STIs Flashcards
What is the most oncogenic type of HPV?
Type 16
What HPV types can cause genital warts?
Types 6 and 11
What causes syphillis?
Treponema Pallidum - spirochaete
What are the features of primary syphillis?
Chancre at site of infection- usually painless
local non-tender lymphadenopathy
What are some features of secondary syphillis?
- Systemic symptoms like fever, lymphadenopathy
- Typical rash- seen on palms and sole
- Snail track ulcers
What is the treatment for syphillis, early and late stage?
Early- 2.4 MU Benzathine Penicillin stat
Late= 2.4 MU Benzathine Penicillin weekly for 3 weeks
Follow up serologically
What causes genital herpes?
HSV1 or HSV2
What herpes virus causes cold sores?
HSV1
What is the treatment of genital herpes?
Aciclovir 400mg TDS (5/7)
Can also consider topical lidocaine ointment 5% if very painful
Saline bathing and analgesia
How is a diagnosis of herpes made?
Swab in virus transport medium of de-roofed blister
PCR test
Viral shedding is more common is HSV2
True or False
True
In what kind of herpes virus are recurrent episodes more commonly seen?
HSV2
Describe primary infection with HSV?
Tends to have more severe symptoms that recurrant episodes
Incubation is 3-6 days
Duration is around 14-21 days
What causes Gonorrhea?
Gram negative diplococci- Niesseria Gonorrhoeae
What is the first line treatment for gonorrhea?
Ceftriaxone 1G IM
What is the 2nd line treatment of Gonorrhea?
Cefixime 400mg oral plus Azithromycin 2G
Only if IM injection in contra-indicated or refused by the patient
How is Gonorrhea tested for?
NAATs
- Male- first pass urine sample
- Rectal and throat swabs
- Eye swabs
- Test for both gonorrhea and chlaymidia
What is the most commonly seen STI in the UK?
Chlamydia
What are the 3 serological groups of chlamydia?
- Serovars A-C= occular infection, Trachoma
- Serovars D-K= Genital infection
- Serovars L1-L3= Lymphogranuloma Venerum- genital ulcerative disease
What is the treatment for Chlamydia?
Doxycycline 100mg BD for 1 week
2nd line= Azithromycin 1G stat followed by 500mg daily for 5 days
How is chlamydia diagnosed?
NAATs- samples are taken from;
- Males- first pass urine sample
- Females- VVS, can be taken by patient
- Rectal and throat swabs
- Eye swabs
What is Fitz Hugh Curtis syndrome?
A complication of PID.
Causes perihepatitis- a piano string from the liver capsule. Causes RUQ pain.
What might vaginal discharge look like in bacterial vaginosis?
Thin, white discharge
What would clue cells indicate?
Bacterial Vaginosis
What criteria is used to diagnose Bacterial Vaginoisis?
Amsel’s Criteris. 3/4 must be present
- thin, white, homogenous discharge
- clue cells on microscopy- stippled vaginal epithelial cells
- vaginal pH of >4.5
- positive whiff test- addition of potassium hydroxide results in fishy oddour
How is bacterial vaginosis treated?
Oral metronidazole for 5-7 days
What is bacterial vaginosis?
An overgrowth of aneorbic organisms like Gardnerella Vaginalis. Leads to a fall in lactic acid producing aerobic lactobacilli resulting in a raised vaginal pH
What would a strawberry cervix support a diagnosis of?
Trichomonas Vaginalis
Describe the discharge seen in Trichomonas Vaginalis?
Offensive. Frothy yellow-green
What is Trichomonas Vaginalis?
A highly motile, flagellated protozoan parasite. STI.
What would investigation show in Trichomonas Vaginalis?
Microscopy of a wet mount shows motile trophozoites
What is the treatment for trichomonas vaginalis?
Oral metronidazole for 5-7 days
What are some factors that make Vaginal Candiasis more likely to develop?
- Diabetes Mellitus
- Drugs- antibiotics, steriods
- pregnancy
- immunosupression- HIV
What might this discribe- cottage-cheese, non-offensive discharge?
Vaginal Candidiasis
How can Vaginal Candidiasis be managed?
- Local- clotrimazole pessary (clotrimazole 500mg PV stat)
- Oral- Itraconazole 200mg PO bd for 1 day or fluconazole 150mg PO stat
- If pregnant only local treatment
