STIs Flashcards
What causes gonorrhoea?
neiserria gonorrhoea
What are symptoms of gonorrhoea in men?
10% no symptoms
Thick yellow discharge, dysuria
Rectal and pharyngeal infection often asymptomatic
What are symptoms of gonorrhoea in women?
50% no symptoms
Vaginal discharge, dysuria, intermenstrual/post-coital bleeding
What are complications of gonorrhoea?
Men; epididymitis
Women; PID, bartholin’s abscess
Both; acute monoarthritis, disseminated gonococcal infection: skin lesions
What is the incubation period for gonorrhoea?
5-6days but can range from 2 days to 2 weeks
How is gonorrhoea diagnosed?
Nucleic acid amplification test (NAAT) on urine or swab from exposed site
Gram stained smear from urethra/cervix/rectum in symptomatic people
Culture of swab-obtained specimen using highly selective lysed blood agar in 5% CO2 environment to assess AB sensitivity
What is treatment for gonorrhoea?
Blind with ceftriaxone 1g im
Can also use sensitivities
What is follow-up for gonorrhoea?
Test of cure at 2 weeks and test of re-infection at 3 months
What causes chlamydia?
Chlamydia trachomatis serovars D to K
What are symptoms of chlamydia in men?
> 70% asymptomatic
Slight watery discharge, dysuria
Conjunctivitis
What are symptoms of chlamydia in women?
> 80% asymptomatic
Vaginal discharge, dysuria, intermenstrual/post-coital bleeding
Conjunctivitis
What are complications of chlamydia?
Men; epididymitis
Women; PID and ectopic pregnancy, pelvic pain and infertility (rare ~1%)
Both; reactive arthritis/Reiter’s syndrome, urethritis/cervicitis
How is chlamydia diagnosed?
First void urine in men
Swab from cervix/urethra/rectum as appropriate
All specimens tested using NAAT
What is treatment of chlamydia?
Doxycycline 100mg bd 1 week
Azithromycin 1g po once if pregnant
What is follow-up for chlamydia?
Test for re-infection at 3-12 months
Earlier test of cure unnecessary unless symptoms persist
What causes herpes?
Herpes simplex virus 1 and 2
What are symptoms of herpes?
80% no symptoms
Rest recurring symptoms; monthly/annually
Burning/itching then blistering then tender ulceration
Tender inguinal lymphadenopathy
Flu-like symptoms
Dysuria, neuralgic pain in back, pelvis, legs
What are complications of herpes?
autonomic neuropathy (urinary retention), neonatal infection
How is herpes diagnosed?
Clinical impression
Swab from lesion tested using PCR
What is treatment for herpes?
Primary outbreak; aciclovir - various regimens, lidocaine ointment
Infrequent recurrences; lidocaine ointment, aciclovir until symptoms gone
Frequent recurrences; aciclovir
What causes trichomoniasis?
Trichomonas vaginalis
What are symptoms of trichomoniasis?
Men; usually asymptomatic
Women; 10-30% asymptomatic, profuse thin discharge; greenish, frothy and foul smelling, vulvitis
What are complications of trichomoniasis?
Miscarriage and preterm labour
How is trichomoniasis diagnosed?
PCR on vaginal swab
Microscopy of wet preparation vaginal discharge
What is the treatment for trichomoniasis?
Metronidazole 400mg po bd for 5 days or 2 single dose
What causes anogenital warts?
HPV 6 and 11
What are symptoms of anogenital warts?
Lumps with surface texture small cauliflower
Occasional itching or bleeding esp if perianal or intraurethral
How are anogenital warts diagnosed?
Appearance
Biopsy if unusual (rare)
What is the treatment for anogenital warts?
Podophyllotoxin, imiquimod
Cryotherapy
Diathermy, scissor removal
What causes syphilis?
Treponema pallidum
What are the stages of syphilis?
Primary; local ulcer (chancre)
Secondary; rash, mucosal irritation, neuro symptoms, patchy alopecia
Early latent; no symptoms but <2yrs since caught
Late latent; no symptoms but ≥2yrs since caught
Tertiary; neurological, CV or gummatous
What are complications of syphilis?
neurosyphilis
cardiac or aortal involvement
How is syphilis diagnosed?
Clinical appearance
Serology for TP IgGEIA, TPPA and RPR
PCR on sample from ulcer
What is treatment for syphilis?
Early; benzathine penicillin 2.4 MU IM once or doxycycline 100mg bd po 2 weeks
Late; benzathine 2.4 MU im weekly for 3 doses
Doxycycline 100 mg bd po 28 days
