STIs Flashcards
what is the most likely differential for a male with purulent discharge and pain on urination
gonorrhoea
what is the most likely differential for a male with mild watery discharge
chlamydia
describe the normal vaginal flora
Normal vaginal flora – lactobacillus spp. Predominate in the healthy vagina produce:
- lactic acid – these suppress growth of other bacteria
- +/- hydrogen peroxide – of other bacteria
can also have small numbers of strep v, group b strep, candida
Intensely itchy white vaginal discharge
candida
what are the risk factors for candida
Recent antibiotic therapy; High oestrogen levels (pregnancy, certain types of contraceptives); Poorly controlled diabetes; Immunocompromised patients
diagnose candida
high vaginal swab for culture
treat oral candida
nystatin
treat vaginal candida
topical clotrimazole pessary or cream
oral fluconazole
Awful smelling discharge and may have dyspareunia
bacterial vaginosis
what is the main cause of BV
gardnerella vaginalis
what mainly has neutrophils on stain
gonorrhoea
what type of cells indicate BV
clue cells
diagnose BV
whiff test (add potassium hydroxide to elicit foul odor) wet mount
treat BV
metronidazole 7 days
describe chlamydia trachomatis
obligate intracellular bacteria with biphasic lifestyle
does chlamydia stain with gram stain ?
no as no peptidoglycan in the cell wall
what are the three serological groupings of chlamydia?
A-C - trachoma (eye infection)
D-K - genital infection
L1-L3 - lymphogranuloma venereum
what are the main tests for chlamydia or gonorrhoea
NAAT or PCR
how do you test for chlamydia and gonorrhoea
male - first pass urine
female - vulvovaginal swab
how do you treat chlamydia
doxycycline (if contraindicated give azithromycin)
what type of bacteria is Neisseria gonorrhoea?
gram neg intracellular diplococcus
what is the incubation period of gonorrhoea
2-5 days
what is the main symptom of gonorrhoea
purulent discharge
treat gonorrhoea
IM ceftriaxone
incubation of syphillus
9-90 days
painful ulcer
herpes
painless ulcer
syphillus chancre
how do you test for syphilis
IgM or IgG elisa for screening
if positive PCR or dark chain microscopy for diagnosis (or VDRL/ TPPA)
in syphilis what do you look for on dark chain microscopu
spirochaetes
what bacetria causes syphillus
treponema pallidum
types 6 and 11 HPV cause
warts
types 16 and 18 cause
cervical cancer
incubation of HPV
3 weeks to 9 months
Painless cauliflower like warts on vagina or penis
HPV viral warts
how do you treat viral warts
warticon (podophyllotoxin)
imiquimoid
cryotherapy
what is the incubation of herpes?
3-6 days
what is the duration of illness of herpes
14-21 days
why can herpes come back
remains in sacral root ganglion
how to test for herpes
viral swab pcr
treat herpes
acyclovir and pain relief
describe trichomonas vaginalis
Single celled protozoal parasite
what STI divides by binary fission
trichomonas vaginalis
diagnose trichomonas in females
high vaginal swab for PCR test
treat trichomonas
oral metronidazole
what is another name for phthirus pubis
crabs
what is the main symptom of phthirus pubis
extreme itch
how long do crabs live for
Males on average live for 22 days, female for 17 days
how is the diagnosis of phthirus pubis made
clinically
treat phthirus pubis
malathion lotion
what are the causative organisms of prostatitis?
Same organisms as UTI (E. coli & other coliforms, Enterococcus sp., but check for STI in patients <35years (gonorrhoea, chlamydia)
diagnosis of prostatitis
clinical signs and mid stream sample of urine for culture and sensitivity
if under 35yo do first pass urine also for chlamydia / gonorrhoea)
treat prostatitis
ciprofloxacin for 28 days
trimethoprim if high c diff risk
