Trichomoniasis Flashcards Preview

B - Gynaecology > Trichomoniasis > Flashcards

Flashcards in Trichomoniasis Deck (48)
1

What is trichomoniasis?

A curable sexually transmitted infection caused by the protozoan trichomonas vaginalis (TV)

2

How common is trichomoniasis?

The most common curable STI worldwide

3

What is happening to the incidence and prevalence of trichomoniasis?

Decreasing

4

How does the incidence of trichomoniasis in the UK compare to worldwide statistics?

Less common - 7000 cases in 2016

5

What age group is trichomoniasis most common in?

Under 25s

6

Which ethnic group is trichomoniasis most common in?

Black

7

How is trichomonas vaginalis transmitted?

- Vaginal sexual intercourse
- Rarely vertical transmission at delivery

8

Is trichomonas vaginalis spread through oral or anal sex?

No

9

What type of organism is trichomonas vaginalis?

Anaerobic flagellated protozoan

10

Does trichomonas vaginalis affect males or females?

Both

11

Where can trichomonas vaginalis infect in women?

- Urethra
- Vagina
- Paraurethral glands

12

Where can trichomonas vaginalis affect in men?

- Urethra
- Underneath foreskin

13

What site is most commonly affected by trichomonas vaginalis?

Urethra

14

How many sites are often affected by trichomonas vaginalis?

More than one

15

How does trichomonas vaginalis affect the site it colonises?

Replicates via binary fission whilst destroying epithelial cells through direct cell contact and by the release of cytotoxins

16

How can trichomonas vaginalis affect the immune system?

Binds to host plasma proteins preventing recognition by complement pathway

17

What can trichomonas vaginalis infection increase the risk of contracting?

HIV

18

What are the risk factors for trichomoniasis?

- Multiple sexual partners
- Unprotected sexual intercourse
- History of other STIs
- Older women

19

What proportion of trichomoniasis cases are symptomatic?

Many

20

In which gender is asymptomatic trichomoniasis more common?

Men

21

How do most men with trichomoniasis present?

As a partner of a symptomatic infected woman

22

When do symptoms of trichomoniasis develop after infection?

Within 28 days

23

What are the symptoms of trichomoniasis in women?

- Offensive vaginal discharge
- Abnormal vaginal discharge
- Itchiness or soreness of the vulva
- Dyspareunia
- Dysuria

24

What is the appearance of the discharge in trichomoniasis?

Can be thick or thin and frothy yellow-green colour

25

What are the symptoms of trichomoniasis in men?

- Urethral discharge
- Dysuria
- Urinary frequency
- Pain or itching around foreskin

26

What are the signs of trichomoniasis in women?

- Abnormal vaginal discharge
- Vulvitis
- Vaginitis
- Strawberry cervix

27

What is a strawberry cervix?

Punctate and papilliform appearance

28

What are the signs of trichomoniasis in men?

- Urethral discharge
- Balanoposthitis

29

What is balanoposthitis?

Inflammation of the glans penis

30

How common is balanoposphitis?

Rare

31

What are the differentials for trichomoniasis?

- Other vaginal infections
- Other causes of vaginal discharge
- Atrophic vaginitis
- Post-surgery discharge
- Other causes of prostatitis, cervicitis and cystitis

32

What are some other vaginal infections?

- Candidiasis
- BV
- Chlamydia
- Gonorrhoea

33

What are some benign causes of vaginal discharge?

- Physiological
- Chemical irritants
- Pregnancy

34

What steps are important to attempt to diagnose trichomoniasis before investigations?

- History
- Examination

35

How is trichomoniasis investigated?

Culture and sensitivity testing

36

How are sample obtained for trichomoniasis culture testing in women?

- High vaginal swab from posterior fornix
- OR self administered vaginal swab

37

How are samples obtained for trichomoniasis culture testing in men?

- Urethral swab
- First void urine sample

38

What is required if a patient tests positive for trichomoniasis?

- Contact tracing
- Full STI screen

39

What type of medication is used to treat trichomoniasis?

Anti-protozoan

40

What is the drug of choice for trichomoniasis in men and non-pregnant/breast-feeding women?

Metronidazole

41

What are the treatment regimes for trichomoniasis with metronidazole?

- 2g orally as single dose
- OR 400-500mg BD for 5-7 days

42

What is an alternative single dose medication for trichomoniasis?

2g tinidazole

43

Which contacts should be tested for trichomoniasis?

Any current or previous sexual partners in the preceding 4 weeks

44

For how long should patients with trichomoniasis abstain from sex?

- Whilst being treated
- OR 1 week after single dose

45

When is a test of cure required for trichomoniasis?

- Patient is not responding to treatment
- Re-infected

46

What is the risk of trichomoniasis in pregnancy?

- Pre-term labour
- Low birth weight
- Maternal post-partum sepsis

47

How is trichomoniasis treated differently in pregnancy?

Avoid high (single) dose metronidazole

48

How is trichomoniasis treated when breast feeding?

- Avoid single dose
- OR avoid breast feeding for 12-24 hours after single dose