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Anatomy > STIs self learning package > Flashcards

STIs self learning package Flashcards

1
Q

Gonorrhoea is caused by?

A

Neisseria gonorrhoea

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2
Q

Symptoms of gonorrhoea in men

A

10% assymptomatic

thick profuse, yellow discharge, dysuria. rectal & pharyngeal infection, often assymptomatic

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3
Q

Symptoms of gonorrhoea in women

A

>50% assymptomatic
vaginal discharge, dysuria or intermenstrual/post-coital bleeding

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4
Q

Complications of gonorrhoea

A

Male- epidyymitis
female- PID, bartholin’s abcess

Both- acute monoarthritis (elbow/shoulder)
disseminated gonococcal infection: skin lesions, pustular with halo

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5
Q

incubation period of gonorrhoea

A

Average 5 to 6 days. Range 2 days to 2 weeks (if get symptoms at all).

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6
Q

Who are most cases of Ghonorrhoea found in?

A

MSM
much less common than chlamydia

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7
Q

How is gonorrhoea diagnosed

A

Nucleic Acid Amplification Test (NAAT) on urine or swab from an exposed site – vagina, rectum, throat. Could be self-obtained or clinician-obtained.
Gram stained smear from urethra/cervix/rectum in symptomatic people.
Culture of swab-obtained specimen from an exposed site using highly selective lysed blood agar in a 5% CO2 environment. Should be done for all confirmed cases to assess antibiotic sensitivity.

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8
Q

Treatment of gonorrhoea

A

Blind treatment with ceftriaxone 1g im. Can also treat according to antibiotic sensitivities.

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9
Q

Follow up for cases of gonorrhoea

A

Test of cure at 2 weeks and test for reinfection at 3 months

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10
Q

Chlamydia- caused by?

A

Chlamydia trachomatis serovars D to K

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11
Q

Symptoms of chlamydia in men, women and both

A

men: >70% asymptomatic
Slight watery discharge, dysuria
women: >80% asymptomatic. Vaginal discharge, dysuria, intermenstrual/post-coital bleeding
Both: conjuctivitis

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12
Q

Complications of chlamydia in men, women and both

A

Men: epidydmitis

Women: PID, ectopic pregnancy, pelvic pain & infertility (only in 1%)

Both: reactive arthritis/reiter’s syndrome- urethritis/cervicitis + conjuctivitis + arthritis

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13
Q

Who is chlamydia most often found in

A

Common
most cases in people under 25, especially sexually active teenage women

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14
Q

Diagnosis of chlamydia

A

First void urine in men
Swab from cervix, urethra, rectum

All specimens tested using NAAT

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15
Q

Treatment of chlamydia

A

Doxycycline 100mg bd 1 week
Azithromycin 1g po once pregnant

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16
Q

Flollow up for chlamydia treatment

A

Test for re-infection at 3-12 months. earlier test of cure not needed unless symptoms persist

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17
Q

Cause of herpes

A

Herpes simplex virus types 1 and 2

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18
Q

Symptoms of herpes

A

80% have no symptoms. The rest have recurring symptoms – monthly, annually. Burning/itching then blistering then tender ulceration.
Tender inguinal lymphadenopathy. Flu-like symptoms.
Dysuria, Neuralgic pain in back, pelvis and legs,

19
Q

Complications of herpes

A

Autonomic neuropathy (urinary retention), neonatal infection, secondary infection

20
Q

Incubation period of herpes

A

About 5 days to months
some people never report symptoms

21
Q

How common is HIV?

A

Very common ~ 15-20% of UK population has it. Both strains equally common in genital infection. Roughly equal between sexes. HSV2 is important co-factor for HIV transmission.

22
Q

Diagnosis of HIV

A

Clinical impression.
Swab from lesion tested using PCR.

23
Q

Describe the treatment of HIV, in the case of a Primary outbreak

A

Aciclovir: various regimens – eg 400mg tds for 5 days Lidocaine ointment

24
Q

Describe the treatment of HIV, in the case of infrequent recurrences:

A

Lidocain ointment
aciclovir 1.2g once daily until symptoms are gone (1-3 days)

25
Q

Describe the treatment of HIV, in the case of frequent recurrences:

A

Aciclovir 400bd long term- as supression

26
Q

Cause of trichomoniasis

A

Trichomonas vaginalis

27
Q

Symptoms of trichomoniasis

A

Men: Usually asymptomatic
Women: 10-30% asymptomatic
Profuse thin vaginal discharge - greenish, frothy and foul smelling. Vulvitis.

28
Q

Is trichomoniasis common & who is it most common in

A

Uncommon, approx 100/yr in Grampian. More common in middle aged women than some other STIs are.

29
Q

Complications of trichomoniasis

A

Miscarriage & preterm labour

30
Q

Diagnosis of trichomoniasis

A

PCR on vaginal swab

Point of care: microscopy of wet preparation of vaginal discharge

31
Q

Treatment of trichomoniasis

A

Metrondiazole 400mg po bd for 5 days
or 2g single dose

32
Q

Anogenital warts; caused by

A

Human Papilloma Virus types 6 and 11 (and occasionally type 1). (NB different strains from those that cause cervical cancer.

33
Q

Symptoms of anogenital warts

A

Lumps with a surface texture of a small cauliflower. Occasionally itching or bleeding especially if perianal or intraurethral.

34
Q

how much of the population gets genital HPV during their life

A

90% of UK population have a genital HPV infection at some point in their life. Only about 20% of those infected with a wart-causing strain of human papilloma virus get warts. A drop in cases is anticipated in response to quadrivalent HPV

35
Q

Any common complications of anogenital warts?

A

None common. Neonatal laryngeal papillomatosis.

36
Q

Diagnosis of anogenital warts

A

Appearance. Biopsy if unusual – to exclude intraepithelial neoplasia, but this is rarely needed

37
Q

Treatment of anogenital warts

A

Podophyllotoxin (brands warticon and condyline), imiquimod (brand Aldara). Both home treatments. Others – cryotherapy

38
Q

Causes of syphillis

A

Treponema pallidum subspecies pallidum

39
Q

Symptoms/stages of syphillis

A

Diverse. Often entirely asymptomatic or mild symptoms

Primary- local ulcer (chancre)

Secondary- rash, mucosal ulceration, neuro symptoms, patchy alopecia, others

Early latent- no symptoms but <2 years since caught

Late latent- no symptoms but >2 years since caught

Tertiary- neurological, cardiovacular or gummatous (skin lesion)- all very rare

40
Q

Who is most commonly affected by syphillis

A

MSM

41
Q

Complications of syphillis?

A

neurosyphilis – cranial nerve palsies are commonest, cardiac or aortal involvement. Congenital syphilis (extremely rare in Scotland).

42
Q

Incubation period of syphillis

A

9 to 90 days until appearance of chancre. But can be asymptomatic.

43
Q

Diagnosis of syphillis

A

Clinical signs
Serology for TP IgGEIA, TPPA and RPR PCR on sample from an ulcer

44
Q

Treatment of syphillis

A

Early (<2 yrs and no neurological involvement): Benzathine penicillin 2.4 MU im once Or Doxycycline 100mg bd po 2 weeks
Late (>2 years) and no neurological involvement Benzathine penicillin 2.4MU im weekly for 3 doses Doxycycline 100mg bd po 28 days

Anatomy (30 decks)

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