STIs Flashcards
How are infections transmitted during sex?
- sexual/genital secretions
- direct innoculation e.g. HSV
- trauma e.g. Hep C
- ingestion
- fomites e.g. sex toys
- injection drug use
List some risk factors for STIs:
- <25 years old
- change sexual partner
- non-condom use
- men who have sex with men
- past history of STI
- large urban areas
- social deprivation
- black ethnicity
Which STIs affect the mouth
- chlamydia
- gonorrhoea
- syphilis
- herpes simplex virus
- human papillomavirus
- human immunodeficiency virus
What is the classical sign of primary syphilis?
How does secondary syphilis present in the mouth?
Diagnosis?
Treatment?
Chancre - seen at site of infection, 70% painless, can be seen in the mouth
- cant fold in half, undulated, button like
Secondary syphilis:
- white glistening patches, greyish membrane, hyperaemic halo, snail track ulcers
- present on soft/hard palate, buccal mucosa, tongue
Diagnosis:
- lesion - swab for treponema pallidum by PCR
- venous blood - antibody and confirmatory tests
Treatment:
- antibiotic - benzathene penicillin or doxycycline
WEAR GLOVES WHEN TREATING PTS WITH SYPHILIS
How can HIV be transmitted?
Who are the high risk groups?
- mostly sexual transmission
- injection use
Everyone is at risk:
- men sex with men
- high prevalence countries
- injecting drugs
- sexual contact of above
How may primary HIV present?
- upto 80% present with symptoms
- onset average 2-4 weeks after infection
- combination of fever, rash, myalgia, pharyngitis, headache
- very high risk of onward transmission
Oral lesions:
- aphthous ulcers
- candidiasis
How may mucosal candidiasis present in HIV?
Mucosal candidiasis:
- pseudomembranous
- erythematous
- angular cheilitis
- oesophageal extension
- predictive of progression to AIDS
How may gingivitis present in symptomatic HIV?
Gingiviitis:
- linear gingival erythema
- necrotising ulcerative periodontitis
- often sudden onset
- absence of plaque/calculus
- relating to other lifestyle issues including IV drug use
How may kaposi’s sarcoma present as symptomatic HIV?
Oral Leukoplakia?
Anything else?
Kaposi’s sarcoma
- vascular tumour
- caused by human herpes virus 8
Oral hairy leukoplakia - associated with EBV
- predictor of progression to AIDS
- may have candida co-infection
Seborrhoeic dermatitis
How do you test for HIV?
How to care for people with HIV?
HIV testing:
- blood test - possible false negative in first 6 weeks
- specific verbal consent to test for HIV
Caring for people with HIV:
- ask patients if they are on treatment
- beware of drug-drug interactions
- do not be scared of patients with HIV
Which HPV strains increase the risk of oropharyngeal/cervical cancers?
- HPV16 and HPV18 strains are oncogenic
- alcohol and smoking add to risk
