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Reproduction > Y4 tutorial STI > Flashcards

Y4 tutorial STI Flashcards

1
Q

What test is used test for chlamydia and gonorrhoea?

A

NAAT (nucleic acid amplification test)

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2
Q

How do you get the sample for a NAAT in men and in women?

A

Men - first void urine

Women - lower vaginal swab (can be self obtained)

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3
Q

What things may you need a high vaginal swab for?

A

BV
Candida
TV (in Grampian use NAAT as more sensitive)

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4
Q

What is the most common STI in the UK?

A

Chlamydia

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5
Q

How can chlamydia present?

A

Asymptomatic in 70% women, 30% men
Men - discharge, dysuria, urethral itch
Women - post-coital bleeding, IMB, dysuria, deep dysparenuia, pelvic pain

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6
Q

What are complications of chlamydia in men?

A

Epididymo-orchitis

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7
Q

What are complications of chlamydia in women?

A

PID

Infertility

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8
Q

What causes lymphogranuloma venereum?

A

Chlamydia trachomatis-3 serovars

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9
Q

Who is LVG mostly seen in?

A

MSM

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10
Q

How does LVG tend to present?

A

Rectal pain
Anorectal bleeding
Mucoid and/or haemopurulent rectal discharge
Tenesmus
Constipation or other symptoms of lower GI inflammation
(Mimics IBS)

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11
Q

How is an uncomplicated chlamydia infection treated?

A

Doxycycline 100mg bd 7d and abstain for duration of course

If CI multidose azithromycin (1g stat, then 500mg daily for 2d)

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12
Q

What is an essential part of treating STIs?

A

Contact tracing and notification

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13
Q

How is LGV managed?

A

Doxycycline 100mg twice daily for 3 weeks

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14
Q

What is a gonorrhoea infection a marker of?

A

High risk sexual behaviour

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15
Q

Why has gonorrhoea infections increased?

A

Due to PrEP effect (more MSM having unrprotected sex)

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16
Q

What kind of pathogen is gonorrhoea?

A

Gram negative diplococcus

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17
Q

What kind of tissue does gonorrhoea infect?

A

Mucous membranes - urethra, endocervix, rectum, pharynx, conjuctiva

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18
Q

What is the incubation period of gonorrhoea?

A

2-5 days

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19
Q

How does gonorrhoea tend to present in men?

A

Urethral infection: Urethral discharge, dysuria, can be asymptomatic
Rectal infection: usually asymptomatic, may get anal discharge, perianal pain/discomfort
Pharyngeal infection: usually asymptomatic

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20
Q

How does gonorrhoea tend to present in women?

A

Similar to chlamydia

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21
Q

What is the first line treatment for uncomplicated gonorrhoea?

A

1g ceftriaxone
REVIEW after 14d for test of cure

If ceftriaxone refused oral cefixime 400mg single dose + oral azithromycin 2g should be used

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22
Q

What does mycoplasma genitalium cause?

A

Non-gonococcal urethritis

23
Q

Who should you test for MG?

A

Those with recurrent/persistent symptoms

24
Q

What ist he first line treatment of MG?

A

Doxycycline

But may req. treatment with moxifloxacin as many are resistant

25
Q

List causes of ‘lumps’ on the genitalia

A 
Genital warts
Molluscum contagiosum
Bartholin's abscess
Cysts/abscesses
Dermatoses
Malignancies
Normal findings
26
Q

What strains of HPV cause genital warts?

A

6 and 11

27
Q

What strains of HPV cause cervical cancer?

A

16, 18

28
Q

What is the name of the quadrivalent vaccine that protects against HPV strains 6, 11, 16, 18?

A

Gardasil

29
Q

What is the investigation for HSV?

A

PCR from ulcers/vesicular fluid

30
Q

How do you treat HSV infection?

A

Aciclovir PO

Analgesics

31
Q

What is the incubation period of syphillis?

A

10-90 days

32
Q

How can syphillis be transmitted?

A

Sexually
Blood borne (rare)
Transplacental after 9 weeks

33
Q

What are the stages of syphillis?

A

Primary
Secondary
Latent
Teritary

34
Q

What happens in primary stage of syphillis?

A

Painless ulcers + associated lymphadenopathy

35
Q

What is the commonest mode of transmission of syphillis?

A

Orogenital contact

36
Q

What happens in secondary syphillis?

A

Haematogenous dissemination so systemically unwell (malaise, fever, myalgia, rash, lympadenopathy)

37
Q

What are features of tertiary syphillis?

A

Gumma
Cardiovascular issues
Neurosyphillis

38
Q

What stage of syphillis carries the greater risk in pregnancy?

A

Early syphillis

39
Q

What consequences to the foetus can syphillis in pregnancy lead to?

A

Spontaneous abortion
Preterm labour
Perinatal death
Congenital syphillis infection

40
Q

Someone presenting to ENT with ______ should be considered to be tested for syphilis.

A

Sensorineural deafness

41
Q

Someone presenting to dermatology with ______ should be considered to be tested for syphilis.

A

Unexplained skin changes

42
Q

Someone presenting to ophthalmology with ______ should be considered to be tested for syphilis.

A

Interstitial keratitis

43
Q

Someone presenting to haematology with ______ should be considered to be tested for syphilis.

A

Unexplained lympadenopathy

44
Q

Someone presenting to cardiology with ______ should be considered to be tested for syphilis.

A

Conduction defects
Aortic regurg
Aortic aneurysm

45
Q

Someone presenting to neurology with ______ should be considered to be tested for syphilis.

A

Meningovascular
Argyll Roberston pupils
General paralysis of the insane
Tabes dorsalis

46
Q

within what time frame should HIV PEPSE be given?

A

72 hours

47
Q

Who should be considered for HIV PEPSE?

A

Anyone who has had a significant exposure to HIV

48
Q

What does HIV PEPSE involve?

A

Combination of antiretrovirals (3 drugs - Truvada and Raltegravir) taken for 1 month

49
Q

What drug is used for HIV PrEP?

A

Truvada

50
Q

What is the discharge in gonorrhoea like?

A

Profuse

Pussy

51
Q

What is the discharge in chlamydia like?

A

Milky, less than in gonorrhoea

52
Q

When should you test for HIV after someone has taken PEPSE?

A

4 weeks after stopping the antivirals

53
Q

What are complications of gonorrhoea?

A

Urethral strictures
Epididymitis
Salpingitis

54
Q

What are key features of a disseminated gonococcal infection?

A

Tenosynovitis
Migratory polyarthritis
Dermatitis

Later complications include septic arthritis, endocarditis, perihepatitis (Fitz-Hugh-Curtis syndrome)

Reproduction (28 decks)

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