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REPRO > STIs > Flashcards

STIs Flashcards

1
Q

Most common STI

A

Chlamydia

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2
Q

Profuse penile discharge, pain on passing urin

A

Gonorrhoea

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3
Q

Chancre develops in which stage in syphily

A

primary

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4
Q

the great imitator ?—resembles many other sti

A

Syphilis

—resembles Genital herpes, chancroid

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5
Q

Which HSV type is viral shedding commonly seen in

A

HSV 2

—-more in the first year of infection

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6
Q

What is chlamydia appear as under the microscope?

A

gram negative

olbigate intracellular bacterium

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7
Q

What is the risk of PID from chlamydia ?

A

9%

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8
Q

What does a single PID episode increase the risk of ?

A
  • ectopic pregnancy by 10 fold

- carries a risk of TUBAL factor infertility of 15-20%

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9
Q

How does Chlamydia present as?

A
  • Post coital or intermenstrual bleeding
  • Lower abdominal pain
  • Dyspareunia
  • Mucopurulent cervicitis
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10
Q

Present. in Males for chlamydia?

A
  • milky, clear discharge
  • dysuria
  • urethritis
  • epididymo-orchitis
  • proctitis (LGV)
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11
Q

Complications of CT?

A
  • PID (50%)
  • REACTIVE arthtritis (can’t see,can’t pee, can’t bend my knee)
  • ectopic pregnancy
  • conjunctivitis
  • transmission to neonate (conjunctivis and pneumonia)
  • Fitz-hugh-curtis Syndrome (perihepatitis)
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12
Q

What advise when testing for CT in women?

A

-STOP testing for CT in women >25y.o with vaginal discharge (false +)
- do test on women who have had CT in the past year
(1 in5 women can be re-infected within 10 months after initial rx)

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13
Q

Where is L1-L3 serovars commonly diagnosed in? What are the symptoms?

A
  • dx in MSM

- rectal pain, discharge and bleeding

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14
Q

What risk does having LGV hold?

A
  • 67% HIV

- HIGH risk of CONCURRENT STI

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15
Q

How to dx chlamydia?

A
  • NAAT (test for gonorrhoea too): vulvovaginal swab (no need speculum), first void urine
  • MSM (do rectal swabs –if receptive ANAL intercourse)
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16
Q

RX of Chlamydia

A
  • doxycycline (100mg BD x 7 days)

- Axithromycin (1g stat FOLLOWED by 500mg DAILY for 2 days)

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17
Q

What is mycoplasma genitalium a.w?

A
  • non-gonococcal urethritis (15-25%)

- small a.w PID

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18
Q

How to test for M.Genitalium?

A
  • NAAT test (same sample as GC/CT)
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19
Q

What is the incubation period of Gonorrhoea?

A
  • urethral infect. in men is SHORT at 2-5 days
  • 50-90% risk from INFECTED MAN to female partner
  • —-20% risk from infected WOMan
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20
Q

Primary site of INFECTION for Gonorrhoea

A

urethra, endocervix, rectum, and pharynx.

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21
Q

Presentation of males for Gonorrhoea?

A
  • <10 % is asymptomatic
  • GREEN, YELLOW mucopurulent discharge from penis ( >80%)
  • dysuria
  • pharyngeal/ rectal infections (ASYMPTOMATIC; don’t forget to swab)
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22
Q

How does gonorrhoea present in females?

A
  • UP TO 50%: ASYMPTOMATIC …esp. with pharyngeal and rectal infection
  • increased vaginal discharge (40%
  • dysuria
  • ## PELVIC pain <5%
23
Q

What is bartholinitis?

A
  • SWOLLEN bartholin glands
24
Q

WHat does gonorrhoea appear as undee the microscope?

A
  • gram -ve, intracellular DIPLOCOCCI
25
Q

What are the advantages of NAAT?

A
  • non-invasive

- less trouble with storage, medium and transport

26
Q

How to treat gonorrhoea?

A
  • 1st line: Ceftriaxone 500mg IM

- second line: cefixime 400 mg AND azithromycin 2g oral (only if IM is c/i)

27
Q

WHen should you ask the patient to come in?

