STIs

Question 1

What are the 2 common pathogens causing cervicitis?

Answer 1

1. chlamydia

2. gonorrhea

Question 2

what are the 5 causes of vaginitis?

Answer 2

• yeast (candida)
• bacterial vaginosis
• trichomonas
• allergy/atrophy
• foreign body

Question 3

What is the Ddx for mucopurulant discharge from vagina?

Answer 3

-chlamydia, gonorrhea, bacterial vaginosis, trichomonas, foreign body (tampon)

Question 4

What are the sx of cervicitis?

Answer 4

• mucopurulant d/c
• asymptomatic**
• dysuria
• altered menstrual bleeding

Question 5

What is the most common bacterial STI in Canada?

Answer 5

Chlamydia Trachomatis

Question 6

What is the main complication of untreated Chlamydia?

Answer 6

-Pelvic inflammatory Disease (PID): infertility, ectopic pregnancy, chronic pelvic pain

Question 7

What is the rx for chlamydia?

Answer 7

azithromycin or doxycycline

• rx partner
• reportable
• no intercourse 1 wk

Question 8

What is the causal pathogen of gonorrhea?

Answer 8

Neisseria gonorrhea

Question 9

What happens w disseminated gonorrhea?

Answer 9

fever, rash, tenosynovitis, polyarthralgias, purulent monoarthritis

Question 10

How to rx Gonorrhea?

Answer 10

-Ceftriaxone IM and Azithromycin PO (bc chlamydia and gonorrhea often package deal)

• rx partner
• reportable
• no intercourse 1 wk

Question 11

Bacterial vaginosis is caused by what pathogen?

Answer 11

Gardnerella vaginalis

Question 12

What are the sx of bacterial vaginosis?

Answer 12

• asymptomatic, thin/gray/white d/d w fishy odour
• not STI

-non reportable

Question 13

What is the rx for bacterial vaginosis?

Answer 13

Flagyl

Question 14

What pathogen causes vaginitis trichomonas?

Answer 14

Trichomonal vaginalis (protozoa)

Question 15

what are the sx of vaginitis trichomonas?

Answer 15

• Asx, or gray/green, frothy d/c w fishy odour

- vaginal/cervical erythema

Question 16

How to rx vaginitis trichomonas?

Answer 16

• Flagyl
• rx partner
• non reportable

Question 17

What are the reportable STIs (to Public Health)?

Answer 17

• Chlamydia
• Gonorrhea
• Trichomonas
• Syphilis
• Hepatitis B

CGTSHB

Question 18

What are the signs/sx of urethritis?

Answer 18

mucopurulent d/c
urinary frequency, dysuria
meatal redness
Asx

Question 19

What are the major pathogens causing urethritis?

Answer 19

1. Gonorrhea (GN intracellular diplococci) 40%
2. Non-gonoccoal urethritis (NGU):
   - Chlamydia (15-55%)
   - Ureaplasma Urealyticum (20%)
3. Other:
   - mycoplasma genitalium
   - trichomonas vaginalis
   - HPV
   - adenovirus (rare)
   - Candida Albican (rare)

Question 20

What is the rx for urethritis?

Answer 20

-azithromycin or doxycyline + ceftriaxone IM (if GC)

• abstinence for 7 days
• rx partner (list 60 days)

Question 21

what is the main complication of untreated urethritis in men?

Answer 21

chronic prostatitis

Question 22

What are the sx for epididymitis?

Answer 22

• gradual onset
• unilateral testicular pain/swelling/tenderness
• maybe fever, maybe d/c

-ddx: trauma, torsion, tumour

35 yo: 3/4 coliforms or pseudomonas

Question 23

What is the rx for epididymitis?

Answer 23

if 35: ofloxacin

Question 24

What is the ddx for genital ulcers?

Answer 24

1. Infectious (most common):
   - genital herpes HSV 1,2
   - syphilis
   - chancroid
   - Lymphogranuloma venereum (LGV)
   - granuloma inguinale
2. Non-infectious
   - Behcet syndrome
   - fixed drug eruption
   - psoriasis
   - sexual trauma

Question 25

Describe the sx of genital herpes:

Answer 25

- painful - multiple vesicles - ulcerate then crust - heal within 14-21 d - constitutional: fever, myalgias, lymphadonopathy

Question 26

Describe HSV:

Answer 26

- dsDNA virus - retrograde transport to sensory ganglia (latent infx, lifelong) - incubation (2-21 d) 90% HSV-2 infx= gential 90% HSV-1= oral

Question 27

What is used to rx HSV infection?

Answer 27

- no cure - rx: anti-virals (lower load): acyclovir, famcyclovir, valacyclovir - valtrex (to dec transmission to partner by 48%)

Question 28

What is the pathogen causing syphilis?

Answer 28

Treponema Pallidum

Question 29

What are the sx of syphilis?

Answer 29

-painless, non-tender lymphadenopathy

Question 30

How is syphilis rx?

Answer 30

Penicillin IM

Question 31

What pathogen causes chancroid?

Answer 31

Haemophilus Ducreyi

Question 32

What forms of HPV progress to cancer?

Answer 32

HPV 16, 18

Question 33

What are the most common strains of HPV?

Answer 33

HPV 6, 11 (low cancer risk)

Question 34

What rx is used for HPV?

Answer 34

LNO2, Imiquimod, Podophyllin , TCA

Question 35

Describe moluscum contagiosum:

Answer 35

- divot in centre of lesion - viral dsDNA pox virus - common in kids - liquid nitrogen rx