk
Tracing contacts

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17
Q

What are important questions to ask in the sexual history?

A
When did you last have sexual contact?
Casual or regular partner?
Male or female?
Can be useful to ask about nature of sex act
Did you use condoms?
Other contraception
Nationality of contact
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18
Q

What is the risk assessment for a man?

A

Have you ever had sexual contact with a man?
Have you injected drugs?
Sexual contact with anyone who’s injected or anyone from outside the UK?
Medical treatment outside the UK?
Involvement with sex industry?

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19
Q

What are common presenting complaints of genital symptoms?

A
Discharge from an orifice
Pain from somewhere
Rashes
Lumps and swellings
Cuts, sores, ulcers
Itching
Change in appearance
Vague sense of things not being right
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20
Q

What are microbial conditions that are not regarded as STDs?

A
Vulvovaginal candidosis
Bacterial vaginosis
Balanoposthitis
Tinea cruris
Erythrasma
Infected sebaceous glands
Impetigo
Cellulitis
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21
Q

What is vulvovaginal candidosis?

A

Thrush

22
Q

What is the most common causative organism of vulvovaginal candidosis?

A

Candida albicans

23
Q

What are symptoms of vulvovaginal candidosis?

A

Itch

Thick ‘cottage cheese’ discharge

24
Q

Who is susceptible to vulvovaginal candidosis?

A
Diabetics
Patients taking oral steroids
Immune suppressed patients
Pregnancy
Sexually active
25
Q

How is vulvovaginal candidosis diagnosed?

A

Characteristic history

On examination - fissuring, eryhtema with satellite lesions, characteristic discharge

26
Q

What investigations are done if vulvovaginal candidosis is suspected?

A

Gram stain

Culture

27
Q

How is vulvovaginal candidosis treated?

A

Azole antifungals - clotrimazole, fluconazole

28
Q

What are symptoms of bacterial vaginosis?

A

Watery grey discharge
May be worse after period or sex
Sometimes sore/itch from dampness

29
Q

What are potential complications of bacterial vaginosis?

A

Associated with endometritis
Associated with premature labour
Increase risk of HIV acquisition

30
Q

How is bacterial vaginosis diagnosed?

A

Characteristic history
On examination - Thin, homogenous discharge
pH
Gram stain of smear of vaginal discharge

31
Q

How is bacterial vaginosis treated?

A

Antibiotics - metronidazole
Clindamycin
Probiotics
Vaginal acidification

32
Q

What organism causes gonorrhoea?

A

Neisseria gonoorhoeae

33
Q

What are symptoms of gonorrhoea?

A

Males - Thick, profuse, yellow discharge, dysuria

Females - Vaginal discharge, dysuria, intermenstrual/post-coital bleeding

34
Q

What are complications of gonorrhoea?

A

Acute monoarthritis
Gonococcal infection
Male - epididymitis
Female - Pelvic inflammatory disease, Barothlin’s abscess

35
Q

How is gonorrhoea diagnosed?

A

Gram stained smear from urethra/cervix/rectum

Culture of swab from exposed site

36
Q

How is gonorrhoea treated?

A

Ceftriaxone 1g IM

Can also treat according to antibiotic sensitivities

37
Q

What organism causes chlamydia?

A

Chlamydia trachomatis

38
Q

What are symptoms of chlamydia?

A

Conjunctivitis
Male - Slight watery discharge, dysuria
Female - Vaginal discharge, dysuria, intermenstrual/post-coital bleeding

39
Q

What are complications of chlamydia?

A

Reactive arthritis
Urethritis/cervicitis + conjunctivitis + arthritis
Male - epididymitis
Female - Pelvic inflammatory disease - ectopic pregnancy, pelvic pain, infertility

40
Q

How is chlamydia diagnosed?

A

First void urine in men, cervical, urethral, or rectal swab

Tested using Nucleic Acid Amplification Test

41
Q

How is chlamydia treated?

A

Doxycycline 100mg twice a day for a week

42
Q

What is herpes caused by?

A

Herpes simplex virus types 1 and 2

43
Q

What are symptoms of herpes?

A
Recurring symptoms - monthly or annually
Burning/itching then blistering, then tender ulceration
Tender inguinal lymphadenopathy
Flu like symptoms
Dysuria
Neuralgic pain in back, pelvis, and legs
44
Q

How is herpes treated?

A

Aciclovir 400mg

45
Q

What organism causes trichomoniasis?

A

Trichomanas vaginalis

46
Q

What are symptoms of trichomoniasis?

A

Male - usually asymptomatic

Female - Profuse thin vaginal discharge - greenish, frothy, foul smelling, vulvitis

47
Q

What are complications of herpes?

A

Autonomic neuropathy
Neonatal infection
Secondary infection

48
Q

What are complications of trichomoniasis?

A

Miscarriage

Preterm labour

49
Q

How is trichomoniasis treated?

A

Metronidazole

50
Q

What causes anogenital warts?

A

HPV types 6 and 11

51
Q

What are symptoms of anogenital warts?

A

Lumps with surface texture of a small cauliflower

Occasionally itching or bleeding especially if perianal or intraurethral