Dermatology: Sexually Transmitted Infections (STIs)
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Questions and Answers

What is the preferred term for Sexually Transmitted Infections?

  • Sexually Transmitted Diseases (STDs)
  • Sexually Acquired Infections (SAIs)
  • Sexually Transmitted Infections (STIs) (correct)
  • Venereal Diseases (VD)
  • Which age group is most commonly affected by STIs?

  • Children (<18 years)
  • Older adults (>65 years)
  • Middle-aged individuals (40-60 years)
  • Young, sexually active people (correct)
  • What is the purpose of pre-exposure vaccines like Gardasil and Cervarix?

  • To prevent transmission of HPV (correct)
  • To diagnose STIs
  • To treat existing HPV infections
  • To cure genital warts
  • Why are STIs more serious in females?

    <p>Due to anatomical differences</p> Signup and view all the answers

    What is a crucial principle in controlling STIs?

    <p>Early and accurate diagnosis</p> Signup and view all the answers

    What is the most contagious STI?

    <p>Phthirus pubis</p> Signup and view all the answers

    Which of the following is a fungal STI?

    <p>Candidiasis</p> Signup and view all the answers

    Why are men more likely to have STIs?

    <p>Men have more sexual partners than women</p> Signup and view all the answers

    What is a common symptom of trichomoniasis?

    <p>Genital pruritus</p> Signup and view all the answers

    Which of the following STIs can cause jaundice?

    <p>Hepatitis</p> Signup and view all the answers

    What is an important aspect of STIs screening?

    <p>Screening for co-prevalence of STIs</p> Signup and view all the answers

    What is the name of the vaginal microbicide that was hoped to decrease STI rates?

    <p>Nonoxynol-9</p> Signup and view all the answers

    What is the most common cause of genital discharge and urethritis in Iraq?

    <p>Gonorrhea</p> Signup and view all the answers

    What is the typical incubation period for Chlamydial urethritis?

    <p>7-28 days</p> Signup and view all the answers

    What is the most common cause of non-gonococcal urethritis (NGU)?

    <p>Chlamydial urethritis</p> Signup and view all the answers

    What is the incubation period of Gonorrhea?

    <p>2-5 days</p> Signup and view all the answers

    What is a complication of STIs in newborns?

    <p>Prematurity</p> Signup and view all the answers

    What is a complication of STIs in women?

    <p>Fallopian tube obstruction</p> Signup and view all the answers

    What is the primary site of infection for N.gonorrhoeae?

    <p>Columnar epithelium</p> Signup and view all the answers

    What is the shape of the bacteria that causes Gonorrhea?

    <p>Kidney shape</p> Signup and view all the answers

    What is the recommended treatment for Chlamydial urethritis?

    <p>Azithromycin 1g as a single dose</p> Signup and view all the answers

    What is the characteristic finding on a smear for gonococcal infection?

    <p>Intracellular gram-negative diplococci</p> Signup and view all the answers

    What is the diagnosis of non-gonococcal urethritis (NGU) based on?

    <p>Exclusion of gram-negative, intracellular diplococci</p> Signup and view all the answers

    Why is it important to treat the sexual partner(s) of the infected individual?

    <p>To prevent re-infection of the index case</p> Signup and view all the answers

    What is the type of organism that causes Chlamydial urethritis?

    <p>Intracellular organism with midway features between virus and bacteria</p> Signup and view all the answers

    What is a common symptom of gonococcal infection in females?

    <p>Vaginal discharge</p> Signup and view all the answers

    What is typically observed during physical examination of males with gonococcal infection?

    <p>Purulent urethral exudates and erythema of the meatus</p> Signup and view all the answers

    What is the primary method of diagnosis for Chlamydial urethritis?

    <p>PCR</p> Signup and view all the answers

    What is the most sensitive method for diagnosing gonococcal infection?

    <p>PCR</p> Signup and view all the answers

    What is the characteristics of the discharge in Chlamydial urethritis?

    <p>Fewer and thicker, mucoid or purulent, whitish in color</p> Signup and view all the answers

    Study Notes

    Clinical Features of Gonococcal Urethritis

    • Male: characterized by purulent urethral discharge and burning urination
    • Physical examination: purulent (yellowish) urethral exudates, erythema of the meatus
    • Female: usually asymptomatic, but may present with vaginal discharge, dysuria, cervisitis, and edema with induced bleeding

    Diagnosis of Gonococcal Urethritis

    • Suspected clinically, confirmed by smear, and made definitely by culture or PCR
    • Smear: intracellular (neutrophil) gram negative diplococci
    • Culture: performed on modified Thayer-Martin media
    • PCR: more sensitive than culture

    Non-Gonococcal Urethritis (NGU)

    • Diagnosed when there is a clinical feature of urethritis without detection of a gram negative, intracellular, diplococci organisms on microscopic examination
    • Causes:
      • Infectious: Chlamydial urethritis, ureaplasma urealyticum, E.coli, Proteus, herpes simplex, intraurethral warts, candidiasis, Trichomonas vaginalis
      • Non-infectious: drug allergy, food, chemical, idiopathic urethritis

    Chlamydial Urethritis

    • Caused by Chlamydia trachomatis, a non-motile, gram negative, intracellular organism
    • Diagnosis: serological tests, PCR (has largely replaced culture)
    • Clinical features: longer incubation period, more gradual presentations, fewer and thicker discharge

    Management of Urethritis

    • History: symptoms, sexual history, type of contraception, and drug and food history
    • Examination: type of discharge, meatal erythema
    • Investigation: GUE, smear, culture, and PCR
    • Treatment:
      • GC urethritis: single dosage of Ceftriaxone, cefixime, or ciprofloxacin
      • Chlamydial urethritis: Azithromycin or doxycycline for 7 days
    • Importance of treating sexual partners to prevent re-infection

    Complications of STIs

    • Pregnancy complications: ectopic pregnancy, miscarriage
    • Newborn complications: prematurity, congenital and neonatal infections
    • Infertility: mostly in females (fallopian tube obstruction)
    • Urethral stricture: due to gonococcal urethritis
    • Malignancy: mostly cervical and rarely penile carcinoma (SCC)

    Genital Discharge Causes

    • Urethral discharge: Gonococcal urethritis, non-gonococcal urethritis
    • Vaginal discharge: ST causes (candidal vaginitis, trichomonal vaginitis), non-ST causes (physiological, cervical erosions, tumors)

    Gonococcal Urethritis (Gonorrhea) Microbiology

    • Caused by Niesseria gonorrhoeae, an intracellular, gram negative, kidney-shaped diplococcus
    • Short incubation period (2-5 days)
    • Pathogenesis: primarily infects columnar epithelium (urethra, cervix, vagina, pharynx, conjunctiva, rectum)

    Epidemiology of STIs

    • Most common in young, sexually active people
    • Underreporting is common
    • More common in males, but more serious in females
    • Control and prevention: early and accurate diagnosis, early and effective treatment, counseling, STIs screening, condoms, vaccines, and nonoxynol-9

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    Description

    Test your knowledge on Sexually Transmitted Infections (STIs) including definitions, terminology, signs, symptoms, and more. Learn about the diverse group of infections caused by microbial agents transmitted through sexual contact.

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