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94 Cards in this Set
- Front
- Back
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What are the 4 major bacterial STI?
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Gonorrhoea
Clamydia Syphilis Chancroid |
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What are the 4 major viral STI?
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HIV
HSV HPV HBV |
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What are the top 3 STI in the developing world?
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HIV
HSV Gonorrhoea |
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What are the top 3 STI in the developed world?
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HSV
HPV Chlamydia |
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What are the notifiable STIs in Australia?
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Syphilis
Gonorrhea Chlamydia Tropical STIs |
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What are the major manifestations of STIs?
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Urethral Discharge -Males
Vaginal Discharge -Females Genital Ulcers |
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What are some of the non-major manifestations of STIs?
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Lumps and Bumps
Rashes Abdominal Pain Scrotal Swelling |
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What are the major consequences of STI?
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Death
Infertility Perinatal infection Systemic infections Psychosexual morbidity Genital tract tumours |
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Name some STIs that can cause perinatal infection
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HIV
Gonorrhoea Chlamydia HSV HPV HBV |
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Name some STIs that can cause infertility
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Gonorrhoea
Chlamydia |
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Name some STIs that can cause systemic infections
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HIV
Syphilis Gonorrhoea |
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What are the mechanisms by which STIs can increase HIV susceptibility?
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Genital ulcers -> mucosal disruption
Target cell recruitment and activation enhanced viral replication |
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What is the reproductive rate equation?
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Ro = bDc
b = probability of infection D = duration of infectiousness c rate of new partners |
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What is the principle behind reducing transmission of STIs?
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reduce the titre at time of intercourse or likelihood of exposure
condoms spermicides/microbicides antiviral treatment pre and post-exposure prophylaxis (antivirals or vaccinations) |
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When is the infectiousness of HIV highest?
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Early infection and late-stage infection
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What is the "core" concept in relation to STI and the population?
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The reservoir of STIs for the larger population is within core groups made up of individuals with are high rate of sex partner changes who also have high connectivity
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What are primary intervention strategies for STI reduction?
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Health promotion/counselling/ vaccination
Condoms |
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What are the secondary intervention strategies for STI reduction?
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Promoting seeking of health care
Accessible, acceptable and effective care Early detection of infection -screening |
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What are the territory intervention strategies for STI reduction?
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Appropriate management (diagnosis, treatment, i.e. comprehensive care)
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True or false:
Male circumcision is effective in reducing female to male sexual transmission of HIV by approx 60% |
True
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True or false
Male circumcision reduces the incidence of HSV-2, prevalence of HPV and infection with syphilis |
False
Had no effect on syphilis transmission |
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What are the methods for contact tracing?
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Patient
Health care provider Public health officials Police |
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What are the 7 contraceptive ages of woman?
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adolescence
sexually active without regular partner stable relationship before pregnancy during lactation after completed family menopause |
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What is the lactation amenorrhoea method?
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Full breast feeding without complementary feeds = maximum prolactin secretion during sucking inhibits ovulation
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How do copper-bearing IUDs work?
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alters IU cavity milieu
influx of leukocytes = local inflammatory process -- hostile environment for sperm migration may influence tubal transport and implantation |
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Name some contraceptive progesterones and what is the main difference in their structures?
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Levonorgestrel (Gonane) -ethyl group
Norethisterone (Estrane) -methyl group |
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Name some oestrogen's which are used in OCP
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Ethinyl oestradiol (main)
oestradiol valerate micronised oestrodiol |
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What drugs make up the core of the Nuva Ring?
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Evatane
Etonogestrel Ethinylestradiol |
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What are the morning after emergency contraception available?
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high dose, oral progesterone only pill (postinor)
High dose, oral, combined pill (Yuzpe) mifepristone IUD |
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What is the mechanism of hormonal emergency contraceptive action?
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inhibition (or delay) of ovulation (follicular development, attenuation of mid cycle LH peak)
Possible adverse influence on sperm migration |
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What is the effect of hormonal emergency contraceptive action on implantation?
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None -no evidence that it prevents implantation
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What is the mechanisms for IU emergency contraceptive action?
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influences follicular and corpus luteum
adverse effect of sperm migration (prevention of fertilisation) may adversely affect implantation (unlikely to be a primary mechanism) |
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Where is the only place in which HPV can infect?
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stratum basale
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What are the two strains of HPV that are commonly associated with cervical cancer?
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16 18
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What is the incubation period for HSV -> cancer
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20-50 years
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True or false
HPV only causes cervical cancer |
False
Its responsible for anal cancer and men and women It has also been implicated in 25% of head and neck cancers (mainly oropharynx) It can also cause vulval and vaginal cancers (found in 75-90% of cases) |
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What factors increase the risk of anal cancer due to HPV in men?
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sex with other men
HIV positive |
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What strains of HPV are associated with genital warts?
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6, 11
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What vaccine covers HPV 6, 11, 16, 18?
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Gardasil
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What vaccine covers HPV 16 and 18?
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Cervarix
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How does HSV gain entry into cells?
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Glycoprotein gC binds to heparan sulfate on cell surface and causes cell to take it up
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What is the treatment of HSV and how does it work?
