STIs - General Flashcards
What is a commensal microorganism
- A microorganism that derives food or other benefits from another organism without hurting or helping it
What is a pathogen
- A microorganism that can cause distress
What is an infection
- The invasion of all or part of the body by a microorganism
- No symptoms - subclinical
- Symptoms - clinical
What is a sexually transmissible organism
- A virus, bacteria, protozoan, insect or arthropod which can be spread by sexual contact
- Commensal
- Pathogen
What is an STI
- An infection by a pathogen which is sexually transmissible and which is unlikely to be transmitted by non-sexuals means
- Neisseria gonorrhoea
- HPV type 6
What is a STD
- A disorder of structure or function caused by a sexually transmitted pathogen
- Pelvic inflammatory disease
- Genital warts
What were thought of as ‘venereal diseases’
- Syphilis (Treponema pallidum pallidum)
- Gonorrhoea (Neisseria gonorrhoea)
- Chancroid (Haemophilus ducreyi)
Examples of bacteria in STIs
- Chlamydia trachmomatis
- Klebsiella granulomatis
- Mycoplasma genitalium
Examples of viruses in STIs
- HSV
- HIV
- HPV
- Molluscum contagiosum virus
Examples of parasites in STIs
- Pthirus pubis
- Sarcoptes scabei
- Trichomaonas vaginalis
What are the characteristics of STIs and the implications these have
- They’re transmissible - partner notified
- Asymptomatic most of the time - hard to eradicate from population, need to prevent
- All manageable but not always curable
- Avoidable - primary prevention/education
Types of transmission of STIs (high to low)
- Group sex
- Anal sex
- Vaginal sex
- Oral sex
- Touching someone else’s genitalia with you genitals
- Mutual masturbation
What activities are required for transmission of certain STIs
- Genital contact only
- Pubic lice (Pthirus pubis)
- Scabies (sarcoptes scabeii)
- Warts (HPV types 6&11)
- Herpes (HSV type 1&2)
- Group sex
- Hep C
Why are STIs important
- Can cause morbidity and can kill
- Unpleasant symptoms
- Psychological stress
- Drain on resources
- Managing infertility due to chlamydia - cost of IVF
- Cost of HIV medication and related condition
- Time off work to freeze warts
- Common
- More than 1m new everyday
- More than 500m have genital herpes
Common symptoms of STIs
- Fever
- Rash
- Lymphadenopathy
- Malaise
- Infertiloity
- Cancer - 250,000 + deaths from cervical cancer
- 300,000 adverse pregnancy outcomes from syphilis
General principles of management of STIs
- History
- Partner notification
- HIV testing
- Health promotion
What needs covered in the consultation for STIs
- Presenting complaint
- HPC
- PMH
- DH
- Gynae history
- Direct Qs about symptoms
Why is a sexual history necessary
- Determining possible cause of symptoms
- Detecting high-risk behaviour and advising to reduce further risk
- Tracing contacts
What is the contents of a sexual history
- When did you last have sexual intercourse
- casual contact vs ‘regular’ partner
- How long
- Male or females
- Nature of sex
- Anxiety
- Location of swab
- Condoms
- Contraception
- Nationality of contact
Risk assessment of male STIs
- Ever had sexual contact with a man
- ever injected drugs
- Sexual contact with
- Someone’s whose injected drugs
- Someone from outside UK
- Medical treatment outside of UK
- Involvement in sex industry
Ways of partner notification of STIs
- Patient tells contact ‘client referral’
- NHS tell contact ‘provider referral’
What is important health promotion regarding STIs
- Condoms prevent transmission of some STIs
- E.g. HIV, chlamydia, gonorrhoea
- Condoms aren’t good at preventing transmission of other STIs
- Herpes, warts
- Oral sex carries risks
- Alcohol and drugs
