STIs

Question 1

What is a commensal micro-organism?

Answer 1

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

Question 2

What is a pathogen?

Answer 2

A micro-organism that can cause disease

Question 3

What is an infection?

Answer 3

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

Question 4

What is a sexually transmissible organism?

Answer 4

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

Question 5

What is a sexually transmitted infection?

Answer 5

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

Question 6

What are examples of organisms causing STIs?

Answer 6

Neisseria gonorrhoeae

Human papilloma virus

Question 7

What is a sexually transmitted disease?

Answer 7

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

Question 8

What are examples of sexually transmitted bacteria?

Answer 8

Chlamydia trachomatis - chlamydia
Klebsiella granulomatis - Granuloma inguinale
Mycoplasma genitalium

Question 9

What are examples of sexually transmitted viruses?

Answer 9

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

Question 10

What are examples of sexually transmitted parasites?

Answer 10

Pthirus pubis
Sarcoptes scabei
Trichomonas vaginalis

Question 11

What are characteristics of STIs?

Answer 11

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

Question 12

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

Answer 12

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

Question 13

What are general symptoms of STIs?

Answer 13

Fever
Rash
Lymphadenopathy
Malaise

Question 14

What are adverse outcomes of STIs?

Answer 14

Infertility
Cancer
Adverse pregnancy outcomes

Question 15

Why may STI reports be increasing?

Answer 15

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

Question 16

Why is sexual history necessary?

Answer 16

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

Question 17

What are important questions to ask in the sexual history?

Answer 17

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

Question 18

What is the risk assessment for a man?

Answer 18

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?

Question 19

What are common presenting complaints of genital symptoms?

Answer 19

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

Question 20

What are microbial conditions that are not regarded as STDs?

Answer 20

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

Question 21

What is vulvovaginal candidosis?

Answer 21

Thrush

Question 22

What is the most common causative organism of vulvovaginal candidosis?

Answer 22

Candida albicans

Question 23

What are symptoms of vulvovaginal candidosis?

Answer 23

Itch

Thick ‘cottage cheese’ discharge

Question 24

Who is susceptible to vulvovaginal candidosis?

Answer 24

Diabetics
Patients taking oral steroids
Immune suppressed patients
Pregnancy
Sexually active

Question 25

How is vulvovaginal candidosis diagnosed?

Answer 25

Characteristic history | On examination - fissuring, eryhtema with satellite lesions, characteristic discharge

Question 26

What investigations are done if vulvovaginal candidosis is suspected?

Answer 26

Gram stain | Culture

Question 27

How is vulvovaginal candidosis treated?

Answer 27

Azole antifungals - clotrimazole, fluconazole

Question 28

What are symptoms of bacterial vaginosis?

Answer 28

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

Question 29

What are potential complications of bacterial vaginosis?

Answer 29

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

Question 30

How is bacterial vaginosis diagnosed?

Answer 30

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

Question 31

How is bacterial vaginosis treated?

Answer 31

Antibiotics - metronidazole Clindamycin Probiotics Vaginal acidification

Question 32

What organism causes gonorrhoea?

Answer 32

Neisseria gonoorhoeae

Question 33

What are symptoms of gonorrhoea?

Answer 33

Males - Thick, profuse, yellow discharge, dysuria | Females - Vaginal discharge, dysuria, intermenstrual/post-coital bleeding

Question 34

What are complications of gonorrhoea?

Answer 34

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

Question 35

How is gonorrhoea diagnosed?

Answer 35

Gram stained smear from urethra/cervix/rectum | Culture of swab from exposed site

Question 36

How is gonorrhoea treated?

Answer 36

Ceftriaxone 1g IM | Can also treat according to antibiotic sensitivities

Question 37

What organism causes chlamydia?

Answer 37

Chlamydia trachomatis

Question 38

What are symptoms of chlamydia?

Answer 38

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

Question 39

What are complications of chlamydia?

Answer 39

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

Question 40

How is chlamydia diagnosed?

Answer 40

First void urine in men, cervical, urethral, or rectal swab | Tested using Nucleic Acid Amplification Test

Question 41

How is chlamydia treated?

Answer 41

Doxycycline 100mg twice a day for a week

Question 42

What is herpes caused by?

Answer 42

Herpes simplex virus types 1 and 2

Question 43

What are symptoms of herpes?

Answer 43

``` 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 ```

Question 44

How is herpes treated?

Answer 44

Aciclovir 400mg

Question 45

What organism causes trichomoniasis?

Answer 45

Trichomanas vaginalis

Question 46

What are symptoms of trichomoniasis?

Answer 46

Male - usually asymptomatic | Female - Profuse thin vaginal discharge - greenish, frothy, foul smelling, vulvitis

Question 47

What are complications of herpes?

Answer 47

Autonomic neuropathy Neonatal infection Secondary infection

Question 48

What are complications of trichomoniasis?

Answer 48

Miscarriage | Preterm labour

Question 49

How is trichomoniasis treated?

Answer 49

Metronidazole

Question 50

What causes anogenital warts?

Answer 50

HPV types 6 and 11

Question 51

What are symptoms of anogenital warts?

Answer 51

Lumps with surface texture of a small cauliflower | Occasionally itching or bleeding especially if perianal or intraurethral