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 (C)</p> Signup and view all the answers

What is a crucial principle in controlling STIs?

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

What is the most contagious STI?

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

Which of the following is a fungal STI?

<p>Candidiasis (C)</p> Signup and view all the answers

Why are men more likely to have STIs?

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

What is a common symptom of trichomoniasis?

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

Which of the following STIs can cause jaundice?

<p>Hepatitis (B)</p> Signup and view all the answers

What is an important aspect of STIs screening?

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

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

<p>Gonorrhea (C)</p> Signup and view all the answers

What is the typical incubation period for Chlamydial urethritis?

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

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

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

What is the incubation period of Gonorrhea?

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

What is a complication of STIs in newborns?

<p>Prematurity (C)</p> Signup and view all the answers

What is a complication of STIs in women?

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

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

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

What is the shape of the bacteria that causes Gonorrhea?

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

What is the recommended treatment for Chlamydial urethritis?

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

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

<p>Intracellular gram-negative diplococci (B)</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 (C)</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 (A)</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 (B)</p> Signup and view all the answers

What is a common symptom of gonococcal infection in females?

<p>Vaginal discharge (B)</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 (D)</p> Signup and view all the answers

What is the primary method of diagnosis for Chlamydial urethritis?

<p>PCR (B)</p> Signup and view all the answers

What is the most sensitive method for diagnosing gonococcal infection?

<p>PCR (C)</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 (D)</p> Signup and view all the answers

Flashcards

Gonococcal Urethritis in Males

Characterized by thick, yellowish discharge from the urethra and painful urination.

Gonococcal Urethritis in Females

Often asymptomatic, but can cause vaginal discharge, painful urination, inflammation of the cervix, and swelling leading to bleeding.

Diagnosing Gonococcal Urethritis

Suspected based on symptoms, but confirmed by identifying Gram-negative diplococci in a smear or through culture or PCR tests.

Non-Gonococcal Urethritis (NGU)

Inflammation of the urethra without the presence of Neisseria gonorrhoeae, caused by various bacteria or other factors.

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Common NGU Causes

Includes infections like chlamydia, ureaplasma, E. coli, and herpes, as well as non-infectious causes like allergies and chemicals.

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Chlamydial Urethritis

Caused by Chlamydia trachomatis, a small, non-moving bacterium that lives inside cells.

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Chlamydial Urethritis Diagnosis

Diagnosed through blood tests or PCR, which is more accurate than culture.

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Chlamydial Urethritis Symptoms

Usually slower onset than gonorrhea, with thinner and less discharge, and milder symptoms in general.

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Managing Urethritis

Involves taking a detailed history, examining the discharge, and testing for the cause, followed by specific antibiotic treatments.

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Gonococcal Urethritis Treatment

Usually treated with a single dose of antibiotics like ceftriaxone, cefixime, or ciprofloxacin.

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Chlamydial Urethritis Treatment

Typically involves taking azithromycin or doxycycline for a week.

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Treating Sexual Partners

Essential for preventing re-infection and further spread of the disease.

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STIs and Pregnancy

Can lead to complications like ectopic pregnancy (tubal pregnancy) and miscarriage.

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Newborn Complications from STIs

Can cause premature birth and infections in babies during delivery.

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STIs and Infertility

Can cause infertility, especially in women, due to scarring of the fallopian tubes.

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Urethral Stricture

Narrowing of the urethra due to scarring, often caused by untreated gonorrhea.

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STIs and Cancer

Linked to some cancers, particularly cervical cancer in women and penile cancer in men.

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Urethral Discharge Causes

Can be caused by gonorrhea, other infections, or non-infectious factors.

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Vaginal Discharge Causes

Can be due to STIs like candidiasis or trichomoniasis, or non-STI causes like physiological changes.

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Gonococcal Urethritis Pathogen

Caused by Neisseria gonorrhoeae, a kidney-shaped bacterium that lives inside cells.

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Gonorrhea Incubation Period

Typically 2-5 days between exposure and symptoms.

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Gonorrhea's Favorite Targets

Infects mucous membranes, including the urethra, cervix, vagina, throat, and rectum.

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Gonorrhea Epidemiology

Most common in young, sexually active people, often underreported, and more common in men but more serious in women.

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Preventing STIs

Key strategies include early diagnosis and treatment, safe sex practices, and vaccinations.

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Condoms and STIs

Effective barrier method that can significantly reduce the risk of STIs.

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Nonoxynol-9 and STIs

A spermicide that can also offer some protection against STIs.

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STIs Screening

Regular testing for STIs is important, especially for sexually active individuals.

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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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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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