W9 STI's Flashcards
What are STIs?
Sexually transmitted infections are grouped together by their mode of transmission – from person to person via sexual contact
Sexual transmission of STI can occur via?
Skin-to-skin contact or exchange of bodily fluids during insertive vaginal or anal sex, other close genital contact, and other types of sexual activity involving genital to mouth, genital to anus, mouth to anus, or hand to genital contact
Chlamydia: uncomplicated genital
- Infection of the urogenital tract typically causes inflammation of the urethra
in men and inflammation of the cervix and/or urethra in women. - It can also affect the conjunctiva, rectum, and nasopharynx.
- Infection is asymptomatic in at least 70% of women and 50% of men.
Chlamydia: uncomplicated genital
Pharmacological Management of STI’s?
For non-pregnant adults and children over the age of 13 years:
* First-line treatment is doxycycline 100 mg twice daily for 7 days (contraindicated in pregnancy and breastfeeding)
* If doxycycline is contraindicated or not tolerated consider azithromycin 1g orally as a single dose for 1 day, followed by 500 mg orally once daily for 2 days
Management
For pregnant women
- Azithromycin, 1 g orally for 1 day, then 500 mg orally once daily for 2 days, or
- Erythromycin 500 mg four times daily for 7 days, or erythromycin 500 mg twice daily for 14 days, or
- Amoxicillin 500 mg three times a day for 7 days.
- If there is any uncertainty, seek specialist advice.
Gonorrhoea
Gonorrhoea is caused by the Gram-negative bacterium Neisseria gonorrhoea
Uncomplicated gonorrhoea infection primarily affects the mucous
membranes of the urethra, endocervix, rectum, pharynx, and conjunctiva.
* Gonorrhoea is transmitted by direct inoculation of secretions from one mucous
membrane to another.
* Infection of the eye most commonly results from autoinoculation.
* Gonococcal infection among infants usually results from exposure to infected
cervical exudates at birth.
Syphilis
What is it?
What are the different types of syphilis?
- Syphilis is an infectious disease caused by the spirochete bacterium Treponema pallidum.
- Most cases are sexually transmitted during direct contact with an infectious lesion.
- Untreated infection can persist for years and progress through several stages:
- Early syphilis (within 2 years of infection) includes 3 stages — primary syphilis, secondary syphilis, and early latent syphilis.
- Late syphilis (more than 2 years after infection) includes 2 stages — late latent syphilis and tertiary syphilis.
- Syphilis can be cured if treated early with appropriate antibiotics.
- If left untreated, around a third of cases progress to later stages of disease which can lead to severe, sometimes irreversible, complications.
What are the complications of syphilis?
- Complications include:
- Neurosyphilis
- Cardiovascular syphilis
- Gummatous syphilis
- Adverse outcomes in pregnancy.
- Facilitation of HIV transmission.
The Stages of Syphilis:
Symptoms of syphilis?
First stage:
Chancres (Sores)
Second stage:
Hair loss
Swollen lymph nodes
Sore throat
Rash
Assessment of Syphilis:
- Suspect syphilis if there is a history or presence of any of the following, especially if there are any risk factors:
- Genital lesion(s) - Chancre
- Associated regional lymphadenopathy
- A non-pruritic maculopapular rash
- Moist wart-like lesions (condylomata lata)
- Patchy lesions on the oral mucosa (‘snail tract’ lesions).
- Generalized lymphadenopathy.
- Unexplained neurological or ophthalmological symptom
How should I manage a person with suspected syphilis?
Syphilis infection is suspected
=Refer to a genito-urinary medicine (GUM) clinic
Manage in GUM clinic (Strongly recommended)
Primary care setting (not recommended)
Explain the condition, risk factors, and potential complications; discuss prevention
* Discuss with a GUM specialist
* Discuss screening for other STIs
Treatment with Benzathine benzylpenicillin:
Preventing syphilis:
Use a condom when having vaginal or anal sex
Use a condom to cover the penis or a latex or plastic (dam) to cover the vagina if you have oral sex
Make sure you complete treatment if you or your partner have syphilis
Do not share sex toys (or wash and cover them with a new condom before anyone else uses them)
Do not share needles if you inject drugs
When untreated, which ONE of the following sexually transmitted infections (STIs) can cause neurological damage, blindness and cardiovascular disease?
A. Genital Herpes
B. Syphilis
C. Gonorrhoea
D. Chlamydia
=B