A
  • resampled AFTER 2 weeks
28
Q

How does genital herpes primary infection present as?

A 
Blistering and ulceration of the external genitalia
Pain
External dysuria
Vaginal or urethral discharge
Local lymphadenopathy
Fever and myalgia (prodrome)
29
Q

How long does genital herpes last?

A

14-21 days

30
Q

How do the recurrent episodes of HSV-2 infection present as?

A
  • usually UNILATERAL
  • small blisters
  • ulcers
  • —minimal systemic symptoms (resolves in 5-7 days)
31
Q

How to treat HSV?

A
  • give ORAL antiviral (ACYCLOVIR)
  • consider LIDOCAINE if very painful
  • —saline bathing
  • —-analgesia
32
Q

How to dx HSV

A
  • swab ulcer base for HSV PCR
33
Q

Why is it important to know if a pregnant lady with HSV has had a previous herpetic episode ?

A
  • -previous herpes episode means antibodies can be passed to the baby
  • —-they don’t know if theyve had it ….do PCR of swab and serology tests for antibodies
34
Q

What genotypes are covered by HPV vaccines?

A

hpv 6 and 11

HIGH risk types (this vaccine covers 90% of HPV cancers): HPV 16 and 18 and others

35
Q

What genotypes are covered by HPV vaccines?

A

hpv 6 and 11
HIGH risk types (this vaccine covers 90% of HPV cancers): HPV 16 and 18 and others

  • also available for MEN (esp. MSM)
36
Q

What is HPV 16 and 18 a.w?

A

16,18 responsible for the vast majority of cervical, anal, penile, vulval and oropharyngealW

37
Q

How long is the Incubation period of HPV?

A
  • 3 weeks to 9 months
38
Q

How are you most l likely going to obtain HPV infection?

A

—–from asymptomative partner

39
Q

Where are genital warts usually found?

A
  • occurs at site of friction

- —-ontriotikc entry to the vagina

40
Q

How to treat HPV ?

A
  • Podophyllotoxin (Warticon)
  • Imiquimod (GOOD - its an immune modifier) —-used on anogenital warts
  • Cryotherapy
  • Electrocautery
41
Q

How is syphilis transmitted?

A

Sexual contact
Trans-placental/during birth
Blood transfusions
Non-sexual contact – healthcare workers

42
Q

How does one contract syphilis?

A
  • may be acquired from years ago
  • become symptomatically only recently
  • —ps. RARE to develope to tertiary syphilis
43
Q

How long is the Incubation period of Primary syphilis?

A

9-90 days (non-tender LOCAL lymphadenopathy)

-mean of 21 days

44
Q

SYmptoms of SEcondary syphilis?

A
  • rashes on hand, torso
  • lymphadenopathy
  • Lesions of mucous membranes
  • Generalized Lymphadenopathy
  • Patchy Alopecia
  • Condylomata Lata (VERY infectious ) —-THE GREAT IMITATOR
45
Q

What skin conditions develop with IIary syphilis?

A
  • Macular/ follicular/ pustular
46
Q

What to expect in follow-up for syphilis?

A
  • until RPR is negative
  • —titres should decrease four fold by 3- 6months
  • —-serological relapse if titres increase by four fold
47
Q

What is a.w PID?

A

Chlamydia

48
Q

Disadvantages of NAAT?

A
  • risk of FALSE positive

- —-NAAT usually confirms results

49
Q

What are the advantages and disadv. of culture?

A
  • allows antibiotic sensitivity
  • monitoring

Disadv.: invasive test/specific medium and incubation needed

50
Q

Advs of microscopy?

Disadvs?

A
  • near pt dx
  • timely rx
    (-)ves: invasive/ low sensitivity/ requires confirmation
51
Q

What is the incubation period of Genital Herpes?

A

3-6 days

52
Q

Is syphilis always infectious?

A

ONLY Primary, Secondary and Early Latent stages are

53
Q

What is the lesion of primary syphilis?

A
  • primary chancre
  • painless
  • lesion at site of innoculation
  • —-90% sites are genital
54
Q

What serological tests specific to Treponema Pallidum?

A
  • TPPA
  • ELISA/EIA
  • INNO-LIA
  • FTA abs

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