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Acyclovir
Converted into ACV-TP in infected cells only (uses herpes thymidine kinase) ACV-TP inactivates HSV DNA pol |
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What allows the attachment of Neisseria Gonorrhoeae?
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pili
S-pilin protein interacts with CD46 on cell |
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Why are some woman asymptomatic in the lower genital tract when infected by Neisseria Gonorrhoeae?
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C3b binds to lipid A protein of LPS and this is quickly inactivated (iC3b) -> stops inflammation
inhibition is less upstream |
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in the life cycle of chlamydia, what are the two forms it takes?
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elementary body
reticulate body |
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What does an infection with T. palladium cause?
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syphilis
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what is the incubation period of T. palladium dependent on?
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inoculum size
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How does T. palladium attach to host cell?
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spirochaete
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What are the stages of T. palladium infection? And what happens in these stages?
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Primary stage: chancre
multiplication, antibody response (IgM and IgG), infiltration with lymphocytes and macrophages Patient is highly infectious Secondary stage When chancre is over and local response has primary stage under control |
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What factors influences the composition of vaginal flora
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age
menstrual cycle sexual experience antimicrobials |
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What is the predominant vaginal flora?
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anaerobes and lactobacillus
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True of false
in the vagina, S. aureus is the minority |
True
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What are the common infective causes of vaginal discharge?
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Vaginal infection:
Candidiasis Bacterial vaginosis Trichomonasis Cervical infection: Gonorrhoea Chlamydia |
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What are the common infective causes of urethral discharge?
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Gonorrhoea
Chlamydia Mycoplasma genitalium Ureaplasma urealyticum |
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What are the common infective causes of genital ulceration?
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Genital herpes
Syphilis Tropical STDs Candidasis |
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What are some topical STDs?
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Chancroids
Donovanosis Lymphogranuloma venereum |
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What are some genital infestations
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pubic lice
scabies |
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What sites are involved in a chlamydia infection?
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male urethra
cervix |
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What are the complications of chlamydia?
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PID
Fitz Hugh Curtis syndrome Epipymo-orchitis Reactive arthritis |
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How would would diagnosis chlamydia infection?
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culture
PCR/LCR |
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How would you treat Chlamydia?
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Azithromycin 1g or Doxycycline 100mg for 7-10 days
Effective for most ureaplasmas as well If patient doesn't respond: Erythromycin 500mg tis for 14 days |
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What sites are involved in Gonorrhoea?
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male urethra
cervix anal canal throat |
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What are the complications of gonorrhoea
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Same as Chlamydia
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How would you diagnose gonorrhoea?
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Gram stain
Culture PCR |
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What is opthalmia neonatorum? And how would you treat it?
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Caused by gonorrhoea and chlamydia in children born to infected mothers
Sight threatening Treat with topical and systemic antibodies |
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How would you treat gonorrhoea?
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Ceftriaxone 500mg IMI
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What is candidiasis associated with and what is the discharged described as?
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discharge: cheesy
associated with pregnancy and diabetes |
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How would you treat candidiasis?
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Topical: Clotrimazole, Econazole
Oral: Fluconazole |
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In bacteria vaginosis how would the discharge be described as?
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frothy
offensive |
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What is bacteria vaginosis caused by?
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anaerobic bacteria?
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If a patient has bacterial vaginosis during pregnancy, how might it affect her child?
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Associated with low birth weight and prematurity
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How would you treat bacterial vaginosis?
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Metronidazole 2g orally
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What causes trichomoniasis?
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trichomonas vaginalis
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How would you describe the discharge caused by trichomoniasis?
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Frothy
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How would you treat trichomoniasis?
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Metronidazole 2g orally
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What are the complications of genital herpes?
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urinary retention
meningitis |
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How would you diagnose genital herpes
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culture
RCP serology |
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How would you treat the first episode of genital herpes?
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Valaciclovir 500mb bd x 5-10days
or oral aclclovir 200mg 5x daily 5-10days Analgesia often required |
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How would you manage recurrent genital herpes?
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Episodic treatment
Suppressive treatment |
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What does the territory stage for syphilis involve?
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neurological, CV and gumatous
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How would you diagnose syphilis
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Serology
Dark Field |
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In syphilis are chancres painful or painless?
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painless
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How would you treat syphilis?
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Procain pencillin 600mg IMI daily for 10-14days
or Benzathine Penicillin 1.8g IMI If allergic to penicillin: Doxycyclin 100mg bd for 30 days or erythromycin 500mg tds for 2 weeks |
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What is the main symptom of Chancroid?
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Painful destructive ulcers
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What is the main symptoms of LGV?
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Transient genital ulceration and LT lymphatic involvement
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What is the main symptom of dovanosis?
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beefy proliferative ulcers
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How would you treat tropical infections?
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Azithromycin
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What are the main sites for genital warts?
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Penis
Vulva Perineum |
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How would you treat genital warts?
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cryotherapy
electocautery chemical cautery podophyllotoxin imiquimod |
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How successful are the treatments for genital warts?
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Successful
but recurrence in about 60% |
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True or false
Molluscum contagiosum is self limiting |
True
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How would you treat mulluscum contagiosum?
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cryotherpay
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How would you treat scabies?
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Quellada or Malathion lotion
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How would you treat pubic lice?
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malathion lotion
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