STIs Flashcards
STI
infection predominanty sexually transmitted
other infections can be sexually transmissable but aren’t classed as STI
STD
the disease the infection causes
gonorrhoea: caused by
neisseria gonorrhoeae
gonorrhoea: symptoms in men
10% no symptoms
thick profuse yellow discharge, dysuria
gonorrhoea: symptoms in women
> 50% no symptoms
vaginal discharge, dysuria or intermenstrual/post-coital bleeding
gonorrhoea: complications
M: epididymitis
F: PID, bortholin’s abscesses
both: acute monoarthritis, disemminated gonococcal infection
gonorrhoea: incubation period
avg 5-6 days
range 2 days - 2wks (if get symptoms at all)
gonorrhoea: diagnosis
nucleic acid amplification test (NAAT) on urine or swab from exposed site - vagina, rectum, throat
gram stained smear from urethra/cervix/rectum in symptomatic people
culture of swab-obtained specimen from exposed site using highly selective lysed blood agar in a 5% CO2 environment
gonorrhoea: treatment
blind treatment with ceftriaxone 1mg
can also treat according to antibiotic sensitivities
gonorrhoea: follow up
test of cure at 2wks
test of reinfection at 3mo
chlamydia: caused by
chlamydia trachomatis serovars D to K
chlamydia: symptoms men
> 70% asymptomatic
slight watery discharge, dysuria
chlamydia: symptoms women
> 80% asymptomatic
vaginal discharge, dysuria, intermenstrual/post-coital bleeding
chlamydia: symptoms in both sexes
conjunctivitis
chlamydia: complications
M: epididymitis
F: PID, ectopic pregnancy, pelvic pain, infertility
both: reactive arthtitis, urethritis, conjunctivitis, arthritis
chlamydia: diagnosis
first void urine in men
self taken or clinical taken swab from cervix, urethra, rectum as appropriate
all specimens tested using NAAT
chlamydia: treatment
doxycycline 100mg bd 1wk
azithromycin 1g po once if pregnant
chlamydia: follow up
test for reinfection at 3-12mo
earlier test of cure not needed unless symptoms persist
herpes: caused by
herpes simplex virus types 1 and 2
herpes: symptoms
80% no symptoms
rest have recurring symptoms - monthly, annually
burning/itching then blistering then tender ulceration
tender inguinal lymphadenopathy
dysuria, neuralgic pain back, pelvis, legs
herpes: complications
autonomic neuropathy (urinary retention)
neonatal infection
secondary infection
herpes: incubation period
about 5 days to months
some people never report symptoms
herpes: diagnosis
clinical impression
swab from lesion tested using PCR
herpes: treatment primary outbreak
aciclovir - various regimens e.g. 400mg tds 5 days
lidocaine ointment
herpes: treatment infrequent recurrences
lidocaine ointment
aciclovir 1.2mg once daily until symptoms gone (1-3 days)
herpes: treatment frequent recurrences
aciclovir 400bd long-term as suppression
trichomoniasis: caused by
trichomonas vaginalis
trichomoniasis: symptoms men
usually asymptomatic
trichomoniasis: symptoms women
10-30% asymptomatic
profuse thin vaginal discharge - greenish, frothy and foul smelling
vulvitis
trichomoniasis: complications
miscarriage and preterm labour
trichomoniasis: diagnosis
PCR on vaginal swab
not validated on urine yet so no test for men
trichomoniasis: treatment
metronidazole 400mg op bd for 5 days or 2g single dose
anogenital warts: caused by
human papilloma virus types 6 and 11 (occasionally 1)
anogenital warts: symptoms
lumps with surface texture of small cauliflower
occasionally itching or bleeding esp if perianal or intraurethral
anogenital warts: complications
none common
neonatal laryngeal papillomatosis
anogenital warts: diagnosis
appearance
biopsy if unusual to exclude intraepithelial neoplasia
anogenital warts: treatment
podophyllotoxin, imiquimod
syphilis: caused by
treponema pallidum sub species pallidum
syphilis: symptoms/staged
primary: local ulcer
secondary: rash, mucosal ulceration, neuro symptoms, patchy alopecia
early latent: no symptom but <2yrs since caught
late latent: no symptoms but 2+ years since caught
tertiary: neurological, cardiovascular or gummatous
syphilis: complications
neurosyphilis - cranial nerve palsies commonest, cardiac or aortal invovlement
congenital syphylis
syphilis: incubation period
9-90 days
but can be asymptomatic
syphilis: diagnosis
clinical signs
serology for TP IgGEIA, TPPA and RPR
PCR on sample rom an ulcer
syphilis: treatment early
<2yrs and no neurological involvement
benzathine penicillin 2.4MU im once
or doxycycline 100mg bd po 2wks
syphilis: treatment late
2+ yrs and no neurological involvement
benzathine penicillin 2.4MU im weekly for 3 doses
doxycycline 100mg bd po 28days
