STIs causing urethritis Flashcards
Examination for males:
Should the patient lie down or stand up?
What should you do?
Stand up
Retract foreskin
Inspect urethral meatus for discharge
Scrotal content/tenderness/swelling
Examination for females:
What position should they be put in?
Look at gynae for examination!!!
Lithotomy
Investigations:
Collection for men?
Collection for women?
Testing:
NAAT - what is it?
Urine sample or swab if there is discharge
Self-taken vulvo-vaginal swab
Endocervical swab if speculum inserted
Nucleic acid amplification test - chlamydia and gonorrhoea
A molecular test that detects the genetic material (DNA) of Chlamydia trachomatis.
Chlamydia genital tract infection:
Pathogen?
Presentation:
- Colour of discharge
- What may they have pain doing? - 2
- What type of bleeding in women?
Chlamydia trachomatis
Clear discharge or just increased vaginal discharge in women
Dysuria
Dyspareunia
PCB
IMB
Chlamydia genital tract infection:
Management - Antibiotics used as:
- 1st line - A
- 2nd line - D
What antibiotic is used if they are pregnant?
How far back do you go in contacting partners in women and men?
What should be avoided during Rx?
Azithromycin 1g PO witnessed - single dose
Doxycycline 100mg BD for 7 days
Erythromycin 500mg BD
6 months for women
1 month for men
Avoid sex
Chlamydia genital tract infection:
Complications:
- PID in women - what does this lead to?
- Fits-Hugh Curtis Syndrome - what is it?
- What type of bone disease may be triggered by this?
Men:
- Unilateral epididymo-orchitis - what is it?
Obstetrics:
- What may having chlamydia cause in pregnancy?
Tubal damage
Ectopic pregnancies
Infertility
A rare complication of pelvic inflammatory disease (PID) involving liver capsule inflammation leading to the creation of adhesions.
Reactive arthritis (Reiters syndrome)
Inflammation of the epididymis and/or testicle (testis). It is usually due to infection, most commonly from a urine infection or a sexually transmitted infection.
Conjunctivitis
Pneumonia
Gonorrhoea:
Pathogen
This pathogen can infect any columnar epithelium. Where does this happen to allow for swabs to be taken in these areas for testing?
Neisseria Gonorrhoeae
Urethra
Endocervix
Rectum
Pharynx
Gonorrhoea:
Men:
- Discharge - 2 things that may be present?
- What may the patient have pain doing?
- Anorectal symptoms - 3
Women:
- Discharge - 2 things that may be present?
- What may the patient have pain doing?
- Anorectal symptom - 1
Pus (purulent) and blood
Dysuria
Anal discharge Tenesmus Procotiits - the lining of inner rectum becomes inflamed ----- Pus (purulent) and blood
Dysuria
Proctitis (directly from anal sex or spread from the vagina)
Gonorrhoea:
Management - Antibiotics used - Single-dose Rx:
- 1st line - C + A
- 2nd line - C
What should be avoided during Rx?
Ceftriaxone 500mg IM + Azithromycin 1g PO witnessed
Cefixime 400mg PO
Avoid sex
Gonorrhoea:
Local Complications:
Men:
- Unilateral epididymo-orchitis - what is it?
Women:
- A type of vulval abscess they can get?
- Another inflammatory process common in women in their pelvis?
Systemic:
Disseminated gonococcal infection means it spread throughout the body. What could the effects of this be?:
- Brain
- Skin
- Joints
- Heart
You may also get arthritis-dermatitis syndrome. What is it?
Inflammation of the epididymis and/or testicle (testis). It is usually due to infection, most commonly from a urine infection or a sexually transmitted infection.
Bartholinitis (abscess)
PID
Meningitis
Pustular rash
Septic arthritis
Infective endocarditis
A form of DGI that usually comprises a triad of manifestations which include tenosynovitis, dermatitis, and polyarthralgia. It is also often associated with constitutional symptoms such as fever, chills, and body malaise.
Gonorrhoea:
Neonatal complications:
- Eyes
- Lungs
- Rectum
What is a rising complication of G which would hinder Rx?
Conjunctivitis
Pneumonia
Rectal infection
AB resistance
What is the difference between Gonorrhoea and NSU?
Non-specific urethritis (NSU) means any inflammation of a MAN’s urethra (the tube that carries urine from the bladder to the outside) that is not caused by gonorrhoea (a sexually transmissible infection).
It is sometimes called non-gonococcal urethritis (NGU).
Several organisms can cause NSU but, in many cases, the specific organism can’t be identified.
LOOK AT VAGINITIS FOR BV, T AND CAND IN GYNAE
LOOK AT VAGINITIS FOR BV, T AND CAND IN GYNAE
Non-gonococcal urethritis (NGU):
What symptoms do they have? - 3
What test is done to rule out chlamydia, gonorrhoea and UTI?
Rx is the same as chlamydia. What is it?
Urethral discharge
Dysuria
Urethral discomfort
Swabs
Urine dipstick
Azithromycin 5 days
