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Questions and Answers
What is the preferred term for Sexually Transmitted Infections?
Which age group is most commonly affected by STIs?
What is the purpose of pre-exposure vaccines like Gardasil and Cervarix?
Why are STIs more serious in females?
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What is a crucial principle in controlling STIs?
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What is the most contagious STI?
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Which of the following is a fungal STI?
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Why are men more likely to have STIs?
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What is a common symptom of trichomoniasis?
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Which of the following STIs can cause jaundice?
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What is an important aspect of STIs screening?
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What is the name of the vaginal microbicide that was hoped to decrease STI rates?
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What is the most common cause of genital discharge and urethritis in Iraq?
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What is the typical incubation period for Chlamydial urethritis?
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What is the most common cause of non-gonococcal urethritis (NGU)?
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What is the incubation period of Gonorrhea?
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What is a complication of STIs in newborns?
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What is a complication of STIs in women?
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What is the primary site of infection for N.gonorrhoeae?
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What is the shape of the bacteria that causes Gonorrhea?
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What is the recommended treatment for Chlamydial urethritis?
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What is the characteristic finding on a smear for gonococcal infection?
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What is the diagnosis of non-gonococcal urethritis (NGU) based on?
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Why is it important to treat the sexual partner(s) of the infected individual?
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What is the type of organism that causes Chlamydial urethritis?
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What is a common symptom of gonococcal infection in females?
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What is typically observed during physical examination of males with gonococcal infection?
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What is the primary method of diagnosis for Chlamydial urethritis?
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What is the most sensitive method for diagnosing gonococcal infection?
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What is the characteristics of the discharge in Chlamydial urethritis?
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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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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.
