STIs Flashcards
What is the most common STI?
Chlamydia, by a long way
What is the causative organism of chlamydia?
Chlamydia trachomatis
What % of people with chlamydia are asymptomatic?
WOmen= 70% Men= 30%
What are the features of chlamydia in men?
Slight watery urethral discharge, esp in morning
Dysuria
Itch
What are the features of chlamydia in women?
Change in bleeding pattern- IMB, PCB Dysuria Vaginal discharge Pelvic pain Dyspareunia
How is chlamydia diagnosed?
NAAT at least 2 weeks after possible exposure of
- first void urine in men
- low vaginal swab in women
- rectal/pharyngeal swab
What is the management of chlamydia?
Doxycycline 100mg 2x daily for 7 days
What is the alternative management of chlamydia?
High dose azithromycin if intolerant to doxy
What are the possible complications of chlamydia?
Reiter's syndrome Men= epididimytis Women -PID -endometriosis -ectopic pregnancy -infertility
What is the 2nd most common STI?
Gonorrhoea
What is the causative organism of gonorrhoea?
Neisseria gonorrhoeae
How % of people with gonorrhoea are asymptomatic?
10% men
50% women
What are the symptoms of gonorrhoea in men?
Profuse thick yellow-y discharge
Dysuria
What are the symptoms of gonorrhoea in women?
Vaginal discharge
Change in bleeding pattern- IMB, PCB
Dysuria
How is gonorrhoea diagnosed?
NAAT of
- first void urine in men
- low vaginal swab in women
- rectal/pharyngeal swab
What is the management of gonorrhoea?
IM ceftriaxone once
What are the complications of gonorrhoea?
Disseminated gonococcal infection
Men= epididimytis
Women= PID, Bartholin’s cyst
What does disseminated gonococcal infection cause?
Tenosynovitis
Migratory polyarthritis
Dermatitis
What causes genital warts?
HPV 6 and 11
What is the normal presentation of HPV 6 and 11?
Asymptomatic
What are the features of genital warts?
Lumps with surface texture of cauliflower
Itching, bleeding
How are genital warts diagnosed?
Clinically on appearance
Biopsy if unusual
What is the management of genital warts?
- Topical podophyllum
- Imiquimod cream
Cryotherapy- good for solitary keratinised warts
Diathermy
Scissor removal
When is podophyllotoxin cream avoided?
Pregnant, or trying women
Teratogenic
What is the causative organism of herpes?
HSV 1 and 2
What ar the features of herpes?
80% asymptomatic
Primary= painful genital ulceration, lymphadenopathy, neuralgic pain, flu like symptoms, dysuria
Recurrences
How is herpes diagnosed?
Clinical impression
Occasional PCR swab of ulcer
What is the management of herpes?
Oral aciclovir and lidocaine ointment
What are the complications of herpes?
Autonomic neuropathy
Neonatal infection
Secondary infection
Who is syphilis seen in?
> 90%= MSM
What is th causative organism of syphilis?
Treponema pallidum
What ar th 3 stages of syphilis?
Primary
Secondary
Tertiary
What are the features of primary syphilis?
Local ulcer aka chancre- firm, round and painless
What are the features of secondary syphilis?
Triad -Rash- involves palms and soles -Mucosal ulceration -lymphadenopathy Fever
What are the features of congenital syphilis?
Blunted incisors Saber shins Saddle nose Keratitis Deafness
What are the types of symptoms in tertiary syphilis?
Neuro, CV or gummatous
How is syphilis diagnosed?
Cardiolipin tests
Treponomal specific antibodies
How is syphilis treated?
IM benzathine penicillin OR doxycycline
What are the complications of syphilis?
Neurosyphilis- CN palsies common , Argyll Robertson pupils
CV involvement
Congenital syphilis
What ar the symptoms of trichomonas vaginalis in men?
asymptomatic
urethritis
What are the features of trichomonas vaginalis in women?
Profuse, thin vaginal discharge- greenish, frothy, foul smelling
Itch
Vulvitis
Strawberry cervix
How is trichomonas vaginalis diagnosed?
PCR and microscopy of swab
What is the management of trichomonas vaginalis?
Oral metronidazole
What are the complications of trichomonas vaginalis?
Miscarriage
Preterm labour
What is lymphogranuloma venereum?
STI of lymphatics caused by chlamydia trachomatis
What are the features of lymphogranuloma venereum?
Pustule progressing to ulcer
Painful inguinal lymphadenopathy
What is a chancroid?
Painful genital ulcer with unilateral lymph node enlargement
Common in developing world but rare in UK
What causes a chancroid?
H. ducreyi